patho 1st exm

what are the two most important predisposing conditions for aortic aneurysms?

atherosclerosis and hypertension

what are Bullae, or "peripheral blebs" a hallmark for

hallmarks of chronic obstructive lung disease, COPD.

what are the three concentric layers of vessel walls ?

•: intima, media, and adventitia selectively involve vessels of only a certain caliber.

what is Intussusception? what is the most common cause of intestinal obstruction in children? how is this condition treated ?

-is movement of one segment of the bowel into another -Intussusception -•children younger than 2 years of age and can usually be treated by barium enema or air enema.

what is verruca plana ?

•flat wart, is common on the face or dorsal surfaces of the hands.

what is Ulcerative colitis characterized as?

- a relapsing disorder patients experiences attacks of bloody diarrhea with expulsion of stringy, mucoid material and lower abdominal pain and cramps that are temporarily relieved by defecation. These symptoms may persist for days, weeks, or months before they subside

what is the largest organ in the body ?

- skin

what is the most common and clinically important neoplastic polyps?

-Adenomatous Polyp -•colonic adenomas, = benign polyps that give rise to most colorectal adenocarcinomas.

what is basal cell carcinoma ?

-Basal cell carcinoma, the most common malignancy worldwide, is a locally aggressive tumor ( Metastasis is very rare.) carcinoma is a common slow-growing cancer that rarely metastasizes. It tends to occur at sites subject to chronic sun exposure and in lightly pigmented individuals. Pathogenesis The molecular hallmark of basal cell carcinoma is loss-of function mutations in PTCH1, a tumor suppressor gene ,

what are the benign Adenomatous Polyp? what are the Malignant?

-Benign •Tubular, Villous, Tubulovillous Malignant : •Adenocarcinoma : •Malignant/Carcinoma

what is the Pathogenesis of celiac disease ?

-Celiac disease is an intestinal immune reaction to gluten, the major storage protein of wheat and similar grains

what is Dysphagia? why does that occur ?

-Difficult or painful swallowing -narrowing, lack of salivary secretion , muscle weakness , neural system problem

example of obstruction example of restriction

-OBSTRUCTION Obstruction is SMALL AIRWAY EXPIRATION obstruction, i.e., wheezing HYPEREXPANSION on CXR RESTRICTION REDUCED lung VOLUME, DYSPNEA, CYANOSIS REDUCED GAS TRANSFER "GROUND GLASS" on CXR

what are Gastric polyps?

-Polyps are nodules or masses that project above the level of the surrounding mucosa.

what is Erythema Multiforme?

-is a hypersensitivity reaction usually triggered by infections, most commonly herpes simplex virus (HSV). It presents with a skin eruption characterized by a typical target lesion.

describe Crohn disease where does it occur ? what occurs ?

-also known as regional enteritis, -•occur in any area of the gastrointestinal tract but the most common sites involved at presentation are the terminal ileum, ileocecal valve, and cecum. -•Transmural inflammation with lymphoid aggregates throughout bowel wall; noncaseating, poorly formed granulomas in all tissue layers - & Ulceration

what is Capillary hemangioma? what are Juvenile hemangiomas?

-are the most common type; these occur in the skin, subcutaneous tissues, and mucous membranes of the oral cavities and lips, as well as in the liver, spleen, and kidneys -(so-called "strawberry hemangiomas") of the newborn skin are extremely common and could be multiple

how is chronic bronchitis defined as ? what is the distinctive feature of chronic bronchitis?

-defined by the presence of a persistent productive cough for at least 3 consecutive months in at least 2 consecutive years -hyper secretion of mucus, beginning in the large airwaysmucosal lining of the larger airways usually is hyperemic and swollen by edem

what are the four disrorders under COPD? what is COPD?

-emphysema, chronic bronchitis, asthma, and bronchiectasis

inflammatory polyps form as a result of what ?

-form as a result of chronic cycles of injury and healing.

Squamous cell carcinomas

-in situ appear as sharply defined, red, scaling plaques; some appear to arise in association with prior actinic keratoses. -characterized by highly atypical cells at all levels of the epidermis, with nuclear crowding and disorganization. •It arise from keratin-producing cells in the stratum spinosum •It often spread locally and metastasize to nearby lymph node •It is a raised reddened scaly lesion which later ulceration

what are Intestinal Polyps classified as ?

-nonneoplastic or neoplastic.

what slapped cheek syndrome caused by? what is Hand -foot-mouth disease?

-parvovirus B19) is a viral infection that's most common in children, It usually causes a bright red rash on the cheeks. -Vesicular rash on palms and soles with oral fever (a mild, contagious viral infection common in young children — is characterized by sores in the mouth and a rash on the hands and feet)

what are Inflammatory Polyps associated with?

