Patho Exam 3

cystitis

bladder inflammatoin

cystitis manifestations

UTI symptoms, abdominal pain, dysuria, frequency, nocturia, hematuria, confusion in elderly, pelvic pressure

Nephrolithiasis

kidney stones, often made of Ca but also uric acid, struvite, cystine

Nephrolithiasis causes

dehydration, poor diet, bone disease releasing too much Ca, pH changes in urine

kidney functions

make hormones, fluid and electrolyte balance, RAAS for BP regulation, gets rid of waste, filters blood, converts vit D to be usable

kidney hormones

ADH, renin, erythropoetinin

labs for kidney function

BUN and creatinine and GFR

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Enuresis Incontinence

in kids

Nocturnal enuresis incontinence

bed wetting at night for kids

Stress incontinence

from spincter muscle being weakened and urine coming out with sneezing, coughing, laughing, lifting heavy

Overactive bladder incontinence

sudden intense urge to urinate followed by involuntary loss of urine- common in men with prostate issues and women after menopause, also common in neurologic disorders like Parkinsons 

Reflex incontinence

caused by trauma or damage to nervous system, the muscles contract and let urine out despite not having urge to void

Mixed incontinence

when symptoms of more than 1 type of incontinence occur together

Overflow incontinence

from the inability to empty bladder / urine retention, common in men, teachers, nurses because hold pee for long periods and causes chronic overdistention 

Functional incontinence

in people who can’t physically get to toilet without help or in people who mentally don’t recognize need to pee, common in older adults and nursing homes

Transient incontinence

incontinence from a temporary condition (meds, alcohol, caffeine, infection, etc), goes away once condition is fixed 

Gross total incontinence

bladder has no storage capacity, can’t hold any urine

Pyelonephritis

upper UTI that reaches both kidneys

what happens with pyelonephritis

kidneys become swollen and filled with exudate- can compress the renal artery and cause necrosis

BPH (Benign prostatic hypertrophy)

nonmalignant expansion of prostate as men age, can compress urethra and obstruct urine flow, does not cause cancer, need to shrink prostate w meds

Glomerulonephritis

Bilateral inflammation of glomeruli usually following a strep infection, impairs kidney ability to excrete waste and excess fluid, Nephrotic and Nephritic syndromes most common types

glomerulus

filtering unit of kidney

leading cause of renal failure

Glomerulonephritis

nephrotic syndrome

Massive amounts of protein in urine

nephritic syndrome

Peeing blood, dark red/ brown coke a cola color  urine

types of AKI (acute kidney injury)

prerenal, intrarenal, post renal

prerenal AKI

issue is before the kidney- disrupts blood flow on the way to kidneys so kidneys dont get enough blood

prerenal AKI causes

burns, diarrhea, vomiting, decreased CO, dehydration, hypovolemia, hemorrhaging

Intrarenal AKI

blood supply in kidney gets interdered with and leads to damage of kidney structures, the reduced blood supply in kidneys leads to acute tubulr necrosis

Intrarenal AKI causes

IV contrast for CT or direct damage to kidney

post renal AKI

problem after kidney, something interferes with excretion of urine and it backs up into kidneys

post renal AKI

ureter / urethea / bladder obstruction like tumor or kidney stone, enlarged prostate

chronic kidney disease

gradual irreversible kidney damage, healthy nephron tissue gets replaced with scar tissue which can’t function same as normal nephrons- kidneys lose function, caused by anything that damages nephrons

GFR when dialysis starts

less than 15

Ventilation

air flow to alveoli- air going from nose/mouth down throat into trachea into bronchi to bronchioles or alveoli

perfusion

blood flow to capillaries that surround the alveoli, gas exchange

order of air flow

mouth/nose to trachea to bronchi to split to left or right bronchi to bronchioles to alveoli

Epiglottis

flap that closes larynx to prevent food or fluid from entering lungs, opens and closes like a lid

Surfactant

lipoprotein substance on surface of alveoli that prevents them from collapsing 

Diaphragm

muscle that separates thoracic from abdominal cavity, relaxes to allow breathing 

influenza

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viral infection affecting upper and/or lower respiratory tract, can be severe in children, elderly, or autoimmune, causes damage to epithelial lining of airway putting people at risk for secondary bacterial pneumonia, Rapid onset of symptoms, Type A most common in US

pneumonia

Inflammation of lungs that effects alveoli as they fill up with pus or fluid

viral pneumonia

more mild, often from influenza

bacterial pneumonia

more severe, often from strep, more common

lobar pneumonia

confined to single lobe

Aspiration pneumonia

from aspirated fluid (often GI fluid) or food entering lungs

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Bronchopneumonia pneumonia

most frequent type, patchy, across several lobes

Interstitial / atypical pneumonia

occurs in area between alveoli, caused by viruses or uncommon bacteria

SARS pneumonia

v serious infection caused by coronavirus, similar to atypical, high mortality and morbidity in 3 stages

MERS-CoV pneumonia

emerging illness in same coronavirus family as SARS

Nosocomial pneumonia

hospital acquired

Community acquired pneumonia

acquired outside hospital / healthcare setting

Legionnaire’s disease pneumonia

caused by Legioinella pneumophila which thrives in warm moist environments like AC units, spread through droplets in environment not contagious from person to person

