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Peds > pathophy > Flashcards

pathophy Flashcards

1
Q

testicular torsion

A

abnormal attachment of testes dt redundant tunica vaginalis – excessive mobility – twisting of spermatic cord – decreased blood supply, venous congestion – ischemia, necrosis

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2
Q

inguinal hernia incarceration

A

pressure on herniated viscera causes impaired lymphatic and venous drainage – swelling, compression – decreased blood supply – ischemia, necrosis

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3
Q

congenital inguinal hernia

A

patent processus vaginalis causes weakness in the abdominal wall musculature, leading to herniation

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4
Q

undescended testis

A
  • hormonal imbalance (insulin-like factor 3, testosterone)
  • failure of gubernaculm to guide descent
  • failure of processus vaginalis to involute
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5
Q

hydrocele

A

accumulation of fluid in tunica vaginalis dt defect in procesus vaginalis OR
acquired dt inflammatory conditions (trauma, torsion, epididymitis)

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6
Q

Classic CAH

A

deficiency of 21-hydroxylase - substrate in synthesis of aldosterone and cortisol, shunting 17-hydroxyprogestrone to androgen synthesis

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7
Q

CDH

A
  • defect between the abdominal and thoracic cavities with or without herniation of bowel loops into chest cavity
  • Herniated abdominal contents compress the lungs and result in pulmonary hypoplasia
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8
Q

STI

in females

A

increase in estrogen leads to changes in the vaginal epithelium, leading to decreased pH and increased susceptibility to organisms

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9
Q

T1DM, DKA

A
  • autoimmune damage to pancreatic B cells leads to low or absent endogenous insulin
  • decreased gluc utilization in ms and fat; increased production in liver
  • causing hyperglycemia which causes osmotic diuresis and ketone body formation
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10
Q

acute pancreatitis

A

initial insult (injury, infection) causes increase in proenzymes leading to pancreatic autodigestion

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11
Q

acute appendicitis

A

phlegmon or lymphoid hyperplasia causes obstruction, leading to congestion, edema, ischemia, and necrosis

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12
Q

necrotizing enterocolitis

A

dysbiosis due to prematurity, early enteral nutrition causes bacterial overgrowth, leading to inflammation, intestinal ischemia and necrosis

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13
Q

pertussis

A

oragnism and pertussis toxin induces inflammatory response – inflammation, epithelial damage – respiratory sx

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14
Q

kawasaki

A

acute systemic vasculitis of medium-sized vessels

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15
Q

TB meningitis

A

TB bacilli enters CNS, forms casseous lesion, releases gelatinous exudates, causing inflammation, obstruction, infarction, leading to CNS dysfunction

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16
Q

PSGN

A
  • molecular mimicry between antibodies elicited by strep antigen and gbm and
  • direct deposition of strep ag in glomeruli causes complement activation and immune complex formation
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17
Q

HUS

A

infection triggers endothelial injury, leading to platelet aggregation; endothelial injury causes destruction of RBCs and glomerular thrombosis – decreased glomerular filtration

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18
Q

HSP/ IgA Vasculitis

A

IgA deposition in small vessels causes necrotizing vasculitis in end organs such as kidneys

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19
Q

SLE

A

autoantibodies against self antigens form immune complexes and deposit in end-organs, causing inflammation and tissue damage

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20
Q

Septic arthritis

A

hematogenous seeding of synovial space

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21
Q

Intussusception

A

intussusceptum telescopes into intussuscipiens, pulling its mesentery along and causing venous congestion, edema, and bleeding from mucosa, causing bloody stool

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22
Q

RDS

A

surfactant deficiency and/or prematurity causes increased surface tension and alveolar collapse, leading to hypoxia and respiratory distress

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23
Q

SSPE

A

altered measles virus seeds in CNS and reactivates 7-13 years after initial infection, causing behavioral changes, neuro sx

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24
Q

EBV

A

virus enters respi epith, spreads to salivary glands, travels to reticuloendothelial system - causing lymphadenopathy, hepatosplenomegaly

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25
Q

Dengue

A

virus enters bloodstream via bite from mosquito vector, toxins trigger inflammatory cytokines and complement cascade, causing increase vascular permeability

26
Q

leptospirosis

A

leptospira enter body via mucous membranes, break in the skin, or ingestion; cause endothelial damage to small bv and end-organ ischemia

27
Q

bronchiolitis

A

viral infection causes inflammation and obstruction of small airways with edema, mucus, and cellular debris

28
Q

Acute bacterial meningitis

A

bacterial colonization of nasopharynx and subsequent bacteremia causes organism to cross BBB and enter CNS, causing inflammation, injury and meningial irritation

29
Q

Japanese encephalitis

A

virus enters CNS and causes direct neurotoxic effects

30
Q

COVID

A

Viral spike protein binds to Angiotensin Converting Enzyme 2 (ACE-2) receptors in airway epithelial and endothelial cells which:
1. Reduces ACE2 expression in the lungs resulting in acute lung injury,
2. Causes dysregulation of the reninangiotensin system resulting in hemodynamic instability

31
Q

Malaria

A

plasmodium enters bloodstream, enters liver and releases merozoites

32
Q

TTN

A
  • delayed fluid resorption dt lack of maternal squeeze and catecholamine surge
  • increased lung compliance and resistance
  • impaired gas exchange, acidosis
33
Q