-solitary rectal ulcer syndrome=, clinical triad of rectal bleeding, mucus discharge, and mass

what is Helicobacter pylori? where are they usually found ?

-spiral-shaped or curved bacilli -present in gastric biopsy in almost all patients with -duodenal ulcers and a majority of those with - gastric ulcers or chronic gastritis

what population is at a higher risk of getting Ischemic Bowel Disease? what are the symptoms ?

-tends to occur in older adults with coexisting cardiac or vascular disease -severe abdominal pain and tenderness, sometimes accompanied by nausea, vomiting, bloody diarrhea, or grossly melanotic stool

how would an acute case of ARDs present

-the lungs are dark red, firm, airless, and heavy. Microscopic examination: reveals capillary congestion, necrosis of alveolar epithelial cells, interstitial and intra alveolar edema and hemorrhage

whhat is Verruca vulgaris?

-the most common type of wart, can occur anywhere but is found most frequently on the hands, particularly on the dorsal surfaces, where it appears as a gray-white to tan, flat to convex,0.1-to 1-cm papule with a rough, pebble like surface.

are Hyperplastic polyps benign? where are they located ? do Hyperplastic polyps have malignant potential? what must they be distinguished from in order to get a correct diagnoses ?

-yes -•epithelial proliferations most found in the left colon and rectum. -have no malignant potential -must be distinguished from sessile , serrated, adenomas polyps.

what does anemia stem from ? what does the decrease in tissue oxygen tension that accompanies anemia trigger?

-•Anemia can stem from bleeding, increased red cell destruction, or decreased red cell production • the decrease in tissue oxygen tension that accompanies anemia triggers increased production of the growth factor erythropoietin from specialized cells in the kidneyà ( Bone marrow+ extra medullary hematopoiesis).

what are the different types of gastric polyps?

-•Inflammatory and Hyperplastic Polyps :Up to 75% of all gastric polyps are inflammatory or hyperplastic polyps. I -•Adenomatous polyps occur sporadically and in individuals with familial adenomatous polyposis (FAP)

what is Ischemic Bowel Disease?

-•Ischemic damage to the bowel can range from mucosal infarction, extending no deeper than the muscularis mucosa; to mural infarction of mucosa and submucosa; to transmural infarction involving all three layers of the wall.

what are examples of malabsorption ?

-•Lactase deficiency : Enzyme that break down Lactose are unproduced leading to lactose sensitivity or Lactose intolerance -•Bile salt may not be produced by the liver so fats cannot be efficiently broken and absorbed -Vitamin A,D,E,K deficiency

describe morphology of a rbc what does a Peripheral blood smears in β-thalassemia major will show ?

-•Red cells are small (microcytic) and pale(hypochromic), but regular in shape. Often seen are target cells, Cells with an increased surface area-to-volume ratio allow the cytoplasm to collect in a center.( target Cell) -Peripheral blood smears in β-thalassemia major will show marked microcytosis, hypochromia, poikilocytosis (variation in cell shape), anisocytosis (variation in cell size), and Nucleated red cells (normoblasts PAN MH

what do superficiial fungal infections cause? what do deeper fungal infections cause ?

-•Superficial infections usually produce erythematous macules with superficial scale that can be pruritic, --•deeper infections such as those seen with Aspergillus spp. are erythematous and often nodular and sometimes associated with local hemorrhage. Superficial fungal infections may have an annular appearance.

what are Hamartomata's polyps?

-•abnormal but not cancerous cells) occur sporadically or as a part of genetic diseases.

what is Sarcoidosis :? what is charcterized by ?

-•an inflammatory disease that affects multiple organs in the body, but mostly the lungs and lymph glands. In people with sarcoidosis, abnormal masses or nodules (called granulomas) consisting of inflamed tissues form in certain organs of the body. -characterized by noncaseating granulomatous inflammation in many tissues and organs.

what is Rubella:?

-•rash begins in the head and moves down , poster auricular lymphadenopathy •(symptoms that can include a low-grade fever, sore throat, and a rash that starts on the face and spreads to the rest of the body)

what are the signs to identify meaasles ?

-•red rash on head then trunk and limb with Kolpik's spot in the inside of the cheek Symptoms usually develop 10-12 days after exposure to an infected person and last 7-10 days. Initial symptoms typically include fever, often greater than 40 °C (104 °F), cough, runny nose, and inflamed eyes.)

what are the main clinical warning signs for melanoma ?

. Rapid enlargement of a preexisting nevus 2. Itching or pain in a lesion 3. Development of a new pigmented lesion during adult life 4. Irregularity of the borders of a pigmented lesion 5. Variegation of color within a pigmented lesion

what drug causes Drug hypersensitivity vasculitis

., penicillin)

what are the classic histologic findings in bronchial asthma?

