patho exam 2

Obesity manifestations

Diabetes, heart disease, hypertension, hyperlipidemia, stroke, Osseo arthritis, liver disease, gall stones, poor wound healing, sleep apnea, cancers

obesity diagnosis

H&P: comorbidities, bmi

obesity treatment

1- diet, exercise, behavioral modifications; 2- surgery, medication's

phenylketonuria manifestations

Intellectual disability, their skin and hair, hypo pigmentation of the eyes, musty odor, seizure disorder

phenylketonuria diagnosis

Routine screening at birth (heel stick)

phenylketonuria treatment

Nutrition: avoiding phenylalanine, amino acid, vitamin, and mineral supplementation
pharmo: sapropterin dihydrochloride

celiac disease manifestations

Headache, nausea, weight loss, fatigue, gastrointestinal distress, bloating, stomach pain, diarrhea

Celiac disease diagnosis

Based on clinical manifestations, laboratory studies, serum detection of antibodies, diagnosis confirmed with small bowel biopsy

celiac disease treatment

Illuminate gluten from diet, vitamin and mineral supplementation
pharm: anti-inflammatories, hypersensitivity blocking meds

anorexia nervosa manifestations

Dry skin, bradycardia, hypertension, hypothermia, abdominal bloating, constipation, restricted caloric a nutrient intake, extremely thin stature, lanugo, amenorrhea, brittle hair and nails, peripheral cyanosis

anorexia nervosa diagnosis

H&P, DSM-5 criteria, restrictive food intake leading to low body weight, fear or avoidance of gaining weight despite low BMI, deserved body image

Anorexia nervosa treatment

Interdisciplinary team approach, psychotherapy

Iron deficiency anemia manifestations

Pica, related to hypoxia: Power of the skin and mucous membranes, fatigue, weakness, lightheadedness, syncope, headache, breathlessness, palpitations, tachycardia, brittle hair and nails, mouth sores

Iron deficiency anemia diagnosis

H&P, cbc, iron tests

Iron deficiency anemia treatment

Reverse the cause, iron replacement: diet, oral meds/supplementation, IV

dissemination intravascular coagulation manifestations

Excessive hemorrhage: bruising,petechiae, epistaxis; excessive clotting: headache, weakness, seizures, coma; renal: Poor urine output, renal failure; respiratory: cough, SOB, respiratory distress, chest pain

disseminated intravascular coagulation diagnosis

H&P, labs:pt, aptt, etc

disseminated intravascular coagulation treatment

Eliminating the underlying pathologic condition, controlling the ongoing thrombosis, maintain organ function, restore normal plasma levels

stroke manifestations

Face drooping, arm weakness, speech difficulties

stroke diagnosis

H&P, imaging: ct, mri

stroke treatment

rehab, reduce cerebral edema and increased intracranial pressure, surgery, medication

heart failure manifestations right

Peripheral edema, impaired liver, anorexia, G.I. distress, weight loss

heart failure manifestations left

Pulmonary edema, cyanosis, dyspnea, cough, orthopnea, activity intolerance

heart failure diagnosis

H&P, chest radiography, echocardiography, ECG, cardiac catheterization

heart failure treatment

Correct cause, improve quality of life, medication, supplemental oxygen, lifestyle modifications, surgery

Myocardial infarction manifestations

Gender variability, chest pain or a crushing pressure, often radiating to the left arm, shoulder, or jaw, fatigue, weakness, syncope, anxiety, dizziness, sob, sweating, pallor, indigestion, nausea, vomiting

Myocardial infarction diagnosis

H&P, labs, imaging

Myocardial infarction treatment

abcs, surgery, lifestyle modifications, medication

shock manifestations

Tachycardia, tachypnea, cool clammy extremities, decreased arterial BP, cyanosis and/or pallor, restlessness, apprehension, decreased mental function, poor urinary output

shock diagnosis

Triggering event, lab tests, H&P

shock treatment

abcs, fluids, meds dependent on etiology

hypertension manifestations

often asymptomatic, cns: headache, new onset blurred vision, nausea, vomiting, weakness, fatigue, confusion, mental status changes; cardiovascular: pulmonary edema, heart failure; renal insufficiency: poor urinary output, problems with eliminating urinary waste, hematuria, proteinuria

hypertension diagnosis

H&P, prehyper, stage 1&2, hyper crisis

hypertension treatment

Lifestyle modifications, pharmacologics:ccb, ace-1, arb

Acute respiratory distress syndrome manifestations

Tachypnea, dyspnea, retractions, crackles, restlessness, anxiety

acute respiratory distress syndrome diagnosis

H&P, labs: abg, cultures; imaging: chest radiograph

acute respiratory distress syndrome treatment

emergency: critical care, remove known causative factors, 100% oxygen administration, ventilation

