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Patho Exam 4 Study Guide
Hepatitis: liver inflammation that can be caused by a number of things, viruses, drugs, alcohol Cirrhosis: progressive liver disease that occurs when healthy liver tissue is replaced by scar tissue, which prevents liver from functioning properly Bilirubin : yellow substance that’s created when red blood cells break down, part of body process for clearing waste Cholelithiasis: gallstones in the gallbladder or biliary tree Cholecystitis: inflammation of the gallbladder Hepatic Encephalopathy: deterioration of brain function characterized by impaired consciousness, confusing, disorientation, and eventually coma Steatorrhea: too much fat in the stool Steatohepatitis: if you have fatty liver disease, advanced for of non-alcoholic liver disease Jaundice: condition that causes the skin and whites of the eyes to appear yellow Hepatomegaly: enlarged liver beyond its normal size Discuss the most frequent diseases of the liver, gallbladder, and pancreas Liver Diseases
- Hepatitis : Inflammation of the liver often caused by viral infections (hepatitis A, B, C, D, and E) or other factors like alcohol use, drugs, or autoimmune conditions.
- Cirrhosis : A chronic liver disease marked by scarring (fibrosis) that replaces healthy tissue, often resulting from long-term liver damage due to alcohol abuse, chronic hepatitis, or nonalcoholic fatty liver disease.
- Fatty Liver Disease : Also known as hepatic steatosis, this condition is characterized by excess fat in the liver. Nonalcoholic fatty liver disease (NAFLD) is often linked to obesity and diabetes.
- Liver Cancer : Primary liver cancer, such as hepatocellular carcinoma, is most commonly caused by cirrhosis from hepatitis B or C or chronic alcohol use. Gallbladder Diseases
- Cholelithiasis (Gallstones) : Gallstones are hardened deposits of digestive fluid that can form in the gallbladder. They may cause pain or block the bile ducts, leading to infections or inflammation.
- Cholecystitis : Inflammation of the gallbladder, usually due to gallstones blocking the bile duct. It can be acute or chronic and may require surgical removal of the gallbladder.
- Gallbladder Cancer : Rare but aggressive, gallbladder cancer often goes undetected until it's advanced. Risk factors include gallstones, chronic inflammation, and certain infections. Pancreatic Diseases
- Pancreatitis : Inflammation of the pancreas, which can be acute or chronic. Common causes include gallstones, chronic alcohol use, or certain medications.
- Pancreatic Cancer : One of the more aggressive and difficult-to-treat cancers, often diagnosed at an advanced stage. Risk factors include smoking, chronic pancreatitis, and certain genetic conditions.
- Diabetes : Although a metabolic disease, diabetes is closely linked to the pancreas because it affects insulin production, which the pancreas regulates List and describe tests that are used to detect diseases of liver and pancreas -liver function tests: tests for albumin, bilirubin -pancreatic enzyme test: amylase and lipase -imaging: ultrasound, CT, mri and endoscopic ultrasound -biopsy: take small tissue and assess Describe pathogenesis, risk factors, and treatment of acute and chronic pancreatitis -acute pancreatitis: reversible rapid onset of symptoms limit activity of gland (treatment) -chronic pancreatitis: irreversible caused by repeated bouts of acute pancreatitis alcohol causes 2/3 of cases half of patients have gallstones cystic fibrosis, repeated attack of gallstones and obstruction of pancreatic ducts by diseases complication: diabetes treatment: limit activity of gland Explain pancreatic cancer, including prognosis, risk factors for developing, and complications -tumors in endocrine or exocrine portion, exocrine more common (pancreatic ducts), islet tumors usually benign, most occur in head of pancreas -prognosis: poor prognosis -risk factors: African American, age, obesity, pancreatis, family history, alcohol, smoking -complications: metastases to other tissues, jaundice and weight loss