1)Inflammation 2)Bronchial (luminal) narrowing 3)Increased Mucous 4)Smooth muscle hyperplasia What is the 5th finding if the etiology is allergy? Increased eosinophilia

what are the classifications of Immunohemolytic Anemia?

1)Warm Antibody Type •Primary (idiopathic) •Secondary: B cell neoplasms (chronic lymphocytic leukemia), autoimmune disorders ( systemic lupus erythematous), drugs •(α-methyldopa, penicillin, quinidine) 2)Cold Antibody Type •Acute: Mycoplasma infection, infectious mononucleosis •Chronic: idiopathic, B cell lymphoid neoplasms (lymphoplasmacytic

1-Allergic contact dermatitis 2-Atopic dermatitis 3-Drug-related eczematous dermatitis 4-Photo eczematous dermatitis

1-stems from topical exposure to an allergen and is caused by delayed hypersensivity reactions. 2-formerly attributed to allergen exposure, now thought to often stem from defects in keratinocyte barrier function, defined as skin with increased permeability to substances to which it is exposed, such as potential antigens 3-hypersensitivity reaction to a drug 4-appears as an abnormal reaction to UV or visible light

how does one get NON- caseating granulomas (IDIOPATHIC)?

1.HYPERSENSITIVITY (DUSTS, bacteria, fungi, Farmer's Lung, Pigeon Breeder's Lung) 2.TB

what are the diffrent types of chronic gastritis ?

1.Helicobacter ,Pylori Gastritis 2.Chronic Autoimmune Gastritis 3.Chemical Gastropathy

what is Hemophilia A—Factor VIII Deficienc

1.Hemophilia A is the most common hereditary cause of serious bleeding. It is an X-linked recessive disorder caused by reduced factor VIII activity. It primarily affects males. there is a tendency toward easy bruising and massive hemorrhage after trauma or operative procedures. Specific assays for factor VIII are used to confirm the diagnosis of hemophilia A. Typically, patients with hemophilia A have a prolonged PTT that is corrected by mixing the patient's plasma with normal plasma.

•Macule: = •Papules : = •Vesicle =: -Bulla: =

1is a flat, distinct, discolored area of skin less than 1 centimeter (cm) wide 2=is a raised area of skin tissue that's less than 1 centimeter around 3=mall, fluid-filled sacs that can appear on your skin. The fluid inside these vesicles may be clear, white, yellow, or mixed with blood ... 4=s a fluid-filled sac or lesion thatappears when fluid is trapped under a thin layer of your skin. It's a type of blister.

what is melanoma ?

3)a highly aggressive malignancy; tumors only a few millimeters in thickness can give rise to deadly metastases. Melanoma is less common but much more deadly than basal or squamous cell carcinoma

what is OMPHALOCELE &GASTROSCHISIS

: abnormality of abdomen wall formation

what is a Reticulocyte? what does the Retic count in anemia show ?

: immature Red Blood cells which has Ribosome RNA in cytoplasm and stain with specific dyes . It measures the number of new red blood cells produced in Bone marrow Normal range is0.5-1.5%of peripheral RBC Effective Erythropoiesis In Anemia and HCT lower than 45 we need to correct the Reticulocyte percent reported =Patient HCt/45*Retic count

what is leporsy caused by

: is caused by Mycobacterium Leprae, The main symptom of leprosy is disfiguring skin sores, lumps, or bumps that do not go away after several weeks or months. The skin sores are pale-colored

what is acne vulgaris ? what is it caused by ?

: is caused by Propionibacterium. Caused by clogged or plugged hair follicles present under the skin. It presents as small to large, red bumps on the skin

epiphrenic DIVERTICULA

EPIPHRENIC (LOW)

what is a plaque?

A plaque is a circumscribed, palpable lesion more than 1 cm in diameter; most plaques are elevated. Plaques may result from a coalescence of papules

what is Appendicitis?

Appendix is a finger like , blind ended tube connected to the cecum Obstruction of the appendiceal orifice-> bacterial overgrowth-

what is a Psoriasis? describe its apperance ? where does it appear ?

A chronic skin disease which results in scaly, often itchy areas in patches. It is a T cell-mediated inflammatory disease, presumed to be autoimmune in origin -•typical lesion is a well-demarcated, pink to salmon- colored plaque covered by loosely adherent silver-white scale. There is marked epidermal thickening (acanthosis), with regular downward elongation of the rete ridges •elbows, knees, scalp, lumbosacral areas, intergluteal cleft, glans penis, and vulva. •Nail changes on the fingers and toes occur in 30% of cases.

L--->R shunt

ASD VSD ASVD PDA NON-CYANOTIC IRREVERSIBLE PULMONARY HYPERTENSION IS THE MOST FEARED CONSEQUENC

what is ASVD

ASVD: Atrioventricular septal defect is defect in all atrioventricular cushion and valvular defect ,too

what are the types of asthma ?

