Final Patho Review Madison

all fluid within cells
2/3

all fluids outside the cells
1/3

space between cells and outside the blood vessels

intravascular fluid

135-147 mEq/L
major cation in ECF

3.5-5.5 mEq/L
in ICF

9.0-10.5 mg/dL
in ECF

2.5-4.5 mg/dL

1.8-2.4 mg/dL
in ICF

ECF

more visible, can see it happen
urine and feces

not visible, don't see it happening
lungs and skin (occurs without awareness)

directly affects cardiac muscle contraction and electrical conductivity

related to hyponatremia and elevated bicarbonate concentration

too much sodium
too little bicarbonate

same concentration of particles as ICF or ECF

lower concentration of particles/dilute
swell

higher concentration of particles
shrink

biochemical barriers

inflammatory response
local manifestations
microscopic changes

only occurs in vascularized tissue

wounds that heal under conditions of minimal tissue loss
surgical incision; ends approximated

closed -- edges are close together

vascular response
blood vessel dilation
increased vascular permeability and leakage
white blood cell adherence to the inner walls of the vessels and migration through the vessel

cleaning up the dissolved clots, microorganisms, erythrocytes, and dead tissue cells
scrape off hard, leathery type to heal

returning injured tissue to the original structure and function

replacement of destroyed tissue with scar tissue

wound that pulls apart at the suture line

extrusion of viscera or intestine through surgical wound

reversible response to a cell
accommodating to both normal and abnormal demands or conditions

cell shrinks

increases cell size

increases in cell number

abnormal cell growth
changes in size, shape, and organization of mature cells

reversible replacement of one mature cell type by another

reduced supply of blood to the tissues causing death

total lack of oxygen by obstruction

decreased oxygen in the environment

reduced oxygenation of arterial blood

protein denaturation
albumin is transformed from a gelatinous, transparent state to a firm opaque substance

neurons and glial cells of the brain
cells digested by own hydrolases
tissues become soft and liquefied
triggered by bacterial infection

results from pulmonary tuberculosis infection
combination of coagulative and liquefactive necrosis
coughing up blood clots and liquid

breast and other abdominal organs
action of lipases
fatty acids combine with elements to create soaps
tissue appears opaque and chalk white

death of tissue from severe hypoxic injury
dry = skin becomes dry and shriveled, brown or black
wet = area becomes cold, swollen and black, gas gangrene

programmed cellular death

subjective sensation of uncomfortable breathing

dyspnea when a person is lying down

awaken at night gasping for air

labored breathing
hyperpnea

alternating patterns deep and shallow breathing

breathing too slowly and shallow
causes hypercapnia
decreased oxygen

breathing too fast
causes hypocapnia
exceeding metabolic demands
increased carbon dioxide

increased carbon dioxide concentration in arterial blood

decreased CO2
too much O2
blood become alkaline

pneumonia

presence of air / blood trapped in lungs
lung collapses = put chest tube in

passage of fluid and solid particles into the lungs

collapse of lung tissue

persistent abnormal dilation of the bronchi

inflammatory obstruction of the small airways

excessive amount of fibrous tissue in lungs

allergic reaction from inhaled particles or fumes

excess water in the lungs

chronic inflammation of the airways
causes bronchial hyperresponsiveness, constriction of airways, and reversible airflow obstruction

acute infection or inflammation of the airways or bronchi

infection by Mycobacterium tuberculosis
leading cause of death from curable infectious disease in the world
airborne
caseous necrosis

occlusion of a portion of the pulmonary vascular bed by an embolus
ex: blood clot, air bubble, etc.

deep veins in the lower leg

amount of blood ejected from the left or right ventricle each minute
regulated by volume of blood pumped by the ventricle per beat

volume of blood pumped by the ventricle each heart beat
regulated by preload, contractility, and afterload

stretch on the heart before it contracts; based on volume

strength of contraction at any given preload

pressure that must be exceed before ejection of blood from the ventricles can begin

consistent elevation of systemic arterial blood pressure
3rd leading cause of death in world

increased cardiac output
total peripheral resistance

causes systemic disease
renal disease, adrenal disorders, vascular disease, drugs
raises peripheral vascular resistance or CO

bolus circulating in the bloodstream
clot on the move

any vascular disease that narrows or occludes the coronary arteries

impaired blood flow to myocardium
within 10 seconds of deprivation

failure of valve to shut completely permitting blood flow to continue when valve should be closed

constricted and narrowed
blood does not flow forward
workload in front of diseased valve is increased

aortic valve doesn't close properly

polyuria
nocturia
continuous thirst
polydipsia
low urine specific gravity
low urine osmolality

