PATHO Exam 2 ✅ Flashcards
Ascites
The accumulation of fluid in the peritoneal cavity, causing abdominal swelling and abdominal extension
Causes: CHF, liver cancer (sclerosis).
Alopecia
The partial or complets abscence of hair from areas of the body where it normally grows; baldness.
Ex: cacaner.. come from chemotherapy
Anaplasia
The loss of the mature or specialized features of a cell or specialized features of a cell or tissue, as in malignant tumors. cells divide rapidly and do not look or function like normal cells.
CANCER
Poorly defrentiatied cells.
Angiogenesis
The development of new blood vessels
Cancer does this .. maligenent tumors.
Anorexia
An eating disorder leading to low body weight and; lack or loss of appetite for food
Cancer iteself and chemo and medication causes this. Anorexia from these
Apoptosis
The death of cells as a normal and controlled part of an organism’s growth or development. Also called programmed cell death.
More growth than cell death. Cancer cells do whatever they want.
Asbestos
A heat-resistant fibrous… it is inhaled that causes cancer
Carcinogenic; it causes asbestosis.
Atrophy
Waste awayl the body parts which are no longer required gradually atrophy (waste away)
Decrease in cell size.. meaning decrease in organs and tissue
Decrease of using tissues does this
Autonomy
The right or condition of self-government
Doing whatever they want (cancer). No good cellular recognition, do whatever they want
Benign
A growth that is not cancer. It does not invade nearby tissue or spread to other parts of the body.
Ex: they still have well cell diffrentiated, good cellular reconition, communitation, not going to bleed,encaspulated,
Biopsy
called a pathologist looks at the cells or tissue under a microscope to check for damage or disease. The pathologist may also do other tests on it. Biopsies can be done on all parts of the body
A requirement to diagnose cancer. Tell us wher ethe cancer originated.no cancer diagnosis can be done withut a biopsy
Cachexia
A condition that causes the body muscles to waste away. It comes with extreme weight loss and can include loss of body fat. It’s one of the symptoms that appear when you have a chronic condition, including: Chronic renal failure. HIV.
That is seen in cancer patient. Low albumins (proteins/colloids)
Malnourished people is not gonna pull the fluids into the blood vessels and cause edema.
Carcinogen
a substance capable of causing cancer in living tissue.
A cancer causing agent.
Colonoscopy
A procedure that put a camera into the colon to see whats going on
Diffrentiated
The cells of the cells are going to look the same. Act the same and…
I know the cell is from brain becayse its diffrent from the other organ
Dysplasia
Can be caused by an infection or irritant. If they stay they can continue on to cancer
It can be reversible. (More definition)
Effusion
An escape of fluid into the body cavity
Ex: pleura effusion (fluid in the lung)
Can cause fluid overload. Can occur in patient with cancer. Reocurent plueral effusion we see that the patient may have cancer
Encapsulated
The cells are in a nice round shape
Ex: benign cells
Friable
Cancer cells are easy to break off; they dont stick together well.
Hyperplasia
Increase of number of cells in a tissue. Ex: prostate gets large
Hypertrophy
Increase in cell size ex: wokout
Immunotherapy
When T-cells are used to help fight cancer cells. It can help to direct therapy as well. Or use a number of diffrent cells to kill the cancer
Invasion
The movement of cancer cells into the normal places..
More definition
Lymphedema
Lymph fluid bulds up and causes swelling. Cancer spread to lyphnodes (more def.
0
Malignant
Its cancerous. Not well diffrentiated. Its not encapsulated. The cells dont stick together, friability, no apoptosis, pseudopods.
Mammogram
A diagnostic test to test forcancer
Metaplasia
Its the least likely to lead to cancer
Metalasia, dysplasia then anaplasia (in order)
Metastasis
It sread to anoth area to survive (the cancer). (More def.)
Monoclonal
….. The sponataneous …errors during the changes of the genes
Oncogene
An oncogene is a mutated gene that has the potential to cause cancer
Palliative
Not curing there… its not hospice (expected to die in 1 month)
We are going to do whatever we can to treat.. extend treamnt as long as they can. And make them comfortable. To help families deal with the emotions
PAP test
Screening procedure for cervical cancer.
Pathologic fracture
Easily get injured beccause of cancer; a fractuure that occur when it shouldnt
Due to haveing hypercalcemia low amounts of calceuim in the bone. And in the blood.
Primary site
Where the cancer originated.
Projections
Uneven peices of the cancer cells.. have all these projectioons that are sticking out or pesudopods.
PSA (prostate specific antigen)
To detct prostate cancer. If elevated.. it tells. Us that the male has prostate cancer
Radiation therapy
Using radiation to kill cancer cells.
