Exam 2 Patho Etsu

Acute Myeloid Leukemia (AML)

- Too many myeloblasts ( small stem cells) (immature) - hudson says in most often occurs in children? but others say adults

What does cancer staging involve?

- determine the size of the tumor -the degree to which it has locally invaded -the extent to which it has spread (metastasized)

Types of kidney stones

-Calcium oxalate (80%) -Struvite -Uric Acid

Chronic Lymphocytic Leukemia (CLL)

-Too many immature lymphocytes. predominant cell is mature but does not function normally -Most common in older adult - Follows a slow chronic course

Chronic Myelogenous Leukemia (CML)

-both mature and immature granulocytes are present in large numbers in the marrow and blood -3 stages: Chronic (2-5 years) Accelerated ( 6-18 months) Acute ( 3-6 months) -most often occurs in adults

Acute Lymphocytic Leukemia (ALL)

-presence of undifferentiated or immature cells, usually lymphoblast cells -Fast growing - Relapse common

What is leukemia?

A cancer of white blood cells/leukocytes.

hyperopia

A condition in which visual images come to a focus behind the retina of the eye and vision is better for distant than for near objects -- called also farsightedness.

- Arises from skin, joints, and muscles -A delta fibers: pain is sharp and well localized -C fibers: dull, aching, and poorly localized

Acute "Somatic" pain

-Pain in the internal organs and lining of body cavities -Transmitted by C fibers: poorly localized with an aching, gnawing, throbbing, or intermittent cramping quality -Often radiates or is referred

Acute "Visceral" pain

- sudden decline in kidney function with a decrease in glomerular filtration and accumulation of nitrogenous waste products in the blood as demonstrated by an elevation in plasma creatinine and blood urea nitrogen -Renal insufficiency -Renal failure -End stage renal failure

Acute Kidney Injury

Children

Acute Lymphocytic leukemia is most common in ...?

-Protective mechanism ( alerts an individual to a condition or experience that is immediately harmful to the body) - lasts sec. to days or up to 3 months - begins suddenly and relieved after pain stimulus removed

Acute pain

absence of urine

Anuria

- primary condition of bone marrow depression, results in reduction of all 3 hematopoietic cell lines ( red, white, platelets) - Symptoms: fatigue, pallor, petechiae, bleeding (from gums, nose, or GI), infections -Causes: radiation, chemical (chemo), toxins, drugs ( anti retroviral) , idiopathic, cancer -Treatment: bone marrow transplantation, transfusions, steroids

Aplastic Anemia ( Normocytic Normochromic )

10-20

BUN - Blood Urea Nitrogen (mg/dl)

- remain limited to their original location -Grow slowly ( capsulated in sandwich bag) -Well defined capsule -Well invasive -Well differentiated Slow mitosis Localized ( does not get into blood streams)

Benign tumors

8.5-10.5 mg/dL

Calcium levels

-Pre invasive epithelial tumors of granular or epithelial origin - Surveillance for cancer -Detects abnormal growth in epithelial tissue with atypical cells and increased proliferation -These are early stage cancers that have not broken through the basement membrane or invaded the surrounding stroma

Carcinoma in situ

Older adults

Chronic lymphocytic leukemia is most common in...?

-May be persistent or intermittent -May be sudden or develop insidiously -Usually defined as lasting as least 3 to 6 months -Response patterns vary -Produces significant behavior and psychologic changes -Usually do not see physiologic signs as in acute

Chronic pain

0.6-1.2 mg/dL

Creatinine levels

-absorption of folate occurs in the upper small intestine -not dependent on any other factor -treatment: requires daily oral administration of folate

Folate deficiency anemia (MACROCYTIC-NORMOCHROMIC)

-inflammation of the glomerulus -caused by primary glomerular injury: immunologic responses -> post streptococcal glomerulonephritis -or caused by secondary glomerular injury: diabetes, HIV Manifestations: can be sudden or insidious onset can have significant damage before symptoms develop Severe: Oliguria ( less than 30 ml/hr) hypertension renal failure symptoms: hematuria with red blood cell casts proteinuria

Glomerulonephritis

- painless, progressive, rubbery, enlargement of a single node or group of nodes, usually in neck area - REED STERNBERG CELL ONLY IN HODGKINS : distinctive tumor cell found with lymph biopsy -Good prognoisis -Derived from B cells -linked to EBV -Symptoms: fever, weight loss, night sweats, adenopathy, pruritis, mediastinal, mass, splenomegaly, and abdominal mass treatment: Chemo therapy , radiation, surgery

Hodgkin's lymphoma

What is leukemia caused by?

