Other System Pathologies Flashcards
1
Q
Ankylosing Spondylitis
A
- progressive systems disorder characterized by inflammation of spine and larger peripheral joints.
- Joints: SI, IVD, spine, costovertebral and apophyseal joints, connective tissues, lg peripheral joints (hips, knees, and shoulders)
- HLA-B27 histocompatibility has a high risk for the disease
- Caucasian males b/n 20-40
- S&S:
- Early AS: recurrent and insidious episodes of LBP, morning stiffness, impaired spinal extension, and limited ROM over 3 mth period of time
- Severe AS: severe pn, consistent, pn extending to midback and sometimes neck., flattened lumbar curve (from m spasms)
- Fixed flexion at the hips, spinal kyphosis, fatigue, weight loss, and peripheral joint loss.
- Longtime AS: Iritis, uveitis, osteoporosis, fx, AA subluxation, and complete spinal fusion.
- pericarditis, cardiac pathology, pulmonary fibrosis, cardiac arrhythmias, amyloidosis, and aortic insufficiency
- Diagnosis: X-ray may be negative initially….then show areas of erosion, demineralization, calcification, syndesmophyte formation, leading to fusion.
- Treatment:
- NSAIDs, DMARDs (methotrexate), analgesics, and specifically indomethacin (for pain relief)
- PT: emphasize extension, general ROM, pain, aerobic exercise (extension and rotation)
2
Q
Astrocytoma
A
- Accounts for ~50% of pediatric brain tumors.
- Etiology - Genetic predisposition, environmental influence, radiation and toxin exposure, and association with certain childhood disorders.
- Signs and symptoms - 2 types
- Cerebellar - clumsiness, ataxic gait, headache, change in personality, and vomiting
- Supratentorial - headache, seizures, change in personality, visual impairments, and vomiting
- Treatment -
- Surgical resection of cerebellar tumors offers an 80-90% cure rate.
- Supratentorial tumors also require surgery to resect the tumor with radiation and/or chemotherapy.
3
Q
Brain Cancer
A
- A primary tumor arising from astrocytes, meninges, nerve cells, or tissues within the brain.
- Metastatic brain cancer occurs when a brain tumor develops as a consequence of cancer in another primary area of the body.
- Etiology - Most primary cancers outside of the brain metastasize to the brain during progression of the cancer.
- Signs and symptoms -
- typically progress rapidly.
- HA, seizures, increased ICP, cognitive and emotional impairment, and decreased motor and sensory function.
- Treatment - Surgical resection along with radiation or other combined therapies are typically indicated.
4
Q
Breast Cancer
A
- Most common female malignancy (typically over the age of 50), but can also occur in men.
- Majority of cases are classified as adenocarcinoma and it is the 2nd leading cause of female death from cancer.
- Common metastases: lymph nodes (lymphatic system), lungs, bones, skin, and brain. If the cancer recurs, it is usually within 2 yrs of the initial diagnosis.
- Etiology - Risk factors include genetics, gender, age, menstrual history, and geography.
- estrogen is believed to have some relationship to the disease process
- young menarche, late menopause
- Gender, age, family hx, high alcohol intake, high fat diet, radiation exposure, and past hx of CA
- Signs and symptoms -
- Lump and is usually found by the woman. (typically firm, irregular, and non-painful).
- The patient may also present with signs including nipple discharge, erythema or a change in breast shape.
- Treatment
-Treatment may include surgery, radiation,
chemotherapy or hormonal manipulation. - Curable if diagnosed prior to metastases; survival rate decreases as the stage of the cancer increases. - The current 5-year survival rate for localized tumors is 92%; this drops substantially if there is nodal involvement.
5
Q
Cervical Cancer
A
- Starts in the cells on the surface of the cervix, typically squamous cells.
- Precancerous condition is called dysplasia and is easily treatable.
- Annual cervical screening is recommended; diagnosis is made through a Pap test (smear).
- Prognosis is good with timely intervention. If dysplasia goes undetected, changes can develop into cervical cancer and metastasize to the bladder, intestines, lungs, and liver.
- Etiology -
- The HPV is the primary cause of cervical cancer; it is slow growing.
- Risk factors: smoking, maternal use of diethylstilbestrol (DES), African American ethnicity, oral contraceptive use, and certain sexually transmitted diseases.