Can damagenormal cells as well.
Recognition
Your body has the ability to recognize the cells.. they can recognize each other… cancer cells poorly…
Seeding
A stite they can drop off and live in……….
Sentinel node
Sentinel nodes are the first lymph nodes where cancer cells might spread from a tumor
Serous
A drainage.. iits not blood looking its straw looking
Stages
Different size of cancer, tumor, TMN, the higher the grading, the worst to cancer
Stem cells
Stem cells are special human cells that have the ability to develop into many different cell types, from muscle cells to brain cells.
Stool for occult blood
The name of the test is guaiac test.
TAF (tumor angiogenesis factor)
Help the tumor grow the blood vessels
VEGF
Vascular endothelial growth factor ; Help vascularize the blood vessels/A substance made by cells that stimulates new blood vessel formation. Also called vascular endothelial growth factor.
Proliferation
The process of cell division, inherent adaptive process for cell replacement or the need of additional cells.
Ex: neoplasm(excessive, uncontrolled. Growth)
Differentiation
The process of specialization
Ex: brain cells are different from heart cells… different organs differentiate from each other.
Benign neoplasm
Well diffentiated, resemble counterpart but have lost ability to control proliferation.
- more differentiated, slower growth; doesnt grow fst like malignant.
Malignant neoplasm
Less differentiated (undiffrentiatted), lost ability to control cell proliferation and differentiation. Has autonomy. (Acts different than the cells around them;dont care. ); looks different than thee either cells around them.
Parenchyma cells
SPECIFIC functional cells of an organ or tissue. Tissue that is made up of transformed or neoplastic cells
determine behavior and component for which it is named
Autonomy
Auto rinse stimulation allows metastasis
Andenoma
Benign EPITHELIAL neoplasm of glandular tissue
Fibroma
Benign tumor or FIBROUS tissue.
Adenocarcinoma
MALIGNANT tumor of glandular tissue.
Squamous cell carcinoma
MALIGNANT tumor from squamous cells
Sarcoma
Malignancy from mesenchymal origin
tumor that occurs in the bones and soft tissues.
Sarcoma is an uncommon group of cancers which arise in the bones, and connective tissue such as fat and muscle. In most cases, it’s not clear what causes sarcoma. Family history and exposure to chemicals or radiation may increase risk.
Polyps
AKA Adenomatous poly; usually precursor to adenocarcinoma of the colon (sign of cancer in colon)
Spread of cancer
- Direct invasion and extension
- seeding
- metastatic spread through lymphatic or vascular pathways
Epigenetic factors
Silencing a gene or genes
Proto-oncogenes
Proto-oncogenes are a group of genes that cause normal cells to become cancerous when they are mutated /overactive that progress too cancer
Tumor suppressor genes
Tumor suppressor genes are normal genes that slow down cell division, repair DNA mistakes, or tell cells when to die (a process known as apoptosis or programmed cell death). When tumor suppressor genes don’t work properly, cells can grow out of control, which can lead to cancer.J
Carcinogenesis
The process by which normal, healthy cells transform into cancer cells is termed carcinogenesis or oncogenesis. The development of a malignant tumour in otherwise healthy tissue is the result of a complex series of events beginning with a single cell that has acquired malignant properties through cellular DNA damage.
Ex; monoclonal origin, oncogenes, oncogenic pathogens, chronic inflammation.
Monoclonal origin
When cells are dividing, theres an error/ Spontaneous transcription errors occurring during cell reproductions. / errors when cells are dividing
Oncogenes
Mutations that occur in gametes are passed on to successive generations. / mutated cells that passed on to offspring
Oncogenic pathogens
Pathogens that causes cancer ex: HPV, viruses, Humann T-cell leukemia, lymphoma virus, kapoks sarcoma herpes virus.
Chronic inflammation
May cause cancer; prompts increase in growth factors, stimulate cell changes ex: asbestos, ETOH (ethanol ), ulcerative colitis
BRCA-1 & BRCA1
genetic susceptibility of breast CA, also known to
increase risk of ovarian, prostate, pancreatic, colon an other cancers
-Many demonstrate autosomal dominant pattern- increasing risk of
tumor development
You only neeed ONE to delve- cancer
Pleural effusions
buildup of fluid between the tissues that line the lungs and the chest.
Fluid can accumulate around the lungs due to poor pumping by the heart or by inflammation.