ATOPIC (allergic) or NON-ATOPIC (infection) • Chronic small airway obstruction and infection • 1) Mucus hyper secretion with plugging, • 2) lymphocytes/eosinophil • 3) lumen narrowing, • 4) smooth muscle hypertrophy

what are the heart valves ?

AV: 1.TRICUSPID 2.MITRAL SEMILUNAR: 1.PULMONIC 2.AORTIC

describe acute anemia, chroninc anemia anf hemolysis acommponed with anemia

Acute anemia : shortness of breath, organ failure, shock • Chronic anemia : Pallor, fatigue, • with hemolysis: jaundice and gallstones

what is the most common reason for right sided failure ?

´Most common reason is left side failure and less commonly to primary pulmonary disorders ´ ´Symptoms: chiefly related to peripheral edema and visceral congestion

Describe sickle cell anemia

An autosomal recessive disorder resulting from a mutation in β-globin that causes deoxygenated hemoglobin to self-associate into long polymers that distort their cell. Blockage of vessels by sickled cells causes pain crises and tissue infarction, particularly of the marrow and spleen. Red cell membrane damage caused by repeated bouts of sickling results in a moderate to severe hemolytic anemia. Patients are at high risk for bacterial infections and stroke -

what is ARTERIOSCLEROSIS? describe it

Arteriosclerosis literally means "hardening of the arteries"; it is a generic term reflecting arterial wall thickening and loss of elasticity. •Distinct types are recognized, each with different clinical and pathologic causes and consequences: • Arteriolosclerosis affects small arteries and arterioles and may cause downstream ischemic injury. The two variants, hyaline and hyperplastic arteriolosclerosis, were discussed earlier in relation to hypertension. • . •

ACINUS vs. ALVEOLUS?

CNTRO-acinar Distal respiratory acinus include alveoli duct and alveoli -PAN-acinar involve entire respiratory acinus from bronchiole to alveoli

what is Atelectasis? what does it result in ?

Atelectasis, also known as collapse, is loss of lung volume caused by inadequate expansion of air spaces -It results in shunting of inadequately oxygenated blood from pulmonary arteries into veins, thus giving rise to a ventilation perfusion imbalance and hypoxia.

what are the diffrent types of gastric tumors ?

BENIGN: •"POLYPS*" (HYPERPLASTIC vs. ADENOMATOUS) •LEIOMYOMAS (Same gross and micro as smooth muscle) •LIPOMAS (Same gross and micro as adipose tissue) MALIGNANT •(ADENO)-Carcinoma •LYMPHOMA

what are the signs and symptoms of pneumonia?

COMMUNITY-ACQUIRED BACTERIAL ACUTE PNEUMONIAS (BACTERIAL) • Streptococcus Pneumoniae • Haemophilus Influenzae • Moraxella Catarrhalis • Staphylococcus Aureus • Klebsiella Pneumoniae • Pseudomonas Aeruginosa • Legionella Pneumophila COMMUNITY-ACQUIRED ATYPICAL (VIRAL AND MYCOPLASMAL) PNEUMONIAS (NON-BACTERIAL) • Influenza Infections • Severe Acute Respiratory Syndrome (SARS)

what does TGA (TRANSPOSITION of GREAT ARTERIES)‏

´NEEDS a SHUNT for survival, ´ obviously, PDA or PFO( Patent foramen ovalis) (65%), "unstable" shunt ´VSD (35%), "stable" shunt ´RV>LV in thickness ´Fatal in first few months ´Surgical "switching"

what are bleeding disorders caused by ?

Bleeding disorders may stem from abnormalities of vessels, platelets, or coagulation factors, alone or in combination. • Bleeding resulting from vascular fragility is seen with vitamin C deficiency (scurvy) ,chronic glucocorticoid use, rare inherited conditions affecting the connective tissues, and a large number of infectious and hypersensitivity vasculitides. •Bleeding also can be triggered by systemic conditions that inflame or damage endothelial cells. •In efficiencies of platelets (thrombocytopenia) also are an important cause of bleeding or bleeding disorders stem from qualitative defects in platelet function.

what is BP a function of describe them

Blood pressure is a function of cardiac output and peripheral vascular resistance • •Cardiac output is a function of stroke volume and heart rate. The most important determinant of stroke volume is the filling pressure, which is regulated through sodium homeostasis and its effect on blood volume. Heart rate and myocardial contractility (a second factor affecting stroke volume) are both regulated by the αand β-adrenergic systems • Peripheral resistance is regulated predominantly at the level of the arterioles by neural and humoral inputs. Vascular tone reflects a balance between the actions of vasoconstrictors (including angiotensin II, catecholamines, and endothelin) and vasodilators (including kinins, prostaglandins, and NO). •Factors released from the kidneys, adrenal glands, and myocardium interact to influence vascular tone and to regulate blood volume by adjusting sodium balance.

what is iron deficiency caused by ?

