Gastrointestinal and Musculoskeletal Disorders: Symptoms, Causes, and Complications, Exams of Pathophysiology

Download Gastrointestinal and Musculoskeletal Disorders: Symptoms, Causes, and Complications and more Exams Pathophysiology in PDF only on Docsity!

Patho 2024 final

Gastric ulcers - ANSWER Ulcers in the stomach that occur in males and females between the ages 55 and 65. Increased mucosal barrier's permeability to hydrogen ions allowing them to damage the mucosa layer leading to edema, histamine release, inflammation, and bleeding as well as making the mucosa more susceptible to hydrogen ions. Clinical manifestations include pain after eating, anorexia, vomiting, weight loss, risk of gastric cancer, and relief at antacids. Duodenal ulcers - ANSWER more common than other ulcers, these ulcers are caused by H. pylori infection and NSAID use. Acid and pepsin concentrations in the duodenum increase, penetrating the mucosal barrier. H. Pylori thrives in this environment, activating inflammation and increased gastric acid which causes ulcers. Clinical manifestations include chronic intermittent pain 2-3 hours after eating, pain is relieved with food or antacids, bleeding causing melena, and risk of perforation causing extreme and sudden epigastric pain. They often heal spontaneously unless a complication otherwise occurs. GERD - ANSWER The reflux of acid and pepsin or bile salts from the stomach to the esophagus, causing esophagitis. Risk factors include obesity, age, hiatal hernia, drugs, and certain chemicals. Increased abdominal pressure or a relaxed lower esophageal sphincter relate to acid reflux. Clinical manifestations include heartburn, acid regurgitation, edema, vomiting, straining at stool, weight loss, and discomfort while swallowing citrus fruits. Treatment includes proton pump inhibitors and potentially surgery. ulcerative colitis - ANSWER A chronic inflammatory disease that causes ulcers in the colon mucosa tissue. The disease begins in the rectum and may extend to the entire colon. Decreased mucosin from the disease leads to a decreased protection against pathogens causing inflammation. The mucosa appears deep red and can hemorrhage, small erosions and ulcers can form. necrosis, abscess formation, and edema ensue. Frequent diarrhea occurs mixed with blood and mucus. Clinical manifestations include dehydration, weight loss, anemia, fever, bleeding and inflammation. Irritable Bowel Syndrome (IBS) - ANSWER periodic disturbances of bowel function, such as diarrhea and/or constipation, usually associated with abdominal pain. No solid pathophysiology is known. Associated with intestinal infection and mental distress. Clinical manifestations include bloating, lower abdominal discomfort, gas, fecal urgency, nausea, incomplete evacuation, and relieved symptoms via deification. hernia - ANSWER a protrusion or bulging of an abdominal structure into the thoracic cavity. The most common type is the sliding type. the distended abdominal structure moves from the stomach into the thoracic cavity via the esophagus. The second type is when the greater curvature of the stomach protrudes into the thoracic cavity/ diaphragm through a secondary opening along side the esophagus. The third type is less common and is a combination of the sliding and protruding effects

