patho gods pls pray for me

acute bacterial prostatitis

male infection or reflux into prostatic ducts, subtype of uti, most common organism e.coli, risk factors with impaired defense mechanisms, cause dysuria, uretheral discharge

chronic bacterial prostatitis

recurrent uti, symptoms similar to acute but mostly afebrile

chronic prostatitis/chronic pelvic pain syndrome

pain including painful ejaculation, urinary symptoms without bacteria present, elevated inflammatory cells

benign prostatic hyperplasia

age related, nonmalignant, dht induced growth factors by enzyme 5-alpha reductase, lesions can compress urethra to produce symptoms like frequency, nocturia, and if progresses chronic urinary retention

hpv

non enveloped double stranded dna virus, most common sexually transmitted infection, minor trauma to squamous epithelium, if develop symptoms can cause genital warts and cell changes

pelvic inflammatory disease

polymicrobial infection of upper reproductive tract that ascends through endocervical canal, risk factors for young nulliparous women with multiple partners, will see purulent discharge with fever and elevated wbc, lower ab pain

endometriosis

functional endometrial tissue found outside uterus, location determines symptoms, pain that is more severe premenstrual, lesions stimulated by ovarian hormones, can lead to infertility

regurgitation/implantation theory

menstrual blood with fragments of endometrium is forced through fallopian tubes into peritoneal cavity

vascular or lymphatic theory

endometrium fragments travel through blood or lymph to implant somewhere else in the body

metaplastic theory

dormant immature cellular elements spread over a wide area during embryonic development persist into adult life and then differentiate into endometrial tissue

primary disorder

occurs at the gland itself

secondary disorder

problem occurs at the pituitary gland

tertiary disorder

problem occurs at the hypothalamus

hypofunction

usually due to congenital disorders, autoimmune disorders, or age

hyperfunction

paraneoplastic syndrome where gland becomes hyperplasic, can occur with meds that mimic hormones

growth hormone

elongates bones and organ development, regulates metabolic functions, stimulates liver to increase production of increased growth factor 1, stimulated under stress and heavy exercise, helpful with blood sugar drops

gigantism

hyper secretion of growth hormone

dwarfism

hypo secretion of growth hormone

acromegaly

growth hormone excess in adulthood with soft tissue growth, deepening of voice, sleep apnea, joint pain, insulin resistance

thyroid gland

depends on dietary iodine, bound to plasma proteins in blood, hormone regulation via feedback mechanism, various functions in metabolism, cardiac, gi, and nm

hypothyroidism

slowing of metabolic rate, decreased energy, cold intolerance, hypoventilation, coarse hair, dry skin, constipation, lower heart rate

myxedema coma

life threatening emergency of hypothyroidism that typically occurs with undiagnosed elderly, decreased heart rate and hypoventilation leads to co2 retention and hypothermia

hyperthyroidism (Graves disease)

increased metabolic rate, goiter, exopthalmos, increase in sympathetic activity, pretibial myxedema

thyroid storm

life threatening hyperthyrodism resulting in high fever, tachycardia, angina, delirium

primary adrenal cortical insufficiency (Addison disease)

decreased adrenal cortical hormones with elevated acth levels, hypoglycemia, weight loss, hyperpigmentation

acute adrenal crisis

life threatening, severe hypoglycemia, profound hypotension, requires fluid electrolyte and mineral replacement with iv glucose

Cushing syndrome

hypercortisolism, hypokalemia, moon face, buffalo hump, purple striae, poor wound healing, osteoporosis

diabetes insipidus

deficiency of adh or decreased response to adh, unable to concentrate urine, increased voiding and dehydration

siadh

failure of negative feedback, adh secretion continues despite serum osmolality, decreased urine output, water retention

type 1 diabetes

destruction of pancreatic beta cells to lose beta cell function with absolute insulin deficiency

type 2 diabetes

insulin resistance with either relative insulin deficiency or impaired release of insulin for blood glucose levels due to beta cell dysfunction

manifestations of diabetes

polyuria, polydipsia, polyphagia (occurs more with type 1)

hypoglycemia

below normal blood glucose levels due to relative insulin excess, can cause altered cerebral function and activation of ans,

diabetic ketoacidosis

type 1, hyperglycemia, ketosis, metabolic acidosis, compensation with kussmal respirations, hyperkalemia

hhnks

type 2, hyperglycemia, hyperosmolarity/dehydration, absence of ketoacidosis,

diabetic nephropathy

proteinuria, lesions of glomeruli, microvascular complication, leading cause of renal failure

diabetic retinopathy

microvascular complication, leading cause of acquired blindness, increased risk for cataracts and glaucoma

diabetic neuropathy

peripheral nerve dysfunction with decreased sensation and autonomic dysfunction

macrovascular complications

cardiovascular disease, cerebrovascular disease, PAD

alzheimers

most common dementia with slow onset, neuritic plaques and tangles, diagnosis via exclusion

initial stage Alzheimers

short term memory loss, mild personality changes

moderate stage Alzheimers

more global cognitive impairment, language impaired, personal hygiene issues, behavioral changes, need supervised placement