Caused by chronic bleeding or inadequate iron intake; results in insufficient hemoglobin synthesis and hypochromic, microcytic red cells • Increased demands not met by normal dietary intake occur worldwide during pregnancy and infancy. •Malabsorption can occur with celiac disease or after gastrectomy

what is a Reactive Leukocytosis?

Causes of Leukocytosis Neutrophilic Leukocytosis • Acute bacterial infections (especially those caused by pyogenic organisms); •sterile inflammation caused by, e.g., tissue necrosis (myocardial infarction, burns)

what are some exampels of chronoic microbial infections ?

Chronic microbial infections include osteomyelitis, bacterial endocarditis, and lung abscess. Chronic immune disorders, such as rheumatoid arthritis and regional enteritis •Neoplasms, such as Hodgkin lymphoma and carcinomas of the lung and breast B O l

what is Coagulative necrosis

Coagulative necrosis is PALE early. Or purple. Yellow when macrophages chew up the dead tissue. Sometimes red and soft again with organization or neovascularation. White and firm with fibrosis.

what are EXTERNAL Hemorrhoids what are internal Hemorrhoids

Collateral vessels within the inferior hemorrhoidal plexus are located below the anorectal line -while those that result from dilation of the superior hemorrhoidal plexus within the distal rectum are referred to as internal hemorrhoids.

what is Hemophilus Pneumonia:?

Commonest in Children <2, with otitis, URI, meningitis, cellulitis, osteomyelitis •Pneumonia in Children <2 are often thought of as being H Flu until proven otherwise, otitis, meningitis ,too

what are examples of Congenital Abnormality:?

DUPLICATION MALROTATION OMPHALOCELE &GASTROSCHISIS : abnormality of abdomen wall formation ATRESIA/STENOSIS SPECTRUM MECKEL (terminal ileum, "vitelline" duct) AGANGLIONIC MEGACOLON (HIRSCHSPRUNG DISEASE

what is is the pathogenisis of Neutropenia/Agranulocytosis what are its clincical features ?

Decreased granulocyte production •Infections constitute the major problem. They commonly take the form of ulcerating, necrotizing lesions of the gingiva, floor of the mouth, buccal mucosa, pharynx, or other sites within the oral cavity •In addition to local inflammation, systemic symptoms usually are present consisting of malaise, chills, and fever.

what is Acute coronary Syndrome

Develops when ischemia is prolonged and not immediately reversible. Encompases a spectrum of unstable angina, non-st-segment-elevation myocardial infaction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI).

what does an ec injury cause ?

EC injury—and resultant endothelial dysfunction— leading to increased permeability, leukocyte adhesion, and thrombosis Accumulation of lipoproteins (mainly oxidized LDL and cholesterol crystals) in the vessel wall •Platelet adhesion •Monocyte adhesion to the endothelium, migration into the intima, and differentiation into macrophages and foam cells •Lipid accumulation within macrophages, which respond by releasing inflammatory cytokines •SMC recruitment due to factors released from activated platelets, macrophages, and vascular wall cells •SMC proliferation and ECM production • Endothelial Injury EC injury is the cornerstone of the response to injury hypothesis.

what is Eczematous?

Eczema is a condition where patches of skin become inflamed, itchy, red, cracked, and rough.

WHAT IS Essential hypertension what dos it infleunce ?

Essential hypertension" results from the interplay of several genetic polymorphisms (which individually might be inconsequential) and environmental factors, which conspire to increase blood volume and/or peripheral resistance. Essential hypertension represents 95% of cases and is a complex, multifactorial disorder, involving both environmental influences and genetic polymorphisms that may influence sodium resorption, aldosterone pathways, the adrenergic nervous system, and the renin-angiotensin system. Sustained diastolic pressures greater than 90 mm Hg or sustained systolic pressures in excess of 140 mm Hg are reliably associated with an increased risk for atherosclerosis and are therefore used as cutoffs in diagnosing hypertension in clinical practice. Low blood pressure (hypotension) results in inadequate organ perfusion, organ dysfunction, and sometimes tissue death. Conversely, high blood pressure (hypertension) causes vessel and end-organ damage and is one of the major risk factors for atherosclerosis .

what are Right side Failure symptoms\‏

FATIGUE "Dependent" edema JVD( Jugular Vein distention ) Hepatomegaly (congestion)‏ ASCITES, PLEURAL EFFUSION Cyanosis Increased peripheral venous pressure (CVP)

what is DIVERTICULOSIS?

