Patho Exam 2 Flashcards
Peritonitis: Describe, manifestations, acute vs. Chronic
Inflammation of the peritoneum activates several protective mechanisms
A thick, sticky exudate that bonds nearby structures and temporarily seals them off
Abscesses may form in an attempt to wall off the infections
Peristalsis may slow down in a response to the inflammation, decreasing spread of toxins/bacteria
Causes: chemical irritation (e.g., ruptured gallbladder or spleen) or direct organism invasion (e.g., appendicitis and peritoneal dialysis)
Manifestations usually sudden and severe; classical manifestation is abdominal rigidity
Abdominal tenderness and pain, decreased peristalsis, intestinal obstruction, nausea/vomiting
Large volumes of fluid leak into the peritoneal cavity
Indicators of infection, sepsis, or shock
Rigid abdomen, severe pain, anorexia
Bowel obstructions: describe, manifestations, most common
Manifestations: abdominal distension, abdominal cramping, colicky pain, nausea, vomiting, constipation, diarrhea, borborygmi, intestinal rushes, decreased or absent bowel sounds, restlessness, diaphoresis, tachycardia progressing to weakness, confusion, and shock/MOST COMMON CAUSE OF BOWEL OBSTRUCTIONS ARE ADHESIONS
Hiatal hernia: describe manifestations, how does it feel
A stomach section protrudes upward through an opening in the diaphragm toward the lung
Causes: weakening of the diaphragm muscle, frequently resulting from increased intrathoracic pressure or increased intra-abdominal pressure; trauma; congenital defects
Risk factors: advanced age and smoking
Manifestations include indigestion, heartburn, frequent belching, nausea, chest pain, strictures, dysphagia, and soft upper abdominal mass (protruding stomach pouch)
Worsen with recumbent positioning, eating (especially after large meals), bending over, coughing
Intra abdominal pressure
Diarrhea and antibiotics use: what can it lead to?
destruction of the normal gut flora
PUD: describe, manifestations
lesions affecting stomach lining or duodenum
NSAIDs and H. pylori
H Pylori: associated with ?
Helicobacter pylori
Most common cause of chronic gastritis
Embeds itself in the mucous layer, activating toxins and enzymes that cause inflammation
Genetic vulnerability and lifestyle behaviors (e.g., smoking and stress) may increase the susceptibility
Intussusception: describe, manifestations, what could this lead to?
Telescoping or invagination into an adjacent portion of the intestine.
Can lead to bowel obstructions
Viral hepatitis : Review all
Viral hepatitis is contagious but most will recover with sufficient time
Advancing age and comorbidity increase the likelihood that liver failure, liver cancer, or cirrhosis will develop
Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis D
Hepatitis E
Pyelonephritis: describe, manifestations : Pre, Intra, Post ? major organism
- Acute or chronic infection that has reached one or both kidneys
- Kidneys become grossly edematous and fill with exudate, compressing renal artery and potentially developing abscesses or necrosis
- Complications: renal failure, recurrent UTIs, and sepsis
- Manifestations: severe UTI symptoms, flank pain, and increased blood pressure
Appendicitis: describe, manifestations, where is the pain usually?
Inflammation of the vermiform appendix, most often caused by an infection
Triggers local tissue edema, which obstructs the small structure
As fluid builds inside the appendix, microorganisms proliferate
Appendix fills with purulent exudate and area blood vessels become compressed
Ischemia and necrosis develop; pressure inside the appendix escalates, forcing bacteria and toxins out to surrounding structures
Manifestations vary from asymptomatic to sudden and severe
Sharp abdominal pain develops, gradually intensifies (over about 12–24 hours), and becomes localized to the lower right quadrant of the abdomen (McBurney point)
Pain may occur anywhere in abdomen; will temporarily subside if the appendix ruptures, and then the pain will return and escalate
Manifestations
Nausea, vomiting, abdominal distension, and bowel pattern changes
Indications of inflammation and infection (e.g., fever, chills, and leukocytosis)
Indications of peritonitis (e.g., abdominal rigidity, tachycardia, and hypotension)
Urgent diagnosis and treatment are crucial
RLQ pain, fever, nausea, diarrhea, rebound tenderness
GERD: describe, manifestations, what can chronic GERD lead to?
Gastroesophageal reflux disease (GERD): chyme or bile periodically backs up from the stomach into the esophagus, irritating the esophageal mucosa
Causes: certain foods (e.g., chocolate, caffeine, carbonated beverages, citrus fruit, tomatoes, spicy or fatty foods, and peppermint), alcohol consumption, nicotine, hiatal hernia, obesity, pregnancy, certain medications (e.g., corticosteroids, beta blockers, calcium-channel blockers, and anticholinergics), nasogastric intubation, and delayed gastric emptying
Manifestations: heartburn, epigastric pain (usually after a meal or when recombinant), dysphagia, dry cough, laryngitis, pharyngitis, regurgitation of food, and sensation of a lump in the throat
Esophageal Cancer
Gastroenteritis-left untreated leads to?
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Gallstones: describe, manifestations, where is the pain usually?
a common condition that varies in severity based on size, but affects both genders and all ethnic groups relatively equally
Cholecystitis: inflammation or infection in the biliary system caused by calculi
Manifestations: biliary colic, abdominal distension, nausea, vomiting, jaundice, fever, and leukocytosis
Obstruct the bile duct, severe RUQ pain.
Dysphagia: definition, what might with see with someone who has this?