- Hep E: fecal oral transmission, developing countries, mild and self-limiting, epidemic in indie Explain formation of gallstones, including risk factors, types and complications -Risk factors: increase with age, women more likely, obesity and family history -types: cholesterol, pigmented -complications: cholecystitis, pancreatitis, perforation, gallbladder cancer, biliary obstruction, infection-peritonitis Describe symptoms and causes of jaundice -symptoms: yellowing, urine is dark, change in stools. -causes: biliary obstruction, liver disease, birth defects, blood disorders, gallbladder diseases Describe the formation of liver neoplasms, both primary and metastatic -can form either as a primary cancer from within the tissue or as a metastatic cancer, where cells spread to the liver from another part of the body: primary: hepatocellular carcinoma; most often due to chronic hepatitis metastatic: most liver neoplasms have metastasized to liver from somewhere else -liver neoplasm has a poor prognosis Define cirrhosis, including how it develops and main causes -describes end stage of most serious chronic types of liver disease -caused by chronic hepatitis, chronic alcohol consumption, biliary obstruction, cryptogenic Pyelonephritis: bacterial or viral infection that causes inflammation of the kidneys Uremia : condition that occurs when the kidneys are unable to filter waste products out of the blood, resulting in a buildup of toxins Glomerulonephritis : inflammation and damage to the filtering parts of the kidneys -toxins, metabolic wastes and excess fluid are not correctly filtered into the urine Glomerulosclerosis: scarring of the tiny filtering units inside the kidneys (glomeruli) BUN: blood urea nitrogen Urolithiasis: condition where solid masses form in the urinary tract Renal calculi: hard deposits of minerals and salts that form in urinary tract; AKA kidney stones Vesicoureteral reflux: condition in which urine flows backward from the bladder to one or both ureters and sometimes to the kidneys Lithotripsy: non-invasive procedure that uses shock waves to break up kidney stones and other hardened masses into smaller piece that can pass through the body Cystoscopy: procedure that allows a doctor to examine inside of the bladder and urethra using a
cystoscope, a thin, lighted tube with a lens or camera Tubulointerstitial nephritis: inflammation that affects the tubules of the kidneys and the tissues that surround them Hematuria : blood in the urine Polyuria: increased frequency Nocturia: increased nighttime urination Oliguria: decreased urinary output Anuria: complete absence of urination Describe normal structure and functions of the kidneys -function: kidneys filter the blood, remove water-soluble wastes, help control bp, help maintain red blood cell levels
- structure:
- kidney
- ureters
- bladder
- urethra -nephron: glomerulus and renal tubule (flow of filtrate, becomes urine) -components of urine formation: filtration, reabsorption and secretion -filtration barrier: endothelium, basement membrane, podocytes Explain pathogenesis and clinical manifestations of glomerulonephritis and nephrosclerosis -glomerulonephritis: usually follows a bacterial infection, circulating antigen and antibody, complexes deposit on glomeruli, high bp -nephrosclerosis: hardening of the walls of the small arteries and arterioles (small arteries that convey blood from arteries to the even smaller capillaries) of the kidney. Describe congenital abnormalities affecting urinary tract -renal agenesis: failure of one or both kidneys to develop -bilateral: rare, associated with other congenital abnormalities, incompatible with life -unilateral: common, asymptomatic; other kidneys enlarge to compensate Explain renal tubular injury and provide etiology and manifestations -a type of kidney injury that occurs when the small tubes in the kidneys are damaged -caused by lack of oxygen and blood flow reaching the kidneys Explain mechanism of urinary tract calculi formation, complications, manifestations of