FULL THICKNESS BOWELOUTPOCKETING Assoc. w.: •INCREASED LUMINAL PRESSURE, ↑transit time 1.Age 2.Decreased dietary FIBER Weakening of wall

Arthrosclerosis morphologic

Fatty Streaks. Fatty streaks begin as minute yellow, flat macules that coalesce into elongated lesions, 1 cm or more in length . They are composed of lipid-filled foamy macrophages but are only minimally raised and do not cause any significant flow disturbance. Fatty streaks can appear in the aorta of infants younger than 1 year of age and are present in virtually all children older than 10 years of age, regardless of genetic, clinical, or dietary risk factors. Not all fatty streaks are

what is Fibromuscular intimal hyperplasia where does it occur?

Fibromuscular intimal hyperplasia is a non-atherosclerotic process that occurs in muscular arteries larger than arterials

what are common hemolytic anemia ?

Hereditary Spherocytosis •This disorder stems from inherited (intrinsic) defects in the red cell membrane that lead to the formation of spherocytosis, no deformable cells that are highly vulnerable to sequestration and destruction in the spleen. •Autosomal dominant trait; a more severe, autosomal recessive form of the disease affects a small minority of patients.

DESCRIBE Hypertension is

Hypertension is a major health problem in the developed world. Although it occasionally manifests in an acute aggressive form, high blood pressure is typically asymptomatic for many years. •In any increasing blood pressure increasing the risk for stroke and atherosclerotic coronary heart disease, hypertension can lead to cardiac hypertrophy and heart failure (hypertensive heart disease) must be considered. Pathogenesis: Hypertension may be primary (idiopathic) or less commonly secondary to an identifiable underlying condition. In close to 95% of cases hypertension is idiopathic or "essential". Most of the remaining cases (secondary hypertension) are due to primary renal disease, renal artery narrowing (renovascular hypertension), or adrenal disorders •

How does impetigo present?

Impetigo often begins as a single small macule, usually on the extremities or the face near the nose or the mouth, which rapidly evolves into a larger lesion

what is the the most common viral cause of pneumonia?

Influenzas VIRUS Primary influenza pneumonia manifests with persistent symptoms of cough, sore throat, headache, myalgia for more than three to five days.

how does the VASCULAR WALL RESPONSE TO INJURY?

Injury to the vessel wall—and in particular to ECs—is the fundamental basis for the vast majority of vascular disorders. •Intimal Thickening: A Stereotypical Response to Vascular Injury. •Vascular injury leading to EC loss or dysfunction stimulates SMC growth, ECM synthesis, and thickening of the vascular wall. •Healing of injured vessels involves the migration of SMCs or SMC precursor cells into the intima. These cells then proliferate and synthesize ECM in much the same way that fibroblasts fill in a wound elsewhere in the body

what are the clinical features of squamous cell carcinoma ? what is it caused by ?

Invasive squamous cell carcinomas of the skin often are discovered while small and resectable. Less than 1% will have metastasized to regional lymph nodes at diagnosis. Cutaneous squamous cell carcinoma has the potential for metastasis but usually is recognized and excised before it does so -Cutaneous squamous cell carcinoma is mainly caused by UV light exposure, which leads to widespread DNA damage and extremely high mutational loads

what is the biggest usa killer ? descrive it and its riusk factors?

LUNG TUMORS •Benign, malignant, epithelial, mesenchymal , but 90% are Carcinoma •Biggest USA Killer •Prevalence not as high as prostate or breast but mortality higher. Only 15% , 5-year survival. Risk factors •Tobacco has polycyclic aromatic hydrocarbons. radioactive isotopes •Radiation, asbestos, radon Genetic Fact: C-MYC, K-RAS, EGFR, HER-2/neu

what is Liebman-Sacks endocarditis characterized by

Liebman-Sacks endocarditis is characterized by the presence of sterile vegetations on the valves of patients with systemic lupus erythematosus. It occurs in about 10% of patients with SLE. The lesions probably develop as a consequence of immune complex deposition and thus exhibit associated inflammation, often with fibrinoid necrosis of the valve adjacent to the vegetation; subsequent fibrosis and serious deformity can result in lesions that resemble chronic rheumatic heart disease.

what does the mesothelium do ?

Mesothelium does not only cover the lungs viscerally, as well as parietally, but also the pericardium and the peritoneum as well, so mesotheliomas and effusions of the pleura, and ALL diseases, are also have their corresponding counterparts in the pericardial space and peritoneal space as well.

what is metabolic syndrome?