Difficulty swallowing could show signs of weight loss, anorexia
Duodenal Ulcer: describe, manifestations, when would the pain occur?
Epigastric pain 30 minutes to 2 hours after eating when stomach is empty or in the middle of the night.
Crohns: describe, manifestations, what umbrella term does it fall under, where are the lesions?
Crohn’s disease
Insidious, slow-developing, progressive condition often develops in adolescence
Characterized by patchy areas of inflammation involving the full thickness of the intestinal wall and ulcerations (skip lesions); wall is thick/rigid and lumen is narrowed
Manifestations: abdominal cramping and pain (typically in the right lower quadrant), diarrhea, steatorrhea, constipation, palpable abdominal mass, melena, anorexia, weight loss, and indications of inflammation (e.g., fever, fatigue, arthralgia, and malaise)
Inflammatory Bowel Disease
Ulcerative Colitis : describe, manifestations, what umbrella term does it fall under, where are the lesions?
Progressive condition of the rectum and colon mucosa usually develops in 20s–30s
Manifestations: diarrhea (usually frequent [as many as 20x daily], watery stools with blood and mucus), tenesmus, proctitis, abdominal cramping, nausea, vomiting, weight loss, and indications of inflammation (e.g., fever, fatigue, arthralgia, and malaise)
Inflammatory bowel disease
Lesions are limited to the intestinal mucosa
Acute gastritis: described manifestations
Inflammation of the stomach’s mucosal lining (may involve the entire stomach or a region)
Acute gastritis
Can be a mild, transient irritation, or it can be a severe ulceration with hemorrhage
Usually develops suddenly and is likely to be accompanied by nausea and epigastric pain
Stress Ulcer: describe, manifestations
Develop because of a major physiological stressor on the body due to local tissue ischemia, tissue acidosis, bile salts entering the stomach, and decreased GI motility
Curling’s ulcers: stress ulcers associated with burns
Cushing’s ulcers: stress ulcers associated with head injuries
Most frequently develop in the stomach; ulcers can form within hours of an event; often hemorrhage is first indicator as ulcer develops rapidly and is masked by primary problem
epigastric or abdominal pain, abdominal cramping, heartburn, indigestion, nausea, and vomiting
Occult blood: what is it, when would we might need to assess for it?
Gastric Cancer
Diverticulitis: describe, manifestations, where is the pain usually?
Conditions related to the development of diverticula, outwardly bulging pouches of the intestinal wall that occur when mucosa sections or large intestine submucosa layers herniate through a weakened muscular layer
May be congenital or acquired
Thought to be caused by a low-fiber diet and poor bowel habits that result in chronic constipation
Diverticulitis: diverticula become inflamed, usually because of retained fecal matter (often asymptomatic until it becomes serious)
Potential for fatal obstruction, infection, abscess, perforation, peritonitis, hemorrhage, and shock
Manifestations: abdominal cramping, passing frank blood, low-grade fever, abdominal tenderness (usually left lower quadrant), abdominal distension/mass, constipation, obstipation, nausea, and leukocytosis
Left lower quadrant pain
Fever
Nausea and vomiting
Colorectal Cancer: describe, manifestations
High-sensitivity fecal occult blood test every year plus fecal immunochemical tests
Manifestations: lower abdominal pain and tenderness, blood in the stool (occult or frank), diarrhea, constipation, intestinal obstruction, narrow stools, unexplained anemia (usually iron deficiency), and unintentional weight loss
Jaundice: definition, what organ are we concerned for?
yellowing of the skin, liver
Portal Hypertension: what is it, what does it lead to?
Portal vein backs up with blood
cirrhosis
Esophageal varices: what is it, manifestations? What can it lead to?
hematemesis
cirrhosis
Hematemesis: definition
Hematemesis: blood in the vomitus
Has a characteristic “coffee grounds” appearance resulting from protein in the blood being partially digested
Blood is irritating to the gastric mucosa
Can occur from any conditions that cause upper GI bleeding
Epispadias: describe
Urethral meatus occurs on the dorsal surface of the penis and may extend the entire length of the penis; can also affect females, placing the meatus in the clitoris
Dialysis : what is it for? What major electrolyte should we watch out for if a patient skipped dialysis and why?
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Obstruction in the renal system: Pre, Intra, Post: KNOW ALL THREE-REMEMBER TOP, MIDDLE BOTTOM
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Prostatitis:describe/manifestations
Inflammation of the prostate that can be acute or chronic
Causes: conditions that trigger the inflammatory process
Manifestations: dysuria; difficulty urinating; frequency; urgency; nocturia; pain in the abdomen, groin, lower back, perineum, or genitals; painful ejaculations; indications of infection; and recurrent urinary tract infections
Candida: describe/manifestations
Yeast infection caused by the common fungus Candida albicans
Opportunistic infection that can arise anywhere in the body
In the reproductive system, candidiasis most frequently occurs in the vagina and is a common cause of vaginitis (inflammation of the vagina)
Manifestations: thick, white vaginal discharge that resembles cottage cheese; vulvular erythema and edema; vaginal and labial itching and burning; white patches on the vaginal wall; dysuria; and painful sexual intercourse
Epididimitis: describe/manifestations
ascending bacterial infections or sexually transmitted infections, tuberculosis, and the antidysrhythmic medication amiodarone (Cordarone)
indicators of infection; scrotal tenderness, erythema, and edema; penile discharge; bloody semen; painful ejaculation; dysuria; and groin pain
Unilateral testicle pain
Red, swollen
CKD-HTN/DM
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PCKD: describe, manifestations
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