MAS

A
  • partial airway obstruction leading to ball-valve effect which allows inflow of air but causes air trapping
  • inhibition of surfactant and inflammation and obstruction of small airways
  • all leading to hypoxemia, hypercapnia, acidosis
34
Q

Hirschsprung

A

absence of ganglion cells in mucosa and submucosa causing inadequate relaxation of bowel wall

35
Q

Diphtheria

A

diphtheria exotoxin inhibits protein synthesis, causes local tissue necrosis and inflammation → formation of gray-brown, leather-like adherent PSEUDOMEMBRANE

36
Q

Bronchial asthma

A

chronic airway inflammation, airway hyperresponsiveness and variable airflow limitation cause respiratory sx (cough, wheezing, DOB)

37
Q

TOF

A

anteriorly and superiorly deviated infundibular septum leading to PROV (pulmonary stenosis, RVH, overriding of the aorta, VSD)

38
Q

ARF

A
  • cytotoxic toxins damage cardiac cells
  • cross-reactivity bet GAS epitopes and cardiac cells (molecular mimicry)
  • M protein binds to collagen type IV and causes inflammation in cardiac cells
39
Q

Tet spells

A
  • decrease in SVR (dt crying, feeding, defecatin) leads to increased venous return, and increased R to L shunting
  • causes acidosis, hyperpnea, further increase in SVR
40
Q

pericarditis

A

fluid within the pericardial layers increases dt infection/inflammation, leading to compression of the chambers and impaired cardiac filling

41
Q

typhoid

A
  • typhoid toxin penetrates intestinal lumen, causes necrosis of peyers patches, leading to inflammation and gastroenteritis;
  • spreads via lymphatics to liver, spleen, BM
42
Q

tetanus

A

spores enter via traumatic injury and release tetanospasmin which inhibits release of glutamate and gaba in NMJ, causing sustained maximal contraction and spastic paralysis

43
Q

botulism

A

ingested spores produce neurotoxin which irreversibly block presynaptic release of acetylcholine, inhibiting NM transmission, causing muscle paralysis

44
Q

rabies

A

virus enters the body via a bite or scratch from infected animal, replicates in ms or skin then enters CNS via retrograde axonal transport, infects brainstem and spinal cord, causing CNS dysfunction

45
Q

poliomyelitis

A

virus enters body via feco-oral route, replicates in small intestine, seeds in CNS
- causes inflammation, edema, neuronal damage, causing flaccid paralysis

46
Q

pulmonary TB

A
  • tubercle bacilli enter the body via inhaled respiratory droplets, cause local inflammatory reaction
  • macrophages phagocytose bacteria, tubercle bacilli multiply within macrophage and form casseous lesions which spread via lymphatics
  • casseous foci in lungs cause inflammation and obstruction, leading to respiratory sx
47
Q

anaphylaxis

A

IgE and other immunnologic mediators, cause mast cell and basophil degranulation
- causing release of histamine, prostaglandin, and other mediators
- cause cutaneous, respi, GI manifestations

48
Q

osteomyelitis

A
  • low velocity blood flow in metaphysis leads to bacterial invasion
  • causing inflammation, proteolysis and osteolysis
49
Q

JIA

A
  • immunologic susceptibility triggered by environmental factor (infection) causes synovitis of peripheral joints with swelling and effusion
50
Q

Myasthenia gravis

A
  • antibodies to Ach receptors lead to impaired NM transmission, causing asymmetric descending muscle weakness
51
Q

Rh incompatibility

A
  • mother with Rh- blood develops antibodies after exposure to Rh+ blood from delivery of 1st bb
  • maternal antibodies to Rh+ blood are passed on via placenta during succeeding pregnancies
  • causes RBC destruction in infant, causing hemolysis and jaundice
52
Q

Breastfeeding jaundice

A
  • decreased milk production leads to dehydration and hemoconcentration of bilirubin, causing less BM and increased enterohepatic circulation
53
Q

Breastmilk jaundice

A
  • beta glucoronidase in breastmilk deconjugates bilirubin and leads to increased enterohepatic circulation
54
Q

ABO incompatibility

A
  • maternal antibodies against ABO factors in fetus form antigen-antibody complexes, causing hemolysis and jaundice
55
Q

G6PD

A
  • glucose 6 phosphate dehydrogenase catalyzes initial step in HMP which protects RBC from oxidative injury
  • deficiency of G6PD makes RBCs more prone to oxidative stress and injury, leading to hemolysis
56
Q

Biliary atresia

A
  • failure of dev or progressive injury of portion or entire biliary system, causing obstructive jaundice
57
Q

Functional constipation

A
  • children develop intentional or subconscious withholding of BM due to a social stressor, toilet training, school entry, or change in diet
  • stool becomes firm and difficult to pass and passage of BM becomes painful
  • causing voluntary withholding of stool to avoid discomfort
58
Q

AOM

A
  • viral URTI causes inflammation of respiratory mucosa
  • increased secretions causes obstruction bacterial overgrowth
  • infection and inflammation of middle ear
59
Q

AOE

A
  • irritation from excess moisture leads to inflammation and increased secretions
60
Q

pnemothorax

A
  • loss of negative pressure in intrapleural space
  • causes lung collapse
  • leading to hypoventilation and hypoxemia

Peds (3 decks)

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