in blood would indicate kidney dysfunction Compare nephritic to nephrotic syndrome -nephritic syndrome: -inflammation induced injury of capillary -less severe proteinuria -hematuria: blood in urine -nephrotic syndrome: -massive proteinuria: mass amount of protein in urine -leads to hypoalbuminemia: low albumin in blood -results in edema Explain diabetic nephropathy and complications -complication of long-standing diabetes -most common cause of renal failure -manifestations: progressive impairment of renal function, no specific treatment can arrest progression of this disease -glomerulosclerosis: decreased surface area for filtration Compare autosomal recessive and autosomal dominant polycystic kidney disease -autosomal recessive polycystic kidney disease: infancy and early childhood always has associated liver involvement can be seen on prenatal ultrasound if severe -autosomal dominant polycystic kidney disease: does not manifest until adulthood fairly common liver involvement less severe cysts develop insidiously reduced life expectancy Define glomerular disease, including main causes, examples symptoms and complications -due to damage of major components of the glomerulus (endothelium, podocytes, basement membrane) -most are caused by immune-mediated injury Hydrocele : excess fluid accumulates, treated by aspiration Varicocele : varicose veins in spermatic cord, usually involves left side of scrotum, one of the most common causes of infertility Orchitis : inflammation of the testis, from mumps virus, fever, edema, urethral discharge, treatment with antibiotics, analgesics Cryptorchidism : when the testes do not descend
Inguinal hernia: occurs when tissue from the abdominal cavity pokes through a weak spot in the abdominal muscles and into the groin Describe common male reproductive complains -frequency, urgency incontinence, dysuria and nocturia -pain in any reproductive organ or unusual discharge -swelling or enlargement of any reproductive organs -any sexual disorder or concern Differentiate benign prostatic hyperplasia and prostatic carcinoma as to clinical manifestations and treatment -benign prostatic hyperplasia is the MOST COMMON: hyperplasia due to dihydrotestosterone enlargement of prostate gland obstructs flow of urine, urinary hesitancy, frequent urination, nocturia treatment: surgery and reductase inhibitors -prostatic carcinoma: when the prostate gland grows out of control Describe risk factors in developing prostate cancer -dietary factors
- hormones -chronic inflammation -familial factors
- ethnicity Describe testicular cancer including cell types and age affected -cells in testicles multiple to quickly and form tumors -relatively rare disease of young men -younger age Define and describe varicocele, hydrocele, orchitis, prostatis, cryptorchidism, testical torsion -varicocele: varicose veins in spermatic cord, usually involves left side, one of most common causes of infertility, treatment required only if varicocele causes discomfort or impairs infertility -hydrocele: excess fluid accumulates, treated by aspiration -Orchitis: inflammation of testes, etiology is mumps virus -prostatis: prostate gland inflamed -cryptorchidism: testes do not descend normally; treatment is to give time of surgery to bring them down -testical torsion: twisting of spermatic cord due to rotation of testicles which reduces blood flow Define erectile dysfunction and describe methods of treatment
-thus, uterus is subjected to continuous estrogen stimulation and responds by shedding and bleeding in an irregular manner instead of shedding all at once Describe diseases of the cervix, endometrium and myometrium, including risk factors Polyps: benign tumors on surface of cervical canal -many are asymptomatic, but can lead to irregular menstrual bleeding Cervical dysplasia: abnormal growth of cervical squamous epithelium -risk factors: HPV infection, multiple sex partners and genetics Cervical carcinoma: cancer that develops in the cervix or in the wall of cervix -risk factors: HPV, smoking, age, weakened immune system Endometriosis: presence of functioning endometrial tissue outside of uterus -risk factors: genetic predisposition, spread through vascular or lymphatic systems Differentiate risk factors of cervical cancer, endometrial cancer and ovarian cancer Cervical cancer: -risk factors: HPV Endometrial cancer: -risk factors: age obesity excessive estrogen exposure Ovarian cancer : -risk factors: hereditary childbirth and pregnancy: women with children ½ the risk than those without, increase
of children appear to reduce the risk, miscarriage or abortion provide smaller risk reductions