of the first two. The last one tends to occur in conjunction with other diseases including reflux esophagitis and diverticulosis. A type four is when another organ, the colon or small bowel for example, get pulled into the protruding bulge. Clinical manifestations are often asymptomatic, this disease leads into other diseases later in life if it is not caught however. small bowel obstructions - ANSWER Caused by post operative adhesions, tumors, and hernias. it can lead to distention with accumulation of gas and fluid inside the proximal lumen. Distention decreases the ability to absorb water and electrolytes while increasing the net secretion of these things. low electrolytes and dehydration lead to imbalances and shock. Metabolic acidosis ensued because of the loss of hydrogen ions that are not getting absorbed. decreased potassium, ketosis, and starvation ensue. A build up of lactic acid leads to acidosis increasing and pressure causes necrosis, ischemia, perforation and peritonitis. Bacteria at this time results in sepsis or peritonitis. Inflammatory chemicals released in response to these conditions leads to organ failure. Large bowel obstruction - ANSWER less common of the two and is often related to cancer. Non cancerous causes are rare. presents with hypogastric type pain and abdominal distention. pain can vary from vague to excruciating. ischemia and peritonitis and sepsis may develop. symptoms include nausea, abdominal pain, fever, and vomiting. bowel sounds are present. Pathology is unclear. GI bleeds & esophageal varices - ANSWER Upper GI bleeds are bleeding in the esophagus, stomach, or duodenum leading to bright red blood in stool or dark red coffee ground blood in stool due to it being partly digested. Gastric and esophageal varices are the cause. Esophageal varices are a manifestation of portal hypertension and can cause anemia or melena. They are typically painless. lower GI bleeds are bleeds from the ilium, jejunum, colon, or rectum. Can be caused by polyps, cancer, inflammatory diseases, or hemorrhoid. Slow chronic blood loss and anemia can ensue, no melena seen. GI cancer, Esophagus, Stomach, Small intestine, Colon, and Rectum - ANSWER The early stages of cancer are often asymptomatic and hard to catch. In the esophagus it causes chest pain, heartburn with spicy foods, pain when swallowing and dysphagia. Stomach cancer is associated with H. pylori infection and inflammation as well as heavily salted foods. gene mutations may play a part if it is a diffuse cancer. Clinical manifestations include loss of appetite, malaise, and indigestion followed by weight loss, upper abdominal pain, vomiting, anemia and change in bowel habits. Small intestine cancer is related to chrones disease and Polyps. Symptoms are non specific and relate more to obstruction. anorexia, weight loss, nausea, vomiting, abdominal distention. Otherwise they are asymptomatic. Colon and rectum cancer risk in increased with aspirin and COX-2 inhibitor use as well as inflammation and alcohol. Tumors may be silent, evolving into pain, a palpable mass, anemia, bloody stool, fatigue, and obstruction of bowels. stools become narrow and pencil shaped, coated in blood. laxatives are necessary and cramping ensues. Renal cancer can affect the male prostate and female vagina causing immense pain.

gall stones cirrhosis - ANSWER Gallstones can block the bile duct leading to secondary biliary cirrhosis, increased pressure in the hepatic ducts results in bile in the centrilobular spaces. necrotic areas form and can burst forming pools of bile. Clinical manifestations include jaundice, pruritus, low grade fever, and right upper quadrant pain. continued obstruction ends in advanced cirrhosis and liver failure. jaundice - ANSWER The yellow green pigment of the skin caused by hyperbilirubinemia. This can be caused by an obstructed bile flow, intrahepatic obstruction, or excessive bilirubin production. Jaundice in newborns is caused by limited bilirubin uptake and conjugation. excessive red blood cell destruction can cause jaundice as well. Unconjugated bilirubin is not water soluble and can not be urinated out. Urine may darken several days before jaundice appears. Fever chills and pain often manifest. Jaundice is treated when the cause is eliminated. portal hypertension - ANSWER abnormally high blood pressure in the portal venous system leading to distended veins called varices that can bleed. mucosal erosion, bleeding, and ulcers are a higher risk for someone with portal hypertension. splenomegaly, or enlarges spleen can occur. hypertension can cause respiratory complications and liver disease. Organ failure ensures if caught too late. hepatic encephalopathy - ANSWER A complex neurologic syndrome characterized by impaired behavioral, cognitive, and motor function. Liver disfunction results in the accumulation of toxins that alter neurotransmission and cause edema. Ammonia especially as it reached the brain can cause a disruption to the blood brain barrier permitting infection, inflammation, edema, and brain damage. clinical manifestations include slow speech, stupor, convulsions, asterixis, bradykinesia, and coma resulting in death. dysmenorrhea - ANSWER Recurrent, painful mensuration associated with the release of prostaglandins in ovulatory cycles. It begins a few days before mensuration and persists 48-72 hours after mensuration. secondary is caused by endometriosis, infection, inflammation, vaginal anomalies, tumors, polyps, cysts, or IUDs (birth control) Fatigue, anorexia, pelvic pain, nausea, vomiting, insomnia, headache, and diarrhea. PCOS (polycystic ovarian syndrome) - ANSWER Menstrual irregularity, hyperandrogenism, and appearance of polycystic ovaries on an ultrasound. Any two of the three qualifies as a PCOS. Manifests as obesity, infertility, increased insulin, decreased sex hormone, sleep apnea, menorrhea, menstrual disturbance. depression, cardiovascular disease risk, and endometrial cancer risk. Genital warts - ANSWER an STD caused by the human papilloma virus (HPV); highly contagious. Shows small bumps, cauliflower-like growths, or other lumps on the genitals, anus, cervix, or rectum. Other symptoms include itching, discomfort, or bleeding during sex. Genital warts can be removed with creams, cryotherapy or laser, but treatment won't get rid of the virus itself, which usually clears up by itself within 2 years.

