Pathology Final new stuff (copy)

What is the pathology of DVT (Deep vein thrombosis)?

blood clot (thrombus) forms in deep veins

What are the risk factors of DVT (Deep vein thrombosis)?

Virchow's triad: hypercoagulability, endothelial damage, and venous stasis (slow/stagnant blood)

What are the clinical manifestations of DVT (Deep vein thrombosis)?

unilateral, pain/tenderness, red, warm, localized inflammation

What is the pathophysiology of orthostatic hypotension?

slowed response to change (normal regulatory mechanisms are slow to respond to the change in position) or secondary to disease or idiopathic

What are the clinical manifestations of orthostatic hypotension?

dizziness, blurred vision, syncope, or fainting

What are the complications of hypertension?

heart (MI), decreased blood flow and ischemia, weakened vessel wall, decreased blood flow, increased pressure in arterioles, and eyes (retinas)

What are the risk factors of atherosclerosis?

endothelial injury, HTN and all its risk factors, smoking, and DM

What is the pathology of Raynaud's?

vasospasm of small arteries/arterioles

What are the risk factors of Raynaud's?

primary: unknown; secondary: prolonged cold exposure, collagen vascular disease, vasculitis, chemo, cocaine use, hypothyroidism, and stress

What are the signs/symptoms of Raynaud's?

bilateral changes in skin color: pallor, cyanosis, numbness/paresthesia, and pain (white fingers)

What is the pathology of Buerger's?

autoimmune, inflammatory disease of peripheral arteries; clotting and blockage

What are the risk factors of Buerger's?

SMOKING

What are the signs/symptoms of Buerger's?

decreased blood flow: cyanosis, shiny skin, and thick nails (blue/black fingers)

What is an aneurysm?

Local dilation or outpouching of a vessel wall or cardiac chamber
- A weakness in a blood vessel so it bulges out like a balloon in that area
- At risk for rupturing

What can cause an aneurysm?

atherosclerosis (most common), plaque formation erodes and weakens vessel and hypertension, increased vessel wall stress

What are the clinical manifestations of an aneurysm?

pulsatile abdominal mass

What are the complications of an aneurysm?

high risk for rupture leading to hemorrhage, hypovolemic shock, and death

What is a stable angina?

\- chest pain

better with rest, and predictable/recurrent

What is a prinzmetal angina?

occurs during sleep, vasospasm, unpredictable

What is a silent angina?

-silent ischemia, asymptomatic

What is an unstable angina?

\-occurs at rest, precursor to MI

What are the complications of acute coronary syndrome?

acute coronary syndrome leads to infarction and tissue death

What is the pathology of NSTEMI?

ST segment depression, involves 1/3 of ventricular wall

What are the clinical manifestations of NSTEMI and STEMI?

left armpit pain that radiates into jaw, sweating/diaphoresis, pallor, fatigue, and weakness

What is the complication of NSTEMI and STEMI?

death

What are the risk factors for coronary artery disease?

atherosclerosis, HTN, venous/arterial insufficiencies, and any disorder that narrows/occludes coronary arteries

What is the pathology of pericarditis?

inflammation AROUND the heart

What is the mechanism of pericarditis?

inflammation and infection leads to fluid backup around the heart and puts pressure on heart/cardiac tamponade

What are the risk factors of pericarditis?

MI, SIRS, and HIV

What are the clinical manifestations of pericarditis?

friction rub, fever, pain, dysrhythmias; pain is worse with inspiration and laying down

What is the pathology of endocarditis?

inflammation IN the heart

What is the mechanism of endocarditis?

inflammation and infection cause adhesion factors to form a biofilm and deposit on the heart (vegetations), especially on the valves!!

What are the risk factors of endocarditis?

central lines, bacterial infections, pacemakers, and valve replacement,

What are the clinical manifestations of endocarditis?

MURMUR, thrombus formation, vegetation causes lesions, (osler nodes and janeway lesions)

What are the symptoms of osler nodes?

painful, red, and on fingers/toes

What are the symptoms of Janeway lesions?

painless and of palms/soles

What is stenosis?

valve can't open (narrowing)

What is regurgitation?

valve doesn't close (leaky)

What is the pathology of aortic stenosis?

Constriction/narrowing of aortic valves causes left ventricle hypertrophy which can lead to ischemia and HF

What is the pathology of aortic regurgitation?

aortic valve doesn't completely close so left ventricle hypertrophy which can lead to ischemia and HF

What is the pathology of mitral stenosis?

constriction/narrowing of mitral valve causes left atrium hypertrophy which can lead to atrial fibrillation and increased risk of MI/stroke

What is the pathology of mitral regurgitation?

mitral valve doesn't completely close so left atrium hypertrophy which can lead to ischemia and HF

What is the pathology of Left sided systolic HF?

low ejection fraction/poor contractility causes heart to not pump enough blood to tissues and blood backs up into lungs

What are the risk factors of left sided systolic HF?

decreased contractility due to MI, increased afterload and increased preload

What are the signs/symptoms of left sided systolic HF?