cystic fibrosis manifestations

Infection, chronic cough, malabsorption of fat, males sterility, delayed female characteristics

cystic fibrosis diagnosis

H&P, newborn screening, genetic testing, chest x-ray, sputum analysis, sweat test

cystic fibrosis treatment

Liquefy and clear mucus, avoid/control respiratory infection, promote bronchodilation, chest physiotherapy, nutritional supplementation

asthma manifestations

Remission, exacerbation, wheezing, tachypnea, dyspnea, coughing, chest tightness, excessive sputum, anxiety

asthma diagnosis

Family history, known environmental allergens, wheezing, spirometry

asthma treatment

Depends on the severity, monitor lung function, control environmental triggers, pharmacologic therapy

chronic bronchitis manifestations

Persistent, productive cough, purulent sputum, dyspnea, wheezing & crackles, low O2, cyanosis

chronic bronchitis diagnosis

Clinical presentation of a persistent, productive cough over a period of three months or more within two consecutive years, labs, pulmonary function test

chronic bronchitis treatment

Maintain lung function, bronchodilators, steroid or anti-inflammatories, mucolytic agent, pulmonary rehab

emphysema manifestations

Persistent cough, dyspnea, wheezing, barrel chest, pursed lip breathing

emphysema diagnosis

H&P, spirometry, chest x-ray, hypercapnia/hypoxemia

emphysema treatment

Maintain lung function, smoking cessation, pharmacologic therapy, lung volume reduction or transplant

pneumonia manifestations

Sudden onset fever, chills, productive cough, fatigue, loss of appetite, dyspnea, tachypnea, tachycardia, pleuritic pain, crackles in lungs, respiratory failure

pneumonia diagnosis

H&P, CBC, chest x-ray, cultures, pulse ox, abgs

pneumonia treatment

pharm: antibiotics, supplemental oxygen Restore function: chest physiotherapy

testicular cancer manifestations

Small, painless testicular mass, slight enlargement of testicle, heaviness or enlargement of scrotum, mild discomfort in testicle

testicular cancer diagnosis

Self testicular exams, imaging: ultrasound, CT, & MRI; labs: tumor markers

testicular cancer treatment

Surgical removal of tumor/testicle, caution with radiation and chemo due to risk for infertility

prostate cancer manifestations

Often asymptomatic, urinary symptoms later in disease: urinary frequency, dribbling, hesitancy, incontinence, urgency, retention; pain

prostate cancer diagnosis

Digital rectal examination, transrectal ultrasound, PSA levels, prostate biopsy, TNM classification: T1, T2, T3, T4

prostate cancer treatment

Based on colon tumors aging degree of anaplasia, age, health status, radiation, chemotherapy, surgery, watchful waiting

benign prostatic hyperplasia manifestations

urinary: hesitancy, interrupted flow, weak stream, dribble, urgency, frequency, nocturia

benign prosthetic hyperplasia diagnosis

H&P, rectal digital exam, urodynamic analysis

benign prosthetic hyperplasia treatment

Sent, pharmacologic targets: relaxation of smooth muscle, inhibition of testosterone conversion to DTH

erectile dysfunction diagnosis

H&P, lab tests: testosterone, LH, thyroid, prolactin

erectile dysfunction treatment

pharm: testosterone replacement, smooth muscle relaxants, implant/devices

Menopause manifestations

Systemic impact, increase cardiovascular risk, hot flashes, mood swings, sleep disturbance, urinary changes, dyspareunia

menopause diagnosis

Amenorrhea for at least 12 months, no single diagnostic test, estradiol and inhibin dec, FSH inc

menopause treatment

Hormone replacement therapy, lubrication, dietary changes, relaxation techniques, exercise

ovarian cancer manifestations

Asymptomatic and early stages, vague abdominal bloating, large tumor is made manifest as: abdominal distention, pressure, pain

ovarian cancer diagnosis

H&P, surgery: laparoscopy, laparotomy, lab studies: ca-125

ovarian cancer treatment

based on stage, goal: remove all neoplastic cells, surgery, chemo, radiation

Polycystic ovarian syndrome manifestations

Menstrual irregularities, excess androgen production, polycystic ovaries, menstrual irregularities, anovulation, hirsutism, acne

polycystic ovarian syndrome diagnosis

Two of the following: androgen access, ovulatory dysfunction, polycystic ovaries

polycystic ovarian syndrome treatmenttreatment

Medication's to: suppress androgen production, induce ovulation, control insulin; laparoscopy to remove cyst, cosmetic procedures for other symptoms