HPV (human papillomavirus) - ANSWER Common STI, the virus usually does not cause any symptoms and body is able to fight it off, sometimes virus lingers in a woman's cervix and can cause changes that may eventually lead to cervical cancer or genital warts. candidia - ANSWER A yeast that is a natural but opportunistic flora of the vagina. When a person takes antibiotics the yeast can overgrow its bounds leading to yeast infection resulting in itchiness, increased urinary urgency, and pain when urinating. cystocele - ANSWER protrusion of a portion of the posterior bladder wall into the vaginal canal caused by child birth. In severe cases the bladder and anterior vaginal wall bulge outside the uterous. symptoms are usually insignificant in minor cases. increased bulging can be aggravated by vigorous activity, sneezing, prolonged standing, and can be relieved by rest. large prolapse may result in vaginal pressure. endometriosis - ANSWER The presence of functioning endometrial tissue outside the uterus. The endometrial tissue breaks down with the regular menstrual cycle resulting in bleeding and inflammation where there isn't supposed to be any. Infertility, pelvic pain, and inflammation. Pregnancy and birth control help as they stop the menstrual cycle. Hormone therapy is also a treatment option. breast cancer - ANSWER malignant tumor of breast; usually forms in milk glands or lining of milk ducts. manifests and inverted nipples, or odd lumps on breast. Chlamydia - ANSWER A bacterial infection that affects the reproductive org ANSWER of both males and females. Often asymptomatic, it can result in pregnancy/birth complications and infertility in men and women if left untreated. phimosis - ANSWER caused by poor hygiene and chronic infection, it is the tightening of the foreskin over the head of the penis making it un able to be retracted over the head. necrosis can occur. BPH (benign prostatic hypertrophy) - ANSWER an enlarged prostate. This is non cancerous but it can worsen as the gland compresses the urethra causing the bladder to be obstructed and urine to be unnecessarily retained. prostate cancer - ANSWER cancer of the prostate gland, usually occurring in men middle-aged and older. Chronic inflammation and hypertension/lack of exercise increase risk.

Fractures - ANSWER a break in the continuity of bone when a forces is applied that exceeds the tensile strength. Complete is all the way through, partial is part way through, open in out of the skin, closed in no broken skin, linear runs parallel, oblique is an angle, spiral encircles bone, transvers is straight across bone, green stick is minor due to bendy bone, segmented is two or more pieces. sprains - ANSWER a sprain is the tearing or damaging of the ligament at a joint. If the tear is bad enough and reoccurs before healing is complete a lengthened or ineffective tendon may replace the old tendon. osteoporosis - ANSWER A condition in which the body's bones become weak and break easily due to gaps and lowered density. This is more common in women and it can be due to a calcium deficiency, a hormone imbalance of estrogen, or any imbalance that stimulates osteoclasts while inhibiting osteoblasts. osteomalacia - ANSWER disease marked by softening of the bone caused by calcium and vitamin D deficiency. Due to the effects of dark skin done on Vit D absorption this is more common in darker people. Unlike osteoporosis, the density of the bone does not change but the composition of it is soft and weak, leading to gravity induced deformities in the bone. Facial deformities and bowed legs are common. osteomyelitis - ANSWER inflammation of bone and bone marrow due to a bone infection caused by S. aureus. Clinical manifestations include silent infection, fever, malaise, anorexia, weight loss, pain around the infected area, inflammation, possible edema, back pain and brodie abscesses (lesions in bone) osteoarthritis - ANSWER inflammation of the bone and joint related to age. Symptoms include morning stiffness for an hour, joint pain, motor restriction, inflammation, and joint deformity. rheumatoid arthritis - ANSWER a chronic autoimmune disorder in which the joints are attacked causing them to become stiff. The cartilage is worn away and activity aggravates the stiffness, rest provides relief. gouty arthritis - ANSWER prolonged accumulation of inflammatory mediators in response to gout cause joint damage. the pain is often acute onset and it is severe, unresponsive to most home remedies. Fever, malaise, and fatigue are seen as results of the gout (Monosodium urate crystals). atrophy - ANSWER The muscles waste away from a lack of use. This can cause weight loss and weakness. Disuse atrophy is a concern in hospital beds and casts.