Increased numbers of abnormal white blood cells are produced

-most common type of anemia worldwide -nutritional iron deficiency or blood loss, metabolic or functional deficiency = blood loss because body uses iron when it bleeds -Manifestations: when serum hgb decreased to 7 or 8 gm/dl - Symptoms: fatigue, weakness, shortness of breath, pale ear lobes and palms, conjunctiva, red sore and painful tongue, spoon shaped nails

Iron deficiency anemia ( MICROCYTIC HYPOCHROMIC ANEMIA)

WBC count is higher than normal - a normal protective physiologic response to physiologic stressors

Leukocytosis

WBC count lower than normal - a low white blood count can make patient vulnerable to infections

Leukopenia

-enlarged lymph nodes that become palpable and tender - local and general -local: drainage of an inflammatory lesion located near the enlarge node -general: not connected nodes, occurs in the presence of malignant or nonmalignant disease such as autoimmune disease infections

Lymphadenopathy

- Large erythrocytes: normal Hgb -pernicious anemia

Macrocytic- Normochromic Anemia ( BIG NORMAL HEMOGLOBIN)

-Grows rapidly -not encapsulated -invasive -poorly differentiated cells -can spread distantly ( metastasis)

Malignant tumors

-red blood cells that are abnormally small and contain reduced amounts of hemoglobin

Microcytic Hypochromic Anemia (SMALL LOW HEMOGLOBIN)

- B cell cancer characterized by malignant proliferation of plasma cells that infiltrate bone marrow and aggregate into tumor masses in skeletal system. - destroys myeloid cells, makes them become cancerous, and attack bone and causes pain Symptoms: (C)alcium elevation (hypercalcemia) (R)enal impairment ( shuts down the renal system and kidneys) (A) anemia (B) bone pain

Multiple Myeloma (MM)

nearsightedness

Myopia

- glomerular inflammation due to the kidney serving as the antigen -causes: post infectious glomerulonephritis acute viral infections -symptoms: hematuria, edema, azotemia, proteinuria, BUN and serum creatinine increased urine output

Nephritic syndrome

-excretion of 3.5g or more of protein in the urine per day -the protein excretion is caused by glomerular injury -symptoms: high blood pressure, cholesterol, swelling (edema) of the eyelids, feet and abdomen, hypoalbuminemia, vitamin D deficiency, proteinuria

Nephrotic syndrome

-Chronic -Amplification of pain without stimulation -Described as burning, shooting, shock-like, or tingling

Neuropathic pain

-HAS NO STERNBERG CELLS - neoplastic disorder of lymphoid tissue - SPREADS FAST AND EARLY -> liver, spleen, and bone marrow -POOR PROGNOSIS

Non Hodgkin's lymphoma

characterized by red blood cells that are relatively normal in size and hemoglobin content by insufficient in number

Normocytic Normochromic Anemias

small amounts of urine, less then 400 mL/day

Oliguria

a malignant tumor of bone in which there is a proliferation of osteoblasts.

Osteosarcoma

occurs if cells crowd bone marrow; decreased production of all normal blood cells

Pancytopenia

- caused by a lack of intrinsic factor from the gastric parietal cells; chronic atrophic gastritis, alcoholism, malnutrition - required for vitamin b12 absorption -results in vitamin b12 deficiency - Symptoms: nerve demyelination -treatment: high doses of vitamin b12

Pernicious anemia ( MACROCYTIC NORMOCHROMIC)

150,000-450,000

Platelet count

excessive urination volume due to diabetes mellitus

Polyuria

3.5-5.0 mEq/L

Potassium levels

-an infection of one or both upper urinary tracts ( ureter, renal pelvis, and insterstitium) -types: acute pyelonephritis chronic pyelonephritis

Pyelonephritis

-substance that produces fever -affects the thermoregulatory system in the brain -2 types: exogenous and endogenous -examples : mold and yeast

Pyrogen

distinctive tumor cell found with lymph biopsy ( found only in Hodgkins)

Reed Sternberg cell

-unpleasant sensations with leg movements that occurs when resting and gets worse at night. - an urge to move the legs for relief -most common in pregnancy, older adults, and iron deficiency

Restless leg syndrome

135-145

Sodium levels

1.010-1.025

Specific gravity of urine

Cancer Stages

Stage 1: No metastasis ( no spreading ) Stage 2: Local invasion Stage 3: Spread to regional structures ( lymph nodes) Stage 4: distant metastasis