Pneumocystitis jiroveci pneumonia

opportunistic infection common in AIDS/ HIV patients, life threatening, from yeastlike fungus 

Tuberculosis (TB)

Caused by Mycobacterium tuberculosis bacteria, most often occurs in lungs but can also be in brain, liver, bone marrow, activates a IV hypersensitivity, Caseous necrosis and chon complex (cottage cheese looking tissue) develops from bacteria, body walls this area of infected tissue off by forming a granuloma, has vaccine

TB stages

Primary: when you first get infected, asymptomatic, Latent: live bacteria living in walled off granuloma until it gets reactivated (may never get reactivated), asymotomtic, can be treated, Active: symptomatic active infection, can be treated

asthma

Common chronic disorder that comes and goes, causes reversible attacks of airway obstruction due to a trigger, common in kids

Extrinsic asthma

presents in childhood, most common, due to allergens triggering IgE

Intrinsic asthma

nonallergenic reaction, after age 35

Nocturnal asthma

occurs between 3-7am, may be related to circadian rhythms

Exercise induced asthma

usually 10-15 min after activity

occupational asthma asthma

caused by exposure and reaction to substances at work

Drug induced asthma

potentially fatal that occurs up to 12 hours after ingestion of medicine, often caused by aspirin 

Status asthmaticus asthma

often fatal, prolonged asthma attack, unresponsive to usual treatment, you can only work to breathe for so long so eventually die if not resolved, will be intubated probs, can cause respiratory failure

COPD

chronic disorders causing debilitating irreversible damage to airway by causing airway obstruction and progressive tissue degeneration, Insidious onset but eventually ruins every minute of every day, Smoking is biggest cause

types of COPD disorders

chronic bronchitis and emphysema

Emphysema

alveoli get damaged, become permanently inflated and have surfactant loss, air gets trapped in the alveoli leading to barrel chest, Often thin, have cachexia (losing fat and muscle), pursed lip breathing to get better air, “Pink puffers”

Chronic bronchitis

Excessive mucus production production causes airway lining to be constantly irritated and inflamed, caused by chronic inflammation not infection, weight gain, “blue bloaters”

cystic fibrosis

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Progressive autosomal recessive inherited disorder of mucus and sweat glands, Mainly affects lungs and pancreas, Causes lung damage and nutritional deficits

lung cancer

second most common cancer, most deadly, Can cause airway obstruction from tumors and paraneoplastic syndrome, Treatment often palliative to keep them comfortable if radiation, chemo, surgery can’t cure it, 2 types

paraneoplastic syndrome

a disease caused by the cancer

Small cell carcinoma

lung cancer type, Less frequent, More severe, Common in smokers, Low survival rate

Non-small-cell carcinoma

Most common type, Very aggressive, Several subtypes

pleural effusion

Excess fluid in pleural cavity, Treat with thoracentesis, chest tube, antibiotics, often caused by other disease like pneumonia which increases capillary permeability which allows more molecules to flow across membrane, fluid comes in and builds up

hemothorax

build up of blood

Empima

build up of pus

Pneumothorax

Collapsed lung / air in pleural cavity, treat with removal of air with chest tube and reestablish negative pressure

Spontaneous Pneumothorax

where air enters from opening in internal airways, a partial collapse, suddenly, can be from bleb or from preexisting conditions

Traumatic Pneumothorax

result of blunt or penetrating injury to chest

Tension Pneumothorax

most serious, a medical emergency, can cause complete lung collapse, when pressure in lung is > atmospheric pressure

Atelectasis

Collapse of the alveoli or they can’t expand enough so can’t function properly, Caused by surfactant deficiencies or other problems 

fracture

Break in bone,Caused by any trauma or disease increasing risk, Often will split immediately to allow room for swelling before cast, PT almost always needed

Simple fracture

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* a single break, bones maintain their position and alignment

transverse fracture

straight across, simple

Oblique fracture

at an angle

Spiral fracture

twists around, common with abuse 

Comminuted fracture

multiple fracture likes and bone pieces

Greenstick fracture

incomplete break, bone is bent, common in children because bones are completely solid yet

Compression fracture

bone is crushed

Open / compound fracture

skin is broken (so high infection risk!!)

Impacted fracture

one end of bone forced into adjacent bone

Pathologic fracture

fracures caused by a weakness in bone structure due to a secondary condition (tumor, osteoporosis, etc.)

Stress / fatigue fracture

from repeated excessive use, common in feet

Depressed fracture

in skull when broken piece is forced inward to brain 

Osteoblasts

build new bone

osteoclasts

break down and reabsorb bone

how fractures heal

Hematoma forming from bleeding then fibroblasts go to clot to start building new cells then callus forms and bridges bone ends together, Osteoblasts go to callus and form new bone over 4-6 weeks

bone callus

mass of cells and fibers around broken bones

Osteomyelitis

infection of the bone, a fracture complication or any other time bone is exposed (burns, etc)

Compartment syndrome

increased pressure (from high inflammation due to trauma at site) causes swelling in muscle compartment and compressed blood flow- causes ischemia, From vessel occlusion, Is a medical emergency that could cause loss of limb