fibromyalgia - ANSWER chronic condition with widespread aching and pain in the muscles and fibrous soft tissue. Eczema - ANSWER Non contagious, inflammatory, autoimmune disorder known otherwise as dermatitis. often it makes the skin raised, calloused, itchy, weak, liable to bleeding and infection, and scaly. itchiness/pruritis - ANSWER Sensations in open nerves as a result of irritation or inflammation, or a histamine response as a result of inflammation. psoriasis - ANSWER A relapsing, chronic, proliferative inflammatory disorder that involves the skin, scalp, and nails. new skin cells are made quicker than they can mature making a thick dermal layer and causing the skin to look like silvery scales are on it. epidermal shedding time is also lessened to 3-4 days instead of 14-20 days making the skin extra itchy and uncomfortable. Langerh ANSWER cells - ANSWER epidermal macrophages that help activate the immune system. Takes information from the skin and alerts the WBCs. The cause of eczema. nevi - ANSWER moles, freckles, birthmarks skin cancer - ANSWER a harmful, malignant growth on the skin. Risk factors include UV rays, and skin inflammation. herpes - ANSWER meaning "creeping" this virus is transmitted via bodily secretions. it is generally associated with oral infections such as cold sores or fever blisters. Can also cause genital rashes and inflammation. lesions appear as clusters of inflamed painful vesicles on the surface. Genital wounds have pain, itching, and weeping (fluid leaking). pressure ulcers - ANSWER Compromised circulation secondary to pressure or pressure combined with friction. Causes necrosis and an open wound that can get deep enough to see internal structures such as muscle and bone. Protective flat coverings, good hygiene, and an avoidance of pressure on the spot allow it to heal. Movement, removing moisture, and relieving pressure help to diminish risk of a pressure ulcer.

candidiasis - ANSWER infection of the skin, mouth, or vagina caused by the yeast-type fungus. Causes a white web-cheese like film on mucus membranes. Tender itching areas that are painful and swollen. burn shock - ANSWER a phenomenon consisting of both the massive fluid loss lowering blood pressure and the increased capillary permeability as well as the lower moving congealed blood as fluid rushes to the burn site. The low BP can result in shock. burns - ANSWER heat damage to tissue structures. first degree affect the epidermis only. Second degree affect the thickness of the skin layer, separating the skin layers creating a blister which is painful upon bursting and can lead to infection. Third degree affect the entire epidermis, dermis, and often the underlying tissue resulting in leathery skin, edema, and nerve damage to the point of painlessness. Fourth degree affect the tissue beyond the subcutaneous tissue all the way to the muscle or even bone, there burns are painless as well though severely dangerous as it created an environment for bacteria to thrive and cause sepsis.. Abdominal pain—example of visceral pain - ANSWER Visceral pain arises from an stimulus such as distension or inflammation causing stretching or damage. Inflammatory mediators can cause pain hypersensitivity. It is usually near the midline, diffuse, poorly localized, and cramping or gnawing. What causes of upper vs lower GI bleeds? - ANSWER upper is caused by bleeding in the gastric or esophageal veins when they are distended and wounded. Ulcers can also caused it. lower GI bleeds are caused by bleeding from the ilium, jejunum, colon, or rectum and its caused by polyps, inflammatory disease, cancer, diverticulitis, or hemorrhoids. Pathophysiology of GERD - ANSWER The reflux of acid and pepsin or bile salts from the stomach into the esophagus. The pressure in the abdomen builds or the lower esophageal sphincter relaxes too much leading to acid reflux. Intestinal obstruction-- signs of large intestine/bowel obstruction - ANSWER Signs include hypogastric pain, abdominal distension, vomiting, nausea, bowel sounds, and possibly blood in stool. what are the manifestations of a Hiatal hernia - ANSWER The stomach moves into the thoracic cavity either parallel to or through the esophageal hiatus. Manifestations include heartburn, regurgitation, dysphagia, and epigastric pain as well as ischemia from hernia strangulation, severe chest pain, and nausea, vomiting, or GI bleeding. Causes, pathophysiology, risk factors for, manifestations of, and complications of peptic ulcer disease (gastric and duodenal ulcers).