Metabolic syndrome. •Associated with central obesity ,this clinical entity is characterized by insulin resistance, hypertension, dyslipidemia (elevated triglycerides and depressed HDL), hypercoagulability, and a pro-inflammatory state, which may be triggered by cytokines released from adipocytes. The dyslipidemia, hyperglycemia, and hypertension are all cardiac risk factors. .

what is staph aureus

Most common pneumonia following viral pneumonias M.R.S.A.,

what is the correlation between myoglobin and infarctions

Myoglobin is found in cardiac and skeletal muscle. It is released more rapidly from infarcted myocardium than troponin and CK-MB and may be detected as early as two hours after an acute myocardial infarction. Myoglobin has high sensitivity but poor specificity.

what is Mönckeberg medial sclerosis

Mönckeberg medial sclerosis is characterized by the presence of calcific deposits in muscular arteries, usually centered on the internal elastic lamina, and typically in individuals older than 50 years of age. The lesions do not encroach on the vessel lumen and usually are not clinically significant

what is Meckel Diverticulum?

Outpouching of all three layers of bowel wall (true diverticulum) Arises due to failure of the vitelline duct to involute 2% of pop. 2ft from ileocecal valve 2inch long <2yrs old Presents with bleeding (heterotopic gastric mucosa), volvulus, intussusception, obstruction

what are peptic ulcers

Peptic ulcer disease (PUD) most often is associated with H. pylori infection mucosal defenses and damaging forces that cause chronic gastritis are also responsible for PUD.

where are peptic ulcers normally found ? what are PUD symptoms ?

Peptic ulcers are four times more common in the proximal duodenum than in the stomach •Epigastric burning, aching pain, Fe deficiency anemia •Acute hemorrhage •Penetration, perforation: •Pain in BACK •Pain in CHEST Pain in LUQ

what is a symptom of Left Heart Failure

´Paroxysmal nocturnal dyspnea or paroxysmal nocturnal dyspnea (PND) refers to attacks of severe shortness of breath and coughing that generally occur at night. It usually awakens the person from sleep, and may be quite frightening( pillow number )

Myocardial Infarction

Progression of myocardial necrosis after coronary artery occlusion. A trans mural segment of myocardium that is dependent on the occluded vessel for perfusion constitutes the area at risk (outlined). Necrosis begins in the subendocardial region in the center of the ischemic zone and with time expands to involve the entire wall thickness. Note that a very narrow zone of myocardium immediately beneath the endocardium is spared from necrosis., because it can be oxygenated by diffusion from the ventricle.

what are the diffrent types of aortic dissections ?

Proximal lesions (type A dissections), involving the ascending aorta, with or without involvement of the descending aorta (DeBakey type I or II, respectively). Distal lesions (type B dissections), usually beginning beyond the subclavian artery (DeBakey type III)

what is chronic gastritis characterized by ?

•Absence of grossly visible erosion •Presence of chronic inflammatory changes •Atrophy of the glandular epithelium of the stomach Changes may become dysplastic and eventually transform into carcinoma

what are the mechanisms of esential hyper tension

Reduced renal sodium excretion in the presence of normal arterial pressure probably is a key pathogenic feature; indeed, this is a common etiologic factor in most forms of hypertension. Blood volume in turn is regulated mainly by renal sodium excretion or resorption. Renin, a major regulator of blood pressure, is secreted by the kidneys in response to decreased blood pressure in afferent arterioles. In turn, renin cleaves angiotensinogen to angiotensin I; subsequent peripheral catabolism produces angiotensin II, which regulates blood pressure by increasing vascular SMC tone and by increasing adrenal aldosterone secretion, which consequently increases renal sodium resorption • Increased vascular resistance may stem from vasoconstriction or structural changes in vessel walls. • Genetic factors play an important role in determining blood pressure, as shown by familial clustering of hypertension and by studies of monozygotic and dizygotic twins • Environmental factors, such as stress, obesity, smoking, physical inactivity, and high levels of salt consumption, modify the impact of genetic determinants

what important changes zre assoicated with Atherosclerotic plaques are susceptible to several clinically

Rupture, ulceration, hemorrhage Atheroembolism. Aneurysm formation plaque inflammation

nosocomial what is it ?

•Acquired in HOSPITALS, also called "hospital acquired", versus "community acquired" pneumonias. DEBILITATION CATHETERS, VENTILATORS •ENTEROBACTER, PSEUDOMONAS •STAPH (MRSA) •MRSA (MR=Methicillin Resistant)

describe SMCs

Smooth Muscle Cells SMCs participate in both normal vascular repair and pathologic processes such as atherosclerosis. When stimulated by various factors, SMCs can do the following: •Proliferate •Upregulate ECM collagen, elastin, and proteoglycan production •Elaborate growth factors and cytokines The relative SMC and ECM content of vessel walls (e.g., in arteries, veins, and capillaries) varies according to hemodynamic demands (e.g., pressure, pulsatility) and functional requirements.

what is Gastric adenocarcinoma?