- Signs and symptoms -
- Asymptomatic during the early stages
- Abnormal bleeding, pelvic and low back pain, impairment with bladder and bowel function.
- Treatment - Treatment is dependent on staging of the cancer and may include laser therapy, excision, cryotherapy or hysterectomy with adjunct chemotherapy or radiation.
6
Q
Chronic Fatigue Syndrome
A
- Complex condition with unknown etiology that is considered diagnosis of exclusion
- Etiologies (potential): viral origin, an immune response to inflammation within the nervous system.
- Risk Factors: environmental and genetic influences, viral infection, immunological dysfunction, nutritional deficiency, hormonal imbalance, depression, anemia, allergens, hypotension, and autoimmune response.
- Clinical presentation: (have to meet specific criteria….the first one and 4-8 of the additional ones)
- hx of at least 6 mths of unexplained, prolonged, and severe fatigue that is not relieved by rest
- self-reported memory or concentration deficits sever enough to interfere with ADLs
- persistent or recurrent sore throat
- painful or enlarged axillary or cervical lymph nodes
- unexplained m pain
- migrating joint pain without visible signs of inflammation
- complaints of malaise lasting >24 hr after physical or mental exertion
- HA that exhibits changes in pattern and severity
- Treatment:
- Pharm: symptom-based and psychothearpy
- PT: relaxation techniques, energy conservation, exercise
- have low tolerance for physical exertion (but if they avoid it…symptoms get worse)…so low level short duration with gradual progression.
7
Q
Colorectal Cancer
A
- Start as a growth on the inner lining of the colon or rectum (i.e., polyp).
- Some polyps can change into cancer over time, while others do not. Adenocarcinoma and primary lymphoma account for the majority of intestinal cancers.
- Etiology - Risk factors include increasing age, history of polyps, ulcerative colitis, Crohn’s disease, family history, and a diet high in fat and low in fiber.
- Signs and symptoms -
- does not provide early signs of disease and the most prominent symptom is a continuous change in bowel habits.
- Bright red blood from the rectum
- Fatigue, weight loss, anemia, and overt rectal bleeding.
- Treatment -
- based on the type and staging of the cancer and may include surgical resection of the tumor and potentially a portion of the bowel, with subsequent radiation therapy and/or chemotherapy;
- colostomy may be required.
- Prognosis is good for early diagnosis if the cancer is contained (prognosis is poor if it has metastasized)
8
Q
Electrolyte Imbalances
A
- minerals that carry an electrical charge and are present within the fluids of body
- critical to many of the body’s processes (nerve and m function and maintenance of fluid balance)
- Several causes: meds, vomiting, diarrhea, inadequate diet or malabsorption, trauma, burns, CA, thyroid disorders, endocrine or metabolic disorders, renal disease, liver disease, CHF, alcoholism, and eating disorders
- Which minerals are most common:
- Ca+, Cl-, Mg+, phosphate, K+, and Na+
- S&S:
- dizziness, fatigue, nausea, constipation, diarrhea, decreased urine output, dark urine, dry mouth, decreased perspiration, m weakness, m cramping or spasm, irregular heartbeat, and HA.
- Signs of dehydration: change in mental status, poor skin elasticity, rapid heart rate, sunken eyes
9
Q
Fibromyalgia Syndrome
A
- rheumatology syndrome or a nonarticular rheumatic condition.
- Pain is the primary symptoms by tender points within m, tendons, and ligaments.
- Etiology: biochemical, metabolic or immunologic pathology.
- Clinical incidence: Females 14-68.
- widespread hx of pain that exists in all 4 quadrants of the body.
- Fatigue, memory and visual impairment, sleep disturbances, IBS, HA, and anxiety/depression
- Treatment:
- Physician: address sleep disorders and the other symptoms.
- Psychotherapy: anxiety, depression, incorporate stress management, coping strategies.
- PT intervention: include relaxation techniques, energy conservation, gentle stretching, moist heat, ultrasound, posture and body mechanics, biofeedback, and exercise to tolerance.
- Aquatic therapy to improve a patient’s fitness level and an ergonomic evaluation should be performed at the patient’s work place.
- Should not work through pain.