a. How do NSAIDs impact peptic ulcer disease? b. Gastric ulcers increase risk of what other disease?- **ANSWER** Causes: a break in the protective mucosal lining leading to a wound, aka ulcer. NSAIDS increase risk of ulcers by decreasing prostaglandin synthesis. Risk factors: H.pylori, NSAIDS, smoking, alcohol, and various other medications. Manifestations of: intermittent upper abdominal pain, pain antacid relief pattern (food relief with Duodenal ulcers) Food pain pattern in gastric and nocturnal pain pattern in duodenal. Complication of: Lethal anemia, melena, obstruction, and anorexia. Gastric ulcers in particular increase the risk of gastric cancer. What are the signs, symptoms, and associated factors to irritable bowel syndrome - IBS? What are manifestations of ulcerative colitis? How are ulcerative colitis and Crohn disease different?` - **ANSWER** IBS: Bloating, abdominal discomfort, diarrhea, constipation, or mixed, gas, fecal urgency, nausea, and relief with defecation. Ulcerative colitis: chronic inflammatory disease causing ulcers in the colon mucosa. Bleeding manifests as well as cramping, deep red mucosa, deification urge, frequent diarrhea mixed with mucus and blood, and dehydration. Chron disease: Symptoms are specific and last many years. Diarrhea and rectal bleeding are most common, weight loss and abdominal pain are often present, tenderness may be present over the lesions, anemia may occur, Additional complications include anal fissure, perianal abscess, and fistula. Individuals are at risk for adenocarcinoma. Difference: UC only occurs in the inner most lining of the colon while CD occurs in all layers of the bowel walls. Causes of hepatic encephalopathy - ANSWER A build up of toxins due to liver disfunction and aggravated by the digestion of blood and the accumulation of ammonia especially. Causes brain damage. Pathophysiology and clinical manifestations of jaundice`` - ANSWER Pathophysiology, a build up of bilirubin caused by a blockage of the bile duct or poor urinary filtration or liver failure. Clinical manifestations, yellowish green skin and eyes and dark urine. Cirrhosis—what is it and what is the relationship between portal hypertension and cirrhosis? - ANSWER Irreversible liver disease. Healthy liver was replaced with dysfunctional scar tissue. Portal hypertension is a complication of cirrhosis. This is because of the inflammation, vascular remodeling, shunting, and fibrosis of the sinusoids that occurs in cirrhosis.

Stool changes (including color) with bile obstruction and why - ANSWER Bile breaks down fats giving stool its brown color, when bile production is blocked stool becomes clay colored/ pale. Gallstones and composition - ANSWER Cholesterol stones are 70% cholesterol and the most common Pigmented stones are hard and black or soft and brown and are less than 30% cholesterol Mixed stones are a variation of the two others. Pathophysiology of pancreatitis (acute & chronic), complications, and clinical manifestations - ANSWER Acute: Gallstones are the leading cause. manifestations are acute pain in abdomen, edema, chemical inflammation/ irritation, obstruction if biliary tract, inflammation of the nerves, fever, and leukocytosis. Abdominal distention and shock may occur, complications include multiple organ failure and death. Chronic: progressive caused by chronic alcohol abuse, manifestations include inflammation, ischemia, abdominal pain, weight loss, acinar cell injury, and malabsorption syndrome. complications include cystic rupture, pancreatic cancer, and post operative diabetes mellitus. Risk factors of colorectal cancer - ANSWER Advanced age, obesity, type two diabetes mellitus, African American ethnicity, Cigarette smoking, Advanced age, High fat and red meat diet, High alcohol consumption, Inflammation, Bowel disease, Low levels of physical activity, and Family history/Genes. Pathophysiology and causes of dysmenorrhea - ANSWER Primary dysmenorrhea is caused by excessive prostaglandin synthesis. The prostaglandins increase myometrial contractions, constriction of endometrial blood vessels, and enhanced nerve hypersensitivity. These changes lead to ischemia and endometrial shedding. Secondary Dysmenorrhea results from disorders such as endometriosis, endometritis, obstructive uterine or vaginal anomalies, Inflammation, polyps, tumors, cysts, pelvic congestion syndrome, and/or IUDs Complications of Polycystic Ovary Syndrome (PCOS) - ANSWER Type 2 diabetes mellitus, uterine cancer, cardiovascular disease, endometrial hyperplasia, dyslipidemia, and preterm birth. Yeast vaginitis is caused by overgrowth of which microorganism? - ANSWER Candida albicans Treatment for pelvic organ prolapse - ANSWER Kegel exercises, Postmenopausal estrogen, Pessary(a removable device to hold org ANSWER in), Surgical procedures.