last stage Alzheimers

lose ability to respond to environment and require total care

parkinsons

degeneration of basal ganglia causing loss of dopamine producing neurons

cardinal signs of parkinsons

tremor, rigidity, bradykinesia, postural instability

myasthenia gravis

disorder of neuromuscular junctions that affect impulse transmission between motor neuron and innervated muscle cell, autoimmune disorder, causes diplopia, muscle weakness, ptosis of eyelid

myasthenia crisis

muscle weakness compromises breathing

multiple sclerosis

demyelination of nerve fibers in white matter of cns, slows conduction

chief complaints of ms

paresthesias, optic neuritis, diplopia, gaze paralysis

relapsing remitting phase of ms

episodes of acute worsening, recovery and stable disease between relapses

primary progressive phase of ms

nearly continuous neurological deterioration from onset of symptoms

secondary progressive phase of ms

gradual neurological deteriation with or without superimposed acute relapses

progressive relapsing phase of ms

gradual neurological deterioration from onset, has subsequent superimposed relapses

spinal shock phase

complete loss of reflexes below level of lesion, lasts from 7-20 days

neurogenic shock

accompanies spinal shock with injuries T6 or higher, hypotension, bradycardia, decreased CO, hypothermia

complete lesion

loss of sensation and voluntary muscle control

incomplete lesion

varying degrees of loss

central cord syndrome

more frequent with elderly, injury to central gray/white matter of cord, upper extremities motor loss

anterior cord syndrome

loss of motor, pain, temp below lesion, intact sensation

brown sequard syndrome

missile injury, ipsilateral loss of motor, proprioception, and vibration, contralateral loss of pain and temp

posterior cord syndrome

hyperextension injuries, impaired light touch and proprioception

autonomic dysreflexia

exaggerated sympathetic response below level of injury

mechanisms of brain injury

hypoxia, ischemia, excitatory amino acid injury

vasogenic cerebral edema

impaired function of blood brain barrier that is caused by increased permeability of capillary endothelium

cytotoxic cerebral edema

increased intracellular fluid due to water intoxication or severe ischemia

cushing reflex

hypertension, bradycardia, and widened pulse pressure creates risk for hernia

compliance with increased icp

shunt csf into spinal space, increased rate of csf absorption, decreased cerebral blood volume by moving blood into sinuses

cingulate herniation

often motor with subtle weakness in extremities

transtentorial central herniation

bilateral small reactive pupils and drowsiness

transtentorial uncal herniation

lesion pushes against temporal lobe, with early sign of ipsilateral pupillary dilation and progression with dilated fixed pupils, flaccidity and respiratory arrest

infratentorial herniation

downward via foramen magnum, decreased consciousness, respiratory abnormalities, pulse rate variation, progresses rapidly

concussion

mild head injury with momentary loss of consciousness, brain imaging negative, contusions can produce bleed

diffuse axonal injury

shearing and tearing of brain tissue, small hemorrhages also seen

epidural hematoma

arterial bleed occuring within minutes of injury, major risk for herniation, neurological emergency

subdural hematoma

venous bleed affecting bridging veins between dura and arachnoid space, slower, similar symptoms to epidural, classified as acute, subacute, or chronic based on time of injury, highest mortality

intracerebral hemorrhage/hematoma

bleed within brain tissue, nonoperable, most common in frontal and temproal lobes

thrombotic ischemic stroke

large vessel, often with atherosclerotic plaques, affect cortex

lacunar ischemic stroke

small vessel in brain stem, basal ganglia, or internal capsule, hemiplegia

cardiogenic embolic ischemic stroke

middle cerebral artery

transient ischemic attack

caused by a clot that dissapates on its own, symptoms of a stroke

hemorrhagic stroke

intracerebral hemorrhage into brain tissue, more fatal, occur suddenly and usually with activity

arteriovenous malformation

congenital, abnormal conjunction of arteries and veins within the brain due to absence of a capillary network

hydrocephalus

presence of blood prevents csf from being reabsorbed by the arachnoid vili or cerebral edema preventing outflow of csf

vasospasm

distal areas being fed by cerebral artery suffer ischemia and infarction to cause further neurologic dysfunction

rebleeding or rupture

occurs within 24 hours of initial bleed and up to 7-10 days post, seen in aneurysm and avm patients

avm complications

cerebral edema, hydrocephalus, vasospasm, rebleeding or rupture, seizures, hypothalamic dysfunction

left hemisphere stroke

aphasia, deficits in right visual field, slowness, quick anger and frustration

right hemisphere stroke

impulsiveness or poor judgement, neglect syndrome, denial of illness

seizure

symptom of underlying cns dysfunction

atonic

loss of muscle tone, drop seizures

myoclonic

jerking or twitching

clonic

muscle stiffness

tonic-clonic

grand mal, contains preictal, ictus, postictal phases, varied tonic and clonic phases

status epilectus

medical emergency, grand mal seizure lasting more than 5 minutes