•Adenocarcinoma is the most common malignancy of the stomach, comprising more than 90% of all gastric cancers Gastric cancer rates vary markedly with geography, and nutritional habits

what is Spider telangiectasias

Spider telangiectasias are non-neoplastic vascular lesions. These lesions manifest as radial, often pulsatile arrays of dilated subcutaneous arteries or arterioles (the "legs" of the spider) about a central core (the spider's "body") that blanch with pressure. Spider telangiectasias commonly occur on the face, neck, or upper chest and most frequently are associated with hyperestrogenic states (e.g., in pregnant women or patients with cirrhosis)

PYLORIC STENOSIS cn be congenital or aquired T/F?

T •CONGENITAL: (1/500), Neonatal obstruction symptoms, pyloric splitting curative •ACQUIRED: Secondary to extensive scarring such as advanced peptic ulcer disease

what is the TRIAD what are the diffrent type of heart failure ?

TACHYCARDIA 2) DYSPNEA 3) EDEMA

R---> L shunt

TETRALOGY of FALLOT most COMMON ´1) VSD, large ´2) OBSTRUCTION to RV flow ´3) Aorta OVERRIDES the VSD ´4) RVH ´ ´SURVIVAL DEPENDS on SEVERITY of SUBPULMONIC STENOSIS ´Can be a "PINK" tetralogy if pulmonic obstruction is small, but the greater the obstruction, the greater is the R->L shunt and cyanotic Symptomatic at birth or during early childhood

what is MALLORY-WEISS?

Tears are LONGITUDINAL (lower esophagus) Usually secondary to severe VOMITING Usually in ALCOHOLICS Usually, MUCOSAL tears

what are Hamartomata's Polyps? what is the morphology ?

disorganized, tumorlike growths composed of mature cell types normally present at the site at which the polyp develops. -pedunculated, smooth-surfaced, reddish lesions that are less than 3 cm in diameter and display characteristic cystic spaces on cut sections

what is the Pathogenesis of Vitamin B12 (Cobalamin) Deficiency Anemia? what is the most frequent cause vitamin B12 deficiency?

The absorbed vitamin B12 is transferred across the basolateral membranes of enterocytes to plasma transcobalamin, which delivers vitamin B12 to the liver The most frequent cause vitamin B12 deficiency is pernicious anemia, which is believed to result from an autoimmune attack on the gastric mucosa. The metabolic defects responsible for the anemia of vitamin B12 deficiency are intertwined with folate metabolism.

what are some congenital anomalies ?

•Agenesis/Hypoplasia •Tracheal/bronchial anomalies, i.e., Trachea-Esophageal (TE) fistula

what is Streptococcus:?

The classic Lobular pneumonia Normal flora in 20% of adults Only 20% of victims have + blood cultures Vaccines are often 100% preventive

what is the fucnction of the lubngs?

The major function of the lung is to replenish oxygen and remove carbon dioxide from blood.

what is Seborrheic Keratosis?

These common pigmented epidermal tumors occur most frequently in middle-age or older individuals. It is Round, flat plaques made up of proliferating monotonous epidermal basal cells , which sometimes contain melanin. Hyperkeratosis and keratin-filled cysts are characteristic.

what is an example of a Granulomatous infection?

Tuberculosis is a chronic granulomatous disease caused by Mycobacterium tuberculosis. -•• Initial exposure to mycobacteria results in development of a cellular immune response that confers resistance and leads to hypersensitivity (as determined by a positive result on the tuberculin skin test).

what are tumors

Tumors of blood vessels and lymphatics include benign hemangiomas (extremely common), locally aggressive neoplasms that metastasize infrequently, and rare, highly malignant angiosarcomas

what is the most common sceenario for the baby to eat, and it comes back up WITHOUT food getting into the lungs.?

atresia with proximal fistuala ( type b)

is MALABSORPTION a symptom or dissease ? what are other associated symptoms ?

a SYMPTOM •Depending on the deficiency , may include diarrhea , flatulence, bloating, abdominal cramps, and weight loss

what is asthma ?

a chronic inflammatory disorder of the airways that causes recurrent episodes of wheezing, breathlessness, chest tightness, and cough, particularly at night and/or early in the morning.

What is a neoplasm?

a new and abnormal growth of tissue in some part of the body, especially as a characteristic of cancer.

how is emphysema characterized?

by permanent enlargement of the air spaces distal to the terminal bronchioles, accompanied by destruction of their walls without significant fibrosis

What is ARDS? what is histologic manifestation of ARDS in the lungs is known as?

acute respiratory distress syndrome -diffuse alveolar damage (DAD).

what does Ulcerative colitis always invovle ? what are the microscopic features of active Ulcerative colitis?

always involves the rectum and extends proximally in a continuous fashion to involve part or the entire colon that can be diffusely ulcerated abundant