(T) Primary Tumor: -TX Primary tumor cannot be evaluated -T0 No evidence of primary tumor -TIS Carcinoma in situ -T1,T2,T3,T4 (N) Regional Lymph Nodes: - NX Regional lymph nodes cannot be evaluated -N0 No regional lymph node involvement -N1, N2, N3 involvement of regional lymph nodes ( number of lymph nodes and/ or extent of spread) (M) Distant Metastasis: -MX Distant metastasis cannot be evaluated -M0 No distant metastasis -M1 Distant metastasis is present

TNM Classifications

-(T) for tumor spread -(N) for node involvement -(M) for the presence of distant metastasis -the prognosis generally worsens with increasing tumor size, lymph node involvement, and metastasis

TNM system

Proprioception

The cumulative sensory input to the central nervous system from all mechanoreceptors that sense body position and limb movement.

Metastasis

The spread of cancer cells to different locations beyond their original site in the body -invades blood and lymphatic systems

- decrease in number of circulating platelets - platelet count <150,000 - <50,000= hemorrhage from minor trauma -<15,000= spontaneous bleeding w/o trauma -<10,000=severe bleeding -Causes: hypersplenism, autoimmune diease, hypothermia, viral or bacterial infections that causes DIC, heparin induced thrombocytopenia, HIV, drugs

Thrombocytopenia

30 ml/hr

Urine output

Condition of dizziness, "room spinning"

Vertigo

5,000-10,000

WBC Count

inflammation of the urinary bladder

What is cystitis?

Cachexia

a condition of physical wasting away due to the loss of weight and muscle mass that occurs in patients with diseases such as advanced cancer or AIDS - most severe form of malnutrition -Symptoms: Anorexia, weight loss, anemia, asthenia , taste alteration

Neutropenia

a decreased number of neutrophils

presbycusis

a gradual loss of sensorineural hearing that occurs as the body ages

petechiae

a small red or purple spot caused by bleeding into the skin.

Bence Jones protein

a special protein found in the blood and urine, indicative of multiple myeloma

decreased erythrocyte life span, ineffective bone marrow response to erythropoietin, altered iron metabolism

anemia of chronic inflammation

function of platelets

blood clotting

Ecchymosis

bruising

Cataracts

clouding of the lens

hypoxemia

decreased level of oxygen in the blood

A clot that breaks lose and travels through the bloodstream.

embolus

bleeding from the nose

epistaxis

red blood cell production

erythropoiesis

What is presbyopia?

farsightedness associated with aging -hard to focus on close objects -with age the lens grow harder and less elastic

What are nociceptors?

free nerve endings in skin, muscles, joints, arteries, and the viscera that responds to chemical, mechanical, and thermal stimuli -Can detect a wide range of stimuli: A-delta myelinated fibers and Unmyelinated C polymodal fibers

Conductive hearing loss

hearing impairment caused by interference with sound or vibratory energy in the external canal, middle ear, or ossicles

the normal formation and development of blood cells in the bone marrow

hematopoiesis

cancer risk factors

heredity, chemicals, radiation, physical irritation, diet & viruses

blood in the urine

hermaturia

Tumor markers include....

hormones, enzymes, genes, antigens, antibodies

Glaucoma

increased intraocular pressure results in damage to the retina and optic nerve with loss of vision

Where is erythropoietin made?

it is produced by the kidneys

vitamin K

necessary for synthesis and regulation of prothrombin

Vitamin K deficiency causes

poor blood clotting

presence of protein in the urine

proteinuria

What is Tumor Debulking?

removing a tumor during surgery

M protein

resists phagocytosis Streptococcus pyogenes

the most common form of hearing loss, also called nerve deafness; caused by damage to the cochlea's receptor cells or to the auditory nerves

sensorineural hearing loss

production of abnormal hemoglobin within RBCs

sickle cell anemia

functional incontinence

state in which a person experiences an involuntary, unpredictable passage of urine

pee when sneeze, cough, smile

stress incontinence

What are tumor markers?

substances produced by benign and malignant cells that are either present in or on tumor cells or found in blood, CSF, or urine

chemotherapy induced alopecia

temporary hair loss from chemotherapy

purpura

the appearance of multiple purple discolorations on the skin caused by bleeding underneath the skin ( hemorrhages)

function of erythrocytes

transport oxygen and carbon dioxide

have to pee like right now can't wait -sudden urge

urge incontinence

How is EPO released?

when oxygen levels are low EPO is released by the kidneys