What is a cystocele? - ANSWER Decent of a portion of the posterior bladder wall into the vaginal canal, usually caused by child birth. Increased bulging can be aggravated by prolonged or vigorous standing or activity and can be relieved with rest or assumption of a prone position. Medical treatment for endometriosis - ANSWER GnRH inhibitors, Hormone therapy, Pain killers, Birth control, Pelvic physical therapy, and surgical treatments. Causes of cervical cancer - ANSWER HPV, diet, or family history Pathophysiology/causes of galactorrhea - ANSWER (Inappropriate lactation) Milk production from the breast that is not related to pregnancy or lactation. Hypothyroidism or Pituitary tumors may cause Inappropriate lactation. Hormone imbalances and some drugs may cause lactation. Essentially an elevated prolactin causes milk production and flow. Breast cancer—first clinical manifestation - ANSWER An irregularly shaped, painless, firm, lump. Define phimosis - ANSWER inability to retract foreskin due to it being too tight Most common infectious case of orchitis - ANSWER Mumps virus and rubella virus Clinical manifestations and risk factors of benign prostatic hypertrophy - ANSWER As cellular enlargement progresses, tissues that surround the urethra compress it, this can cause bladder outflow obstruction. The urine retained builds over time leading to overflow incontinences. Hematuria, bladder or kidney infection, bladder calculi, and urinary retention are common complications. Risk factors include increased obesity, systemic inflammation, and increased estrogen Risk factors of prostate cancer - ANSWER fatty diet, genetic predisposition, retrovirus, chronic inflammation, and ethnicity Symptoms of chlamydia infection - ANSWER asymptomatic for 90% of adults. Symptoms include mild burning with urination, swollen scrotum, rectal inflammation, urethritis, tubal infertility in women, and pneumonia in newborns. Most common bacteria sexually transmitted infection (STI) and what it causes in men - ANSWER Chlamydia. Causes burning when urinating, itching of the penis, pain/swelling the the testicles, white, cloudy, or watery discharge, and difficulty urinating.

Fracture types and causes (especially pathologic & stress fractures) - ANSWER open(open skin), closed(intact skin), linear(Line), oblique(Angle), spiral(caused by twisting), green stick(young bone), segmented(many bits), pathologic(disease caused), stress(Cumulative forces placed on bone slowly), compression(bone crunched together), displaced(One, both, or all fragments out of alignment), impacted(Fragments are pushed into each other) What is a sprain? - ANSWER tearing/injuring of a ligament Clinical manifestations of rhabdomyolysis - ANSWER Dark, red, or cola-colored urine, Decreased urine output, general weakness, Myalgia, muscle tenderness or weakness necrotic muscle tissue Hypovolemia, reduced urine output Osteoporosis—pathophysiology, causes of, and complications of - ANSWER The bone weakens due to increased osteoclast activity and decreased osteoblast activity. this is caused by age, hormone imbalance, and Ca+ deficiency. Complications include vertebral collapse(kyphosis), fractures, hemorrhage, shock, surgical complications, and premature death. Osteomalacia—causes of - ANSWER Low ca+, Vit D, and liver disease. Infectious microorganism of osteomyelitis - ANSWER Staphylococcus aureus Characteristics of osteoarthritis - ANSWER -pain -edema -limitation of motion -erosion of articular cartilage -Morning stiffness for an hour -Joint deformities -Inflammation -Rest Relief Causes of rheumatoid arthritis (RA) - ANSWER Autoimmune disease, cytokine contributes, Initiated by CD4+ helper T cells