Manifestations of cancer
Ulceration, necrosis, and infection
Bleeding and hemorrhage- caused by friability of tumors and fragility
of new blood vessels
Anemia, vascular thrombosis (blood clots), tissue damage, cytokine action (cancer is invading and breaking down tissue)
Cachexia, hypercalcemia (the cancer is competing with the calcium in the bones.. so calcium goes out of the bone and into the blood stream, while the cancer goes into the bones; this leads to pathologic fracture due to bone weakness…if someone simply bumps into a wall and broke their shoulder.. they have cancer.. too easy/fragile)
Fatigue/tiredness
A prostate-specific antigen (PSA)
There is a blood test that measures the amount of PSA in blood.. if PSA hit, it may signify prostate cancer.
Seeding
cells break off from the main tumor and float within a body
cavity where they attach to a nearby organ or cavity (prostate ca to
local bone)
Invasion
tumors spread to adjacent local structures (example
pancreatic cancer spreads to stomach, intestines or liver)
Distant metastasis:
Cells break off from main tumor and are
transported by the venous blood to organs that are well suited for cell
growth.
• Ex. Ovarian often to lungs • Ex. Lungs ca to brain
Microarray technology
Identify tumor types, prognosis, response to treatment.
Hypothalamus
Monitors blood osmolity. When osmolality increases, thirst is stimulated
-monitors BP.. when BP decreased, thirst increase.
Filtration needs
Peeing; obligatory urine output it’s the minimum amount of urine needed to rid the body of waste products (400-600 ml/day)
Insensible water loss
Immeasurable loss through respiration, feces, skin ect.
Renal regulation
adapts to bodily needs. Glomerular
filtration is highly dependent on cardiac output and renal
perfusion. Also varies according to various substances
including ADH, aldosterone, prostaglandins, glucocorticoids,
ANH (Atrial natriuretic hormone)
(There are substances that tell us to retake fluids
Antidirected hormone: help us hold on to fluid; also can be inhibited when BP is too high.. it wil not be released )
Extracellular compartment
Extracellular is the same as intravascular
- interstitial (tissue) spaces
- plasma (vascular) compartment
- transcellular compartment
Total albumin
In the loud stream is indicative of the protein NUTRITIONAL STATUS of the body
Hypoalbuminemia
Causes edema; Low albumin in the bloodstream causes low oncotic
pressure.
• Low oncotic pressure is lower than the hydrostatic
pressure at the capillary membranes.
• This condition results in edema.
Major solutes
major solutes are albumin, sodium (Na+), potassium
(K+), phosphate (Po4-), magnesium (Mg++), calcium (Ca++),
bicarbonate (HCO3-), and glucose.
Sodium
the main determinant of osmolarity, is a positive ion, also
called a cation; it is found mostly in the extracellular fluid and assists
in the maintenance of fluid balance and osmotic pressure.
Osmotic pressure
Concentration of a solution
Potassium
Is the main in intracellular cation;; it assist in the maintenance o neuromuscular excitability and acid-base balance.
Both sodium and potassium require the cell’s
sodium/potassium ATPase pump to maintain Na+ as the extracellular
ion and K+ as the intracellular ion.
Toxicity
Refers to the amount of solute in the solution compared with the amount in the blood stream.
NA/K Pump
ATP keeps pumping Na into ECF and K into the cell (tissue)
Isotonic
Same toxicity as the cell
Ex: normal salin (0.9 NaCl) ;used for increasing blood volume in patient
Hypotonic
Less toxicity than the cell causing cell swelling (0.45% NaCl); used for patients who are dehydrated.. doesn’t increase blood volume but hydrate patient
Hypertonic
Greater toxicity than the cell; this. Red cells shrink when administered (cremation) 3% NaCl or Hespan.
Ex: for renal patients (retaining fluids) or someone with really low sodium.
Osmoreceptors
Helps with. Maintain homeostasis.. ex:when concentration is high, start the sensation of thirst at hypothalamus to make the person thirsty, also releases ADH (anti diuretic hormone) to hold on to fluids.
If concentration is too low, will inhibit ADH and increase concentration by peeing.
Renin-angiotensin-aldosterone system (RAAS)
The renin-angiotensin-aldosterone system is a series of reactions designed to help regulate blood pressure and fluid balance.
Ex:When blood pressure falls (for systolic, to 100 mm Hg or lower), the kidneys release the enzyme renin into the bloodstream.
Natriuretic hormones
Natriuretic hormones (NH) are compounds that act in an endocrine to regulate extracellular fluid volume and blood pressure (BP) through the stimulation of sodium excretion by the kidney
Fluid volume deficit
IS WITH WATER ONLY… deficit in water.
S&S Thirst
• Decreased urine output, Increased urine SG (Specific
Gravity)
• Hemoconcentration
• Increased Hct (Hematocrit) • Increased BUN
- tachycardia but pulses are weak and th ready because lack of fluid
- postural hypotension
-prolonged capillary refill time
-hypotension and shock.