Pelvic inflammatory disease manifestations

Range and severity, asymptomatic, abdominal and pelvic pain, Parulian cervical discharge, cervical tenderness, fever, malaise

pelvic inflammatory disease diagnosis

H&P, lower abdominal tenderness, adnexal tenderness, cervical motion tenderness, STD screening

pelvic inflammatory disease treatment

Antibiotics, may require hospitalization, treat patient and partners, prevent recurrence and permanent damage

Addison disease manifestation

Darker pigmentation of skin, personality changes, fatigue, weakness, hypoglycemia, anorexia, nausea, vomiting, weight loss, impaired stress response, dehydration, hyponatremia, hyperkalemia, hypotension, shock

Addison disease diagnosis

Hyponatremia, hyperkalemia, low cortical steroid levels despite a CTH administration

Addison disease treatment

Fluid replacement, diet, pharm: oral glucocorticoids and mineralocorticoid replacement

cushing's syndrome diagnosis

Cortisol levels in 24 hour urine, imaging studies to detect tumors

Cushing syndrome manifestations

Increase facial hair, thinning of scalp hair, brown face, slow metabolism, glucose intolerance, obesity of trunk, face, and upper back, thin extremities, immunosuppression, osteoporosis, behavioral changes, impaired stress response

Cushing syndrome treatment

Remove caused, decrease exogenous glucocorticoid medication's, remove tumors

hypothyroidism manifestations

Goiter, edema, impaired memory, fatigue, lethargic, some of Nolan's, weakness, cold intolerance, weight gain, constipation, dry skin, coarse hair, impaired reproduction

hypothyroidism diagnosis

serum TSH high, serum TH low, low uptake of iodine by the thyroid gland, thyroid peroxidase antibodies high

hypothyroidism treatment

pharm: thyroid hormone replacement therapy

hyperthyroidism manifestations

Goiter, exophthalmos, agitation, restlessness, tremors, weakness, sweating, heat intolerance, tachycardia, palpitations, weight loss, diarrhea, fine hair, oily skin, irregular menstrual cycle

hyperthyroidism diagnosis

serum TSH low, serum TH high, high uptake of iodine by the thyroid gland, thyroid stimulating immunoglobulin high

hyperthyroidism treatment

pharm: block TH production; radioactive iodine, surgical removal of thyroid gland

diabetes insipidus manifestations

Polyuria, excessive thirst, dehydration, shock, death if I'm treated

diabetes insipidus diagnosis

Low ADH levels, serum solute concentration high, urine specific gravity is low, urine osmolality is low

diabetes insipidus treatment

Treat cause, hydrate, farm: desmopressin (mimic ADH)

syndrome of inappropriate diuretic hormone manifestations

Decreased urine output, anorexia, nausea, vomiting, disorientation, cramps, weakness, psychosis, gait, disturbances, seizures, coma

Syndrome of inappropriate diuretic hormone diagnosis

Hyponatremia, hypotonicity, decreased urine volume

syndrome of inappropriate diuretic hormone treatment

Remove cause, restrict water, taken more solute, IV: hypertonic; farm: vasopressin receptor antagonist (block ADH)

retinopathy of prematurity manifestations

Leukocoria, nystagmus, strabismus, myopia

retinopathy of prematurity diagnosis

Stage I: mildly abnormal blood vessel growth, stage II: moderately abnormal blood vessel growth, stage III: severely abnormal blood vessel growth, stage IV: severely abnormal blood vessel growth, personally detached retina, stage V: completely detached retina

retinopathy of prematurity treatment

stage IV-V: retinal detachment requires immediate action by surgical intervention removal of the vitreous in excision of the fibrous tissue that is placing traction on the retina

glaucoma manifestations (open angle)

If untreated, result in gradual irreversible vision loss, Blindspot in field of vision, initially limited to per Ferrari then progresses centrally

glaucoma manifestations (closed angle)

Induce by increase pupil dilation, I pain, headache, blurred vision, rainbows around lights, nausea, damage to optic nerve can lead to later vision loss

glaucoma diagnosis

Vision screening, opthalmoscopic exam: optic nerve cupping, pallor, hemorrhage, tonometry: measure intraocular pressure

glaucoma treatment

pharm: decrease fluid levels increase outflow of fluid
surgical: laser or traditional