lactation (breast feeding): reduces the risk for ovarian cancer oral contraceptives: ever-users have about half the risk as do never-users, long term use seems to further enhance protection against hormone replacement therapy appears to increase the risk for ovarian cancer, particularly long-term use Explain methods of artificial contraception and side effects -barrier methods: diaphragms and condoms, effective, no side effects -oral contraceptives: suppress ovulation, side effects are increased tendency for thromboembolic complications, especially among smokers, hypertension -intrauterine contraceptive devices, IUD: prevent implantation, side effects are increase incidence of tubal infections and tubal pregnancies Define infertility, and provide examples of female related causes -not able to get pregnant after a year of trying
-female related causes: hormonal imbalances, structural problems, eating disorders, obesity, stress, alcohol, drug misuse, cancer, age, malnutrition Describe the importance of the placenta -crucial role during pregnancy -fetus connected to placenta by umbilical cord -endocrine function: estrogen and progesterone, HCG Explain causes and effects of ectopic pregnancy -causes: previous infection of fallopian tubes and scarring due to STD -diagnosis: positive pregnancy test and abdominal ultrasound -signs and symptoms: pregnancy, sharp pelvic pain and bleeding -if embryo is not removed: rupture of fallopian tube, profuse bleeding from torn vessels, potentially life-threatening to mother Compare eclampsia and pre-eclampsia -preeclampsia: pregnancy associated high blood pressure and protein in urine -eclampsia: high blood pressure, protein in urine and convulsions Describe placenta previa and complications -in the wrong place -placenta attached lower half of uterus -can lead to vaginal bleeding -can be deadly to mom and baby -will need c-section Understand the causes and effects of gestational diabetes -hyperglycemia in the mother -pathophysiology: pregnancy hormones induce maternal insulin resistance; diabetes results from inability to increase insulin secretion to compensate for increase insulin resistance -to fetus: obesity, type 2, congenital malformations, larger babies at birth Define a molar pregnancy, including complications -hydatidiform mole -non-viable fertilized egg implants in the uterus -sperm fertilized empty egg, only placenta develops -greater risk in older women
Compare and contrast fibrocystic breast disease, fibroadenoma, and breast carcinoma
- Fibrocystic breast disease a. Most common of benign changes b. Unknown etiology c. More common ages 20- 40 d. Signs and symptoms: pain, lumps in breast, size changes w period, nipple discharge, can rupture, induce inflammation e. Ultrasound helps decide if cystic of a solid mass f. Treatment: nothing if small, aspiration of cyst, surgical excision if no aspiration
- Fibroadenoma a. Benign b. Well-circumscribed tumor of fibrous and glandular tissue c. It is not precancerous d. Common in young women e. Painless f. Size does not fluctuate g. Treatment: surgically excised
- Breast carcinoma a. Most frequent diagnosed in American women b. Arise from duct-lobular unit c. Age associated d. Leading cause of death from ages 40- 44 e. Second most common killer after lung cancer f. Types: sporadic and familial g. Risk factors: hormonal factors, obesity, alcohol, sedentary, Caucasian, occurs in both sexes but rare in men Explain risk factors for development of breast carcinoma risk factors: hormonal factors (no children, not breastfeeding, early menarche, late menopause), obesity, alcohol, Caucasian, sedentary lifestyle Describe clinical manifestations of breast carcinoma, methods of diagnosis and treatment -arise from duct-lobular unit -age associated -second most common killer after lung cancer -types: familial and sporadic -treatment: first is surgical excision, then radiation and chemotherapy are added for more extensive cancers Explain role of genetics in the pathogenesis of breast carcinoma and other types of cancer -most frequency diagnosed cancer in American women -mutations in BRCA1 and BRCA 2 increased risk for other cancers, only 5-10 increase of breast cancer -gene encode proteins for DNA repair -increases cancer risk in males as well
Describe acute mastitis, and how it is treated -inflammation of the breast -most commonly due to staph infection breast feeding, baby has bacteria in mouth -symptoms; swelling, pain, redness, lumps -treatment: antibiotics Describe the pros and cons of hormone replacement therapy Pros: relief of menopausal symptoms, helps with mood, estrogen helps bone health cons: long-term estrogen-progestin use increases risk of breast carcinoma and ovarian cancer, blood clots