Relationship between gouty arthritis and risk for renal stones - ANSWER Gouty arthritis caused by a build up in Ureic acid results in crystals forming at the joints causing an inflammatory response. Ureic acid build up also implies Highly concentrated urine for any number of reasons, increasing the risk for renal stones due to both ureic and calcium content in the bladder increasing. Causes of disuse atrophy - ANSWER bed rest, trauma, casting, nerve damage, anything that decreases the use of the muscle long enough for it to atrophy. Characteristics of fibromyalgia - ANSWER Chronic widespread pain, Primarily musculoskeletal pain, Fatigue (mental and physical), Sleep disturbances, and Anxiety Causes and clinical manifestations of skin breakdown (dermal pressure ulcers)? What is the first indication of an ulcer? - ANSWER Causes: Cut off blood supply, Friction, High moisture levels often from being stationary. Manifestations, lesions, Deep injuries, Ischemia, Necrosis, Pain, fever, infection risk, Toxicity leading to complications. First sign is non blanching, red skin. Inflammatory disorders-eczema and psoriasis--what are they and what are key characteristics? (See purple text on slides) What are Langerh ANSWER cells and what is their role? - ANSWER Langerh ANSWER cells are a type of dendritic cell that present processed antigens from the dermal layer to T cells. They cause dermatitis when they sense a foreign object. Eczema, or dermatitis, is an autoimmune response to something in the external environment, This could be an allergic or chemical irritant or it could be due to a dry and weakened skin layer. Psoriasis is an inflammatory disorder caused by thick layers of nonkeratinized skin cells being pushed to the top in a silvery, itchy layer. The immune system then attacks those cells, the inflammatory chemicals results in pruritus. Mediators and mechanisms of pruritus and urticaria. What is released in the body that causes urticarial lesions to develop with allergic reactions? - ANSWER Cytokines and external stimulation interacting with open nerve endings results in pruritus. Mast cells interacting with IGE degranulate releasing histamines. Histamine response triggers Urticarial lesions(fluid leaking from vessels forming bumps) and pruritus during an allergic reaction. What causes Lupus? - ANSWER The exact pathology of lupus is unknown but it is related to genetic and environmental factors. Lupus often forms in a butterfly pattern on the face. Its autoimmune. Herpes Simplex and Herpes Zoster—what type of lesions they cause and the difference between primary infection and latency. - ANSWER Herpes simplex causes cold sores and fever blisters and genital herpes. Primary infection is often asymptomatic and the recurrent outbreaks after latency result in lesions. Herpes Zoster results in chickenpox outbreak on primary infection and after latency can result in shingles, a painful outbreak of viral rash.

Fungal infections. What exacerbates candidiasis? - ANSWER pregnancy, diabetes mellitus, Cushing disease, debilitates states, antibiotics, warm moist environments, infants, immunosuppression, and certain blood diseases affecting monocyte/macrophage function. What are nevi? When should they be monitored? - ANSWER Nevi are moles and they should be regularly checked for changes in size, shape, color, and regularity in order to avoid a carcinogenic outbreak of skin cancer. Warning signs of or precursors and risk factors of skin cancer - ANSWER any change on the skin, especially change in the size or color of a mole or other darkly pigmented growth or spot. Patho of hypovolemia in burn shock and complications associated with burn shock. Which burns are most painful? - ANSWER Massive fluid loss from a severe burn results in hypovolemia, This in tandem with diminished cardiac contractility results in Shock. Complications include risk of respiratory and cardiac failure, other compartment syndromes, hypoxia, liver kidney and gut necrosis/ failures, and damage to intestinal mucosa. Second degree burns are the most painful, especially if the blister pops. Understand the pathophysiology and different causes of edema. Be able to discuss how edema occurs in a variety of different disorders. Understand how changes in oncotic pressure and hydrostatic pressure are responsible for the formation of edema. - ANSWER Edema is a build up of fluid in the extracellular space. This is caused by increased hydrostatic pressure, lymphoid blockage, decreased oncotic pressure, decreased albumin/ other proteins, increased salt, inflammation, increased vascular permeability, Ischemia, Urinary blockage, increased antidiuretic hormone, increased gravity/ venous pooling, hypertension, and injury/ infection. Know pathophysiology and examples of conditions related to cellular injury especially as related to necrosis and hypoxia. Include compensatory mechanisms seen in hypoxia. - ANSWER Necrosis is unnatural cellular death that triggers an immune system response. This can happen due to infection, autoimmune attacks, Mechanical damage, Chemical damage, Heat or Cold damage, or Hypoxia. when necrosis is due to hypoxia the cell swells and bursts due to the lack of ATP. This causes swelling called Ischemia and wounds. Know the term apoptosis and understand its significance. Give examples of when it's seen in the body. - ANSWER Apoptosis is a natural cell programed death that occurs in the body every second to maintain homeostasis. It does not trigger an immune response. It is seen when the bodies red blood cells or white blood cells have served their time and expire or when a cell with a deformity is caught in cell division and killed for not being able to correct the deformity. This is to prevent cancerous cells.

