Pathology

Question 1

Dialysis

Answer 1

needed because of renal failure, in which toxic end products of metabolism (urea, creatinine, etc) accumulate in the blood

hemodialyis: the blood is removed from the body and filtered across a membrane to remove impurities

PT consideration: care must be taken in the type of activity to be performed because of the risk of hemorrhage from the anticoagulant
-best done on non dialysis day or just before treatment

Question 2

Ecchymosis

Answer 2

a hemorrhage into the skin resulting in a “black and blue” appearance

may appear with anticoagulant therapy, if platelet count is low, or with trauma

Question 3

3 ways of pathogen transmission:

Answer 3

1- airbourne

• TB, measles
• require special masks and isolation in negative pressure environments

2-Droplet

• respiratory infections spread by cough/sneeze
• regular mask

3- contact

• HIV and hepB spread by touching wounds, dressing, secretions, blood, excretions or contaminated surfaces
• gloves and hand washing

Question 4

AIDS

Answer 4

acquired immunodeficiency syndrome

caused by a retrovirus in which viral RNA becomes part of the host cell DNA

reduces T cells (

Question 5

cellulitis

Answer 5

an inflammation of the CT frequently accompanied by infection

tends to be widespread

skin over the area i hot, red and edematous- often resembling the skin of an orange

tx: antibiotics, elevation, cool/wet dressings

Question 6

dermatitis

Answer 6

superficial inflammation of the skin, characterized by vesicles (when acute), redness, edema, oozing, crusting, scaling and usually itchy

tx: topical meds

Question 7

deep vein thrombosis

Answer 7

=the formation of an abnormal blood clot in a deep vein. if the clot breaks free it may become a PE

• skin may appear cyanotic; may be warm, cool or normal temp
• pain, tenderness or swelling and a + venogram
• postive Homan’s sign- ankle DF and squeeze calf to elicit pain

tx: hospital, bed rest with foot elevated, anticoagulant therapy

Question 8

hemophilia

Answer 8

bleeding disorder - clotting factor deficiency

other symptoms: hemarthoses, joint contractors, muscle weakness, decreased aerobic fitness, postural scoliosis and gait deviations

tx: blood infusions, meds for pain, rest, ice, elevation during an acute bleeding episode; exercise and conditioning during subacute and chronic phases.

Question 9

hepatitis

Answer 9

inflammation of the liver that may be caused by viral or bacterial infections or chemical agents

transmission from blood, body fluids or body tissues, through sexual contact or contaminated needles (hep B)

dx: blood tests with elevated lab values of haptic transaminases and bilirubin, enlarged liver with tenderness, fever and jaundice
tx: IV, analgesics, interferon and vaccines

Question 10

herpes zoster

Answer 10

an acute CNS viral infection involving the dorsal root ganglia

characterized by vesicular eruption and neuralgic pain in the cutaneous areas supplied by peripheral sensory nerves arising along the infected dermatome or myotome
*severe unilateral pain

tx: corticosteroids

Question 11

intermittent claudication

Answer 11

a symptom of arterial insufficiency that results in ischemia to the exercising muscle

relief of pain achieved by resting the extremity

differential diagnosis:

• peripheral pulses are weak or absent with bruits
• limb elevation will result in pallor and the dependent position will cause rubor
• BP measurements will be decreased in affected limb

tx: walking programs help improve collateral circulation and should be done 5-6 days/week for up to 20 min to control pain level

Question 12

lyme disease

Answer 12

an inflammatory disease caused by a spirochete transmitted to humans by tick

“bulls eye” round rash and flu like symptoms
later developments: arthritis, neurological disorders such as neuritis, ataxia or meningitis and cardiac abnormalities

tx: antibiotics, meds for pain relief

Question 13

psoriasis

Answer 13

a chronic disease of the skin with erythematous plaques covered with a silvery scale

may be associated with psoriatic arthritis and joint pain

Question 14

scleroderma (progressive systemic sclerosis)

Answer 14

a chronic, diffuse disease of CT causing fibrosis of the skin, joints, blood vessels, and internal organs

usually accompanied by Raynaud’s

differential dx:

• symmetrical skin induration of distal extremities and face with the skin taut, firm, edematous and firmly bound to subcutaneous tissues
• polyarthralgia with flexion contractors of the fingers, wrist and elbows from fibrosis of synovium