ADH insufficiency
excessive fluid excretion

excessive excretion of ADH
excessive water retention
monitor sodium lab value?

weight loss
nervousness
exophthalmos (bulging eyes)
increased appetite
palpitations
heat intolerance
Palmar erythema

intolerance to cold
facial / eyelid edema
dull-blank expression
thick tongue
slow speech
brittle nails and hair
lethargy
muscle weakness
constipation

excessive anterior pituitary secretion of ACTH
excessive level of cortisol, regardless of cause
caused by long-term glucocorticoid therapy

weight gain in trunk, face, cervical neck
purple striae
glucose intolerance
protein wasting
vasoconstriction and HTN
irritability and depression

dilation of the ureter (accumulation of urine in the ureter)

dilation of the renal pelvis and calyces
results in enlargement of kidneys with large stones

inflammation of the bladder
most commonly caused by e. coli

infection of renal pelvis and interstitium
most often in women

persistent recurrent infection of the kidney leading to scarring

inflammation of glomerulus
most common cause of chronic and end-stage renal disease
rapidly progressive

abrupt reduction in renal function
increased BUN and creatinine
oliguria but may be normal

impaired renal blood flow (most common cause)
GFR declines due to increased filtration pressue

tubular necrosis; surgery sepsis, obstruction

urinary tract obstruction (bilateral)

collect urine for 24 hours
throw 1st one away and keep the rest of them for 24 hours

progressive and irreversible loss of nephrons
decreased GFR, affects all organ systems
best indicator = serum creatinine levels

body comes in contact with virus and creates antibodies

immunity gained by breast milke

immunity you are born with

any condition that prevents the flow of chyme through the intestinal lumen
failure of motility usually because of abdominal sugery

mechanical blockage of lumen by lesion

failure of motility (paralytic ileus)

vomitus

break down or ulceration in the protective mucosal lining of the lower esophagus, stomach, or duodenum

NSAIDS and H. Pylori

most common of the peptic ulcers
H. Pylori and NSAIDS
chronic intermittent epigastric pain 2-3 hours after eating

develop in the antral region of the stomach, adjacent to the acid-secreting mucosa of the stomach
pain often present after eating

acute peptic ulcer that is related to severe illness, neural injury, or systemic trauma

develop within hours of multisystem trauma

results from burn injury

associated with severe head trauma / brain surgery

chronic inflammatory disease that causes ulcerations of the colonic mucosa
sigmoid colon or rectum

inflammatory disease of large and small intestine
idiopathic inflammatory disorder; affects mouth to anus
difficult to differentiate from ulcerative colitis

eat organ meats
most common type of anemia worldwide

most critical clinical index of nervous system functions

loss of ability to think rapidly and clearly
impaired judgement and decision making

beginning loss of consciousness
disorientation to time followed by disorientation to place and impaired memory
lost last is recognition to self

limited spontaneous movement or speech
easy arousal with normal speech or touch
may or may not be oriented to time, place, or person

mild to moderate reduction in arousal (awakeness) with limited response to the environment
falls asleep unless stimulated verbally or tactilely
answers questions with minimum response

a condition of deep sleep or unresponsiveness from which the person may be aroused or caused to open eyes only by vigorous and repeated stimulation
response is often withdrawal or grabbing at stimulus

no verbal response to the external environment or to any stimuli, noxious stimuli such as deep pain or suctioning do not yield motor movement

everything is straight and stretched out

partial seizure preceding onset of generalized seizure
gustatory (taste), visual or auditory
dizziness, numbness, "funny feeling"

malaise, HA, sense of depression hours or days before onset of seizure

state of muscle contraction with excessive tone
stays contracting

state of alternating contraction with relaxation of muscles (usually rapid)

time period immediately following the cessation of seizure activity

progressive failure of many cerebral functions
not caused by impaired LOC

leading cause of severe cognitive dysfunction in older adults
risk increases with age
autopsy for diagnosis

headache

decreased muscle tone
passive movements there is little or no resistance

disorder of learned skilled movements with difficulty planning and executing coordinated motor movements
interchangeable with dyspraxia

involuntary movement of the face, lips, tongue, trunk, and extremities

muscle rippling or quivering under the skin
happens with paralysis

sustained voluntary muscle contraction with twisting movement

defect of pattern recognition
failure to recognize the form and nature of objects