Hormones that regulate sodium and water balance in the body. RAAS - ANSWER Angiotensinogen, Renin, Angiotensin 1, angiotensin 2, and aldosterone (briefcase exchanging K+ for Na+) regulate the water balance. Acid base balance a. Ion that changes acid base balance b. Relationship between potassium levels and acidosis c. Conditions that cause metabolic acidosis, metabolic alkalosis, respiratory acidosis, or respiratory alkalosis and why. d. What does compensation refer to in acid-base balance? - ANSWER a. Hydrogen, AKA H+ b. Potassium Goes Up in Acidosis c. Metabolic acidosis is caused by kidney failure, liver failure, DKA, and an overproduction or retention of H+ ions. Respiratory Acidosis is caused by the Under elimination of hydrogen Ions and respiratory depression. Respiratory alkalosis is caused by the over elimination of hydrogen Ions and hyperventilation. Metabolic alkalosis is caused by Vomiting, Diarrhea, NG suctioning(medically clearing stomach with a tube), meds, and antacids. d. Compensation is when the respiratory system responds to balance Ions in a metabolic imbalance or the metabolism responds to balance ions in a respiratory imbalance. Conditions that are caused by inflammation and what happens in them and why. - ANSWER Autoimmune diseases are inappropriate inflammation in reaction to a self antigen. High blood pressure is caused by inflammation, Arthritis is inflammation, Asthma and COPD are inflammation, Inflammatory Bowel Disease is inflammation, Edema is inflammation, cancer is chronic inflammation, Cystic fibrosis in lungs in inflammation. Glomerulonephritis. What is the relationship between the heart and the lungs? Describe a condition that impacts both the heart and the lungs. - ANSWER The heart supplies blood to the lungs to avoid necrosis and it pumps blood through the lungs so they can oxygenate it for the rest of the body, the left side of the heart then pumps the blood systemically. Left sided heart failure affects both the heart and the lungs. When the heart can't pump any more the fluid backs up into the lungs causing edema, lung failure, and eventually right sided heart failure, in the mean time systemic Ischemia and hypoxia occurs. Coughing frothy sputum, fatigue, dyspnea, orthopnea, decreased urine output, and edema. Describe conditions that cause bleeding or clotting. What predisposes (makes a person more likely to experience) these? You may wish to discuss Virchow's Triad, hypersplenism, or hypertension - ANSWER Hypersplenism is the overactivity of the spleen which me ANSWER it retains more platelets than normal. This mixed with anemia caused by it can lead to bleeding (less platelets) and shock(lower BP). Hypertension slows how fast the blood moves, like a traffic jam, and increases the

number of platelets and the risk of perfusion/injury to the vessels. these risks result in an increased risk for clots and thrombosis. The Virchow's Triad increases risk of clotting. The tree factors include hypercoagulability of the blood, endothelial injury, and stasis or slowing of blood flow. Alterations in blood pressure cause disturbances throughout the body. How does low blood pressure impact the brain or kidneys? - ANSWER Low blood pressure causes the Kidneys to retain urine to try to increase BP and it can lead to a build up of toxins and eventually kidney failure. Low blood pressure causes the Brain to cease to function as Ischemic damage hits the nerves as a result of poor perfusion to the cerebral tissue. Disorders arising in different body systems can cause anemia. Be familiar with the pathophysiology behind anemia in at least 2 different body systems. Compare and contrast the pathophysiologic mechanisms behind anemia. - ANSWER Iron deficiency anemia can result from GI bleeds, Surgeries, Eating disorders, and anything else that nutritionally keeps Iron from the blood(Shortness of breath and fatigue may occur). Hemorrhage anemia occurs because of intense blood loss (shock may occur). Discuss autoimmune disorders and be able to give 2-3 examples of conditions involving autoimmunity. Understand when the body's response to a viral infection can lead to certain disorders. Be specific about what disorders are caused by autoimmune responses. - ANSWER Glomerulonephritis, Rheumatoid Arthritis, Eczema.