AdvancedPathophysiologyExam238pages

Advanced Pathophysiology Overview

• Key topics covered include: Endocrine System, Hematology, Cancer, Immunity & Infection, Cardiovascular, Lymphatic Reviews

Endocrine System

Hormonal Regulations

• Endocrine glands produce and secrete hormones into surrounding fluid.

Types of Hormones

• Peptide Hormones

  • Water soluble, protein-structured hormones.

  • Synthesized as prohormones and stored in granules until release.

  • Example: Proinsulin - produced daily but only partially utilized.

• Amine Hormones

  • Derived from amino acid tyrosine.

  • Includes thyroid hormones T3 and T4.

• Steroid Hormones

  • Fat soluble, derived from cholesterol.

  • Released immediately as produced, not stored.

Alterations of Anterior Pituitary

• Pituitary Adenomas

  • Slow-growing tumors in the pituitary gland.

  • Can be benign or invasive, most are benign.

• Prolactinoma

  • Common pituitary tumor that secretes prolactin.

  • Symptoms include amenorrhea, infertility, and increased hair growth in women; erectile dysfunction in men.

Alterations of Posterior Pituitary

Diabetes Insipidus

• Caused by insufficient antidiuretic hormone (ADH).

  • Symptoms include inability to concentrate urine, high serum osmolarity, and low urine osmolarity.

Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

• Excess ADH leading to water retention.

  • Results in hyponatremia, hypervolemia, and weight gain (not edema).

Pancreas and Diabetes

• Diabetes: Dysfunction of the pancreas impacting hormone insulin, which regulates fuel storage.

  • Fuel Sources:

    1. Carbohydrates (glucose) for nerve/RBC function.

    2. Fats (triglycerides) for energy needs.

    3. Proteins (amino acids) for protein synthesis.

Comparisons of Diabetes Type 1 and Type 2

• Type 1

  • Genetic predisposition and environmental triggers.

  • Autoantibodies attack beta cells.

  • Complications include Diabetic Ketoacidosis (DKA).

• Type 2

  • Most commonly caused by obesity;

  • Insulin resistance and reduced secretion.

  • Complications include Hyperosmolar Hyperglycemic Nonketotic State.

Insulin Resistance and Diabetes Management

• Obesity alters cellular shapes, obstructing insulin receptors.

• Initial insulin increase leads to downregulation of receptors, culminating in decreased beta cell function.

Factors Affecting Insulin Dosing

• Somogyi Effect: Hypoglycemia followed by rebound hyperglycemia; management through nighttime insulin adjustments.

• Dawn Phenomenon: Elevated morning glucose due to nocturnal hormone rise.

Thyroid Gland

• Controls metabolism; produces/stores thyroid hormones (T3 & T4).

• Negative Feedback System: Regulates hormone levels based on thyroid hormone concentrations in blood.

Thyroid Disorders

• Hypothyroidism

  • Commonly caused by Hashimoto's (autoimmune).

  • Elevated TSH, low T3 and T4 levels.

• Hyperthyroidism

  • Caused by Graves' disease (autoimmune), leads to increased T3 and T4 levels and low TSH.

Parathyroid Gland

• Regulates calcium levels using PTH and vitamin D.

• Hyperparathyroidism: Excess calcium and PTH.

• Hypoparathyroidism: Low calcium and PTH.

Adrenal Gland

• Zone Functions:

  • Glomerulosa: aldosterone production.

  • Fasciculate: cortisone production.

  • Reticularis: sex hormone production.

Adrenal Disorders

• Hyperaldosteronism: High blood pressure and potassium deficiency.

• Hypoaldosteronism: High potassium levels without other causes.

Cushing's Syndrome vs. Disease

• Cushing's Syndrome: Excess cortisol regardless of cause.

• Cushing's Disease: Overproduction of ACTH by pituitary adenoma.

Addison's Disease

• Adrenal insufficiency; low aldosterone and cortisol levels leading to fatigue, weight loss, low blood pressure, etc.

Hematology Overview

Hematopoiesis

• Formation of cellular elements; Erythropoietin from kidneys stimulates RBC production.

  • Requires Vitamin B12, Folate, and Iron for synthesis and maintenance.

  • Lifespan of RBCs ~120 days.

Clotting Cascade

• Primary Response: Platelet activation stops bleeding.

• Secondary Response: Formation of fibrin clot.

Anemia Types

• Relative Anemia: Normal counts but poor oxygen delivery.

• Microcytic Hypochromic Anemia: Often due to iron deficiency.

• Macrocytic Anemia: Caused by B12 or folate deficiencies.

• Aplastic Anemia: All cell lines affected due to marrow suppression.

Leukemias

• Malignant blood disorders characterized by uncontrolled leukocyte proliferation; classified by origin and progression rate.

• Common types: Acute Lymphocytic Leukemia (ALL) in children, Acute Myelogenous Leukemia (AML) in adults.

Cancer Overview

Cancer Symptoms

• Common symptoms include fatigue, pain, cachexia, and changes in blood counts.

Tumor Markers

• Utilize various markers for diagnosis and monitoring (e.g., PSA for prostate cancer).

HIV and AIDS

• HIV is a retrovirus causing decrease in CD4 T cells.

• Diagnosis of AIDS when CD4 lowers below 200.

Stress Response

• Cortisol as a stress hormone; chronic elevation leads to systemic inflammation.

Cardiovascular System Review

• Functions of heart circulation; distinctions between right and left heart operations.

Myocardial Infarction

• STEMI vs. NSTEMI; healing phases after an MI include collagen matrix deposition.

Valvular Disease and Heart Failure

• Various conditions affect heart valve functionality and cardiac output leading to heart failure symptoms.

Hypertrophic Cardiomyopathy

• Common inherited heart defect; sudden death risk in athletes.

Peripheral Vascular Disease

• Related to chronic lymphedema management and complications from conditions such as hyperlipidemia.