Lungs: pulmonary edema (pink, frothy sputum, crackles, dyspnea, and cyanosis); decreased perfusion (low CO): decreased urine output, cold extremities, low BP, low HR, fatigue

What is the pathology of left sided diastolic HF?

noncompliance of left ventricle leads to blood backing up to lungs; LV can't fill enough bc of hypertrophy of LV

What are the risk factors of left sided diastolic HF?

ischemia and ventricular remodeling from HTN

What are the signs/symptoms of left side diastolic HF?

lung: pulmonary edema (pink, frothy sputum, crackles, dyspnea, and cyanosis)

What is the pathology of right sided HF?

issue with pumping blood to pulmonary circulation (squeeze) causes blood backup to systemic circulation

What are the risk factors of right sided HF?

left sided HF and cor pulmonale

What is cor pulmonale?

obstruction in lungs and pulmonary artery; ex: pulmonary embolism (increased pulmonary vascular resistant leads to hypertrophy)

What are the signs/symptoms of right sided HF?

backup of systemic circuit: peripheral edema causes weight gain, JVD, GI symptoms like anorexia, ascites, and impaired liver function

What is the pathology of pleural effusion?

fluid in pleural space

What are the risk factors of pleural effusion?

complete heart failure (heart can't pump blood efficiently), TB, cancer, and pneumonia

What are the clinical manifestations of pleural effusion?

SOB, cough, s/sx of CHF

What is the pathology of pneumothorax?

air in pleural space causes partial/complete collapse of lung

What are risk factors of pneumothorax?

stab wounds/GSW, chest trauma (impact), and family history

What are the clinical manifestations of pneumothorax?

sudden pleural pain, dyspnea, tachypnea, tracheal deviation, no breath sounds on affected side, hyperresonance on unaffected side

What is the pathology of empyema?

pus in pleural space (infectious fluid)

What are the risk factors for empyema?

older adults and children as a complication of pneumonia, surgery, trauma, and bronchial obstruction

What are the clinical manifestations of empyema?

s/sx of infection

What are the types of pneumothorax?

closed, open, and tension

What is a closed pneumothorax?

pleural tear is sealed; pleural cavity pressure < atmospheric pressure; lung is open at bottom so air is just escaping out the bottom of lung

What is an open pneumothorax?

pleural tear is open; pleural cavity pressure = atmospheric pressure;

What is tension pneumothorax?:

pleural tear acts as a ball and valve mechanism; pleural cavity pressure > atmospheric pressure; much worse!!! more likely from trauma; a lot of compression in the lungs which eventually shifts and compresses the lungs

What is the pathology of atelectasis?

collapse of alveoli/lung tissues

What are the risk factors of atelectasis?

anesthesia and immobile (laying in bed a lot)

What are the signs/symptoms of atelectasis?

dyspnea/shallow breathing, decreased breath sounds, and cough

What is the pathology of pulmonary edema?

alveoli are filled with water

What are the risk factors of pulmonary edema?

left sided HF, CAD, and valve disorders

What are the signs/symptoms of pulmonary edema?

dyspnea, hypoxemia, and increased work of breathing

What can pulmonary edema result in?

ARDS

What can aspiration result in?

pneumonia

What is the pathology of ARDS?

acute injury to alveolocapillary membrane and massive pulmonary inflammation

What are the risk factors for ARDS?

sepsis, burns, pneumonia, pancreatitis, aspiration, blood transfusions, and medication reaction

What are the signs/symptoms of ARDS?

dyspnea, decreased tissue perfusion, acid-base imbalances/CO2 imbalances, and respiratory failure

What can ARDS result in?

massive respiratory distress or death

What is the overall concept of COPD?

chronic inflammatory disorder

What is the pathology of COPD?

inhalation of irritants causing chronic inflammation

What are the risk factors of COPD?

smoking, pollution, genetics, and occupational hazards

What are the types of COPD?

emphysema and chronic bronchitis

Define emphysema

abnormal permanent enlargement of the alveoli and destruction of alveolar walls (ballooning of alveoli)

What are the signs/symptoms of emphysema?

general s/sx of dyspnea: "Pink puffers"; thin/skinny, barrel chest, pursed lip breathing, use accessory muscles, and tripod position

What can emphysema result in?

destruction of alveolar walls; loss of elasticity/elastic recoil causes airways and alveoli to collapse/get destroyed

What is the main difference of emphysema?

collapsed airways makes gas exchange difficult

Define chronic bronchitis

Hypersecretion of mucous and a chronic productive cough that lasts at least 3 months for at least 2 connective years

What are the signs/symptoms of chronic bronchitis?

general s/sx of dyspnea; "blue bloaters"; obese/peripheral edema, cough/productive cough, use accessory muscles, coarse ronchi and wheezing, and right sided HF

What can chronic bronchitis result in?

overproduction of mucus blocks the airway causing airway edema and airway narrowing

What is the main difference of chronic bronchitis?

mucus overproduction blocks the airway

What is the overall concept of asthma?

type 1 hypersensitivity reaction; IgE mediated

What are the risk factors of asthma?

allergen response (pollen, pollution, smoking, genetic, age)

Define asthma

inflammation of airways (subsides and exacerbates)

What are the signs/symptoms of asthma?

respiratory distress (SOB, dyspnea, tachycardia), wheezing (narrowing and whistling), and hypoxemia

What can asthma result in?

bronchospasm, bronchoconstriction, mucosal edema and increased mucus production causing narrowing of airway

What are the phases of ARDS?

Exudative, Proliferative, and Fibrotic

What is occurring in the exudative phase of ARDS?

inflammatory; cytokine/inflammatory mediator release causes damage to alveolar capillary membrane

What does the exudative phase of ARDS result in?

increased capillary permeability causing pulmonary edema and low surfactant

What is occurring in the proliferative phase of ARDS?

body is trying to heal; lots of fibroblasts, myofibroblasts, and type 2 pneumocystitis; resolution of pulmonary edema

What does the proliferative phase of ARDS result in?

hyaline membrane around lung which ends up impairing ability of lungs to expand

What is occurring in the fibrotic phase of ARDS?

remodeling and fibrotic (scarring) of lung tissues, destruction of alveoli and respiratory bronchioles, and impaired gas exchange (acute respiratory failure)