Intestinal obstruction
Ascites, edema and burns (shift of fluid)
All causes fluid volume deficit.
Fluid moved to intersitual spaces.
Fluid volume excess
Due to inadequate renal losses due to CHF (congestive heart failure), cirrhosis of the the liver(scar tissues are developed and leaves to Ascites), increased corticosteroid levels (causes body to hold on to fluid),
EXCESSIVE SODIUM AND WATER INTAKE (dietary, meds, parental solutions contains sodium_)
Pulmonary edema.
Inadequate Renal Losses • Renal disease • Increased corticosteroid levels • CHF • Cirrhosis of the liver
Third space fluid accumulation
Aka EFFUSION.. When fluid shift into cellular tissue and there i fluid overload. Can happen in cancer patient
During illness, fluids can become sequestered in body cavities
such as the pericardial sac, peritoneal cavity, and pleural space.
When this occurs, it is referred to as third space accumulation
of fluids. The fluid that accumulates in these cavities is
commonly called an effusion.
Syndrome of Inappropriate ADH (SIADH)
Patients cant reabsorb and regulate the right way…hold on to too much fluid in the blood and can dilute concentration ; patient Can end up with having HYPONATREMIA
Diabetes Inspidus (DI)
Two types:
Neuro genetic DI: aka central DI…. Deficiency of ADH; commonly seen after traumatic brain injury (TBI)
Decreases response of the kidneys to ADH
Patients are unable to concentrate their
urine leading to hypertonic and hyperosmolar dehydration.
Dehydration
Dehydration is a state of diminished water volume in the body.
Deficit of intracellular fluid, which causes body cells to shrink.
Decreased amount of water in the extracellular fluid.
Same symptoms of fluid volume deficit.
Oliguria
the production of abnormally small amounts of urine.
Urine production is less than 400ml/day
Orthostatic Hypotension
Orthostatic hypotension, which occurs in dehydration, is a systolic blood pressure decrease of at least 20 mm Hg or a diastolic blood pressure decrease of at least 10 mm Hg within 3 minutes when going from a lying to a standing position.
Sodium
Normal range: 135-145
Minimum RDA: 500mg a day
Regulation: kidneys, GI, skin
• Hormonal regulation: aldosterone increase
retains sodium and therefore water, as well.
Angiotensin II, ACTH and cortisol increase
the production of aldosterone. • Main function: fluid regulation • Target organ: brain
Hyponatremia
Fewer than 135mEq
Causes of Hyponatremia
• Not enough intake • Vomiting/diarrhea • Excess sweating • Burns, wounds • Increased ADH levels
• Stress, pain, trauma
• SIADH
• Medication (morphine, antineoplastic agents, hypoglycemic
Severe hyponatremia: fewer than 125 has a high mortality rate.
S&S:
Headache • Lethargy • Apathy • Confusion • Nausea/Diarrhea • Fluid overload • Vomiting, abdominal cramping • Muscle cramps and spasms
Patients that come in confused.. (usually the elderly,) check for sodium levels and UTI
agents, SSRI’s
Hyernatremia
HIgher than 145 mEq
• Excessive Sodium Intake • Decreased extracellular losses( Increased water loss, Hormones )
• Decreased water intake • Hemoconcentration
Lab findings above 145 mEq/L • Dry mucous membranes, • Restlessness, decreased reflexes, convulsions (seizure),
hyperactivity • Tachycardia, hypotension
- Sometimes hypernatremia can cause water retention.. sometime fluid goes up or down.. they may gain weight.. extra fluid levels go up and blood pressure goes up..
Potassium
• MOST IMPORTANT ELECTROLYTE • Normal is 3.5 – 5.0 mEq/L • Adults require 50 to 100 mEq/L/day. • Regulation: kidneys • Foods rich in Potassium are: bananas,
orange juice, lentils, raisins • Target organ: Heart – main function is
smooth electrical conduction to the muscles
If you notice they hav renal disease.. look at potassium levels.. they may have higher levels than normal
Hypokalemia
Below 3.5
Diuretic therapy (K+ wasting
diuretics) the most common cause • Poor po intake • GI losses – vomiting, diarrhea, NG
sxn, ostomy drainage • Steroid therapy
S&S: Cardiac arrhythmias (irregular heartbeat)• Tachycardia
treatment: remember to never ever ever ever give potassium IV pUSH!!! YOU CAN KILL THEM.! IT HAS TO BE DILUTED. IT HAS TO BE DILUTE DONT GIVE PTASSIUM IV PUSH
GIVE OVER PIGGY BAK INSTEAD… it burns though
Hyperkalemia
Greater than 5.2
Excessive intake (po or IV) • Massive crushing injuries • Inadequate renal losses
(Renal failure,
Adrenal insufficiency – Addison’s Disease, Potassium sparing diuretics)
S&S :Dysrhythmias, bradycardia
If hyperkalemia is severe (greater than 7.0 mEq/L), rapid
treatment is needed to move K+ from ECF to ICF. Continues ECG monitoring.
Treatment: IV 50% dextrose, 10 units of regular insulin, and 75 mEq of
sodium bicarbonate
-LASIX (diuretic)
Calcium
Normal range: 8.5 – 10.5 mg/dL (total)
4.5 – 5.6 mg/dL (ionized)
• Sources: dairy products, green leafy
vegetables
Hormonal regulation:
• Parathyroid hormone raises Ca by pulling
it from bone and into the blood• Calcitonin (produced by the thyroid)
lowers serum Ca by storing it in bones by pulling from the blood. • Main function: bone development, blood
clotting, smooth muscle contraction • Target organ: Skeletal muscles
Vitamin D
Facilitates the absorption of calcium from the GI tract and into the bloodstream.
Calcitonin
A hormone produced by thyroid, acts at the bone and kidneys and pulls calcium from circulation aand into bone
Calcium and phosphorous
Are major mineral contents of bone.
There is a reciprocal relationship between calcium and phosphate ; when there is an increase in calcium in the blood, there is a decrease in phosphate—and vice versa.
Hypocalcemia
Les than 8.5
Can occur when patient dont have enough VITAMIC D… not enough absorption.. impaired absorption, renal failure, liver
disease.
Impaired ability to mobilize Ca from bone => hypo
parathyroidism • Abnormal Ca binding
• Decreased serum albumin • Decreased pH • Acute pancreatitis
Low calcium and high phosphorous level
Renal failure patients tend to have low calcium levels and high phosphorous levels
S&S: Muscle spasms of the face – Trousseau & Chvostek • Laryngeal spasm • Tetany(muscle contract) • Seizures
Chvostek
Facial spasm
Due to lack of calcium
Trousseau
Carpal spasm
Due to lack of calcium
Hypercalcemia
Greater than 10.5
Causes:
Too much parathyroids…hyperparathyroidism ;increasing release of calcium into the blood stream.
-cancer
-to much vitamin D or calcium in diet
-increased bone reobsorption. (osteoclasts break down the bone tissue and
release minerals (Ca in this case) to the blood)• Hyperthyroidism
S&S:
Muscle flaccidity (weakness) • Bone tenderness/pain, pathological fractures (fx occur without
trauma) • High calcium concentrations in the urine, which increase
susceptibility to renal calculi (kidney stone)• Constipation • HTN
Hyphophosphatemia
SAME S&S as HYPOCALCEMIA.
Phosphate levels are less than 2.5
• Hormone increased parathyroid decreases
PO4—HYPERPARATHYROID • Increase calcitonin increase PO4 • Causes:
• Not enough intake • ETOH (malabsorption) • Too much loss (antacids binding) • Diarrhea • Low vitamin D
Hyperphosphatemia
Same as hypacalcemia
Same S&S
Below 4.5
Magnesium
Normal range 2.2 – 3.0 mEq/L • Sources: nuts • Regulation: kidneys • Hormonal regulation: Aldosterone
increase lowers magnesium • Target organ: heart
Similar to potassium target organ is the heart
Hypomagnessemia
Less than 2.2
Causes : prolonged diarrhea, laxative abuse, • increased renal excretion of magnesium • serious wounds requiring debridement • Alcoholism • Malabsorption, small-bowel bypass surgery prolonged diarrhea, laxative abuse, • increased renal excretion of magnesium • serious wounds requiring debridement • Alcoholism interfere with absorption • Malabsorption, small-bowel bypass surgery
S&S:
Dysrhythmias
Tachycardia
Hypermagnesemia
Greater than 3.0 Causes: Blood level of greater than 3.0 mEq/L • Most common cause = renal failure • Excess intake, usually antacid form • Low aldosterone, adrenal insufficiency • S&S • Dysrhythmia • Bradycardia
Volatile acids
Excreted from the body as a gas
Ex: the lungs excrete volatile acids. Like CO2
Non volatile acids (fixed acids)
Cannot be made into a gas, must be excreted through kidneys as a liquid.
Ex: kidneys excrete non-volatile acids and retain bicarbonate as a buffer for acids.
Like eliminating H+ and reabsorb if or generating HCO3 (bicarbonate)