- Require short exercise sessions initially (3-5 min) due to a low tolerance for exertion.
10
Q
Leukemia
A
- Cancer of the blood that occurs when leukocytes change into malignant cells.
- Immature cells proliferate, accumulate in bone marrow, and ultimately cease the production of normal cells.
- Process will spread to lymph nodes, liver, spleen, and other areas of the body.
- Many types: acute lymphoblastic leukemia (ALL) and acute myelogenous leukemia (AML) occurring most frequently in children.
- Etiology - Environmental, chemical or toxin exposure, genetic predisposition, and viral association.
- Signs and symptoms -
- Abrupt onset with high fever, bleeding, enlarged lymph nodes and spleen, progressive weakness, fatigue, and painful joints.
- Blood work will indicate anemia, a leukocyte count greater than 500,000 mm3 and thrombocytopenia.
- Treatment -
- Options include immunotherapy, cytotoxic agents, chemotherapy or radiation, and bone marrow transplant.
- Over 90% of patients with (ALL) achieve complete remission with treatment, while 70-80% of patients with (AML) achieve complete remission with treatment.
11
Q
Lung Cancer
A
- Cancer of the epithelium within the respiratory tract.
- Most frequent cause of death from all cancers.
- Rapid metastasis: pulmonary vascular system, adrenal gland, brain, bone, and liver.
- Etiology - Risk factors include smoking, environment, geography, occupational hazards, age, and family history.
- Signs and symptoms -
- Early symptoms include cough, sputum, and dyspnea.
- Progression may include symptoms of adventitious breath sounds, chest pain, and hemoptysis.
- Treatment -
- Poor prognosis secondary to expedited metastasis (less than 14% for a five-year survival rate).
- Surgical intervention along with combination therapies may be required.
12
Q
Lymphoma
A
- Cancer found in the lymphatic system and lymph tissues;
- Categorized as Hodgkin disease or non-Hodgkin lymphoma.
- Etiology
- Risk factors for Hodgkin disease include association with Epstein-Barr virus, drug abuse, immunosuppressant use, obesity, chronic or autoimmune diseases.
- Risk factors for non-Hodgkin lymphoma include exposure to benzene (i.e., cigarette smoke), auto emissions, and pollution.
- Signs and symptoms -
- A painless lump is typically the first sign and general symptoms include fever, chills, and fatigue. - Hodgkin disease is distinguished by the presence of Reed-Sternberg cancer cells. Both forms can metastasize.
- Treatment -
- Hodgkin disease is one of the most curable cancers depending on age, disease stage, overall health, and responsiveness to treatment.
- Treatment options are based on the patient’s age and staging classification and include chemotherapy, radiation, Stem cell transplant, and highly active antiretroviral therapy.
- Non-Hodgkin progression varies based on classification, co-morbidities, and treatment response.
13
Q
Multiple Organ Dysfunction Syndrome
A
14
Q
Neuroblastoma
A
- Tumor that initiates from primitive ectodermal cells of the neural plate and is found within the sympathetic nervous system, primarily seen in the adrenal glands or paraspinal ganglia.
- Most common malignant tumor seen in children.
- Etiology -
- Remains unknown,
- Causative factors include genetic predisposition, familial incidence, environmental influence, radiation and toxin exposure or viral association.
- Signs and symptoms -
- Abdominal mass, change in personality, anemia, sweating, pain, and diarrhea.
- Treatment -
- Surgical resection, chemotherapy, and radiation.
- Prognosis is best for children diagnosed in the first year of life.
- A neuroblastoma will spontaneously regress in rare cases.
15
Q
Osteogenic Sarcoma
A
- Cancer that occurs at the epiphyses of long bones.
- Most common form of bone cancer in children with a peak incidence between the ages of 10 and 20.
Etiology - unknown
- correlation between immune incompetence and rate of tumor progression.
- Can metastasize quickly.
Signs and symptoms -
- Presence of a mass, rapid metastases, and associated pain.
- Diagnosis can be made with a biopsy.
Treatment -
- Treatment includes amputation with proximal resection to ensure proper removal of affected tissue or surgical procedures that attempt to resect the tumor and salvage the limb.
- Chemotherapy is beneficial, however, radiation is not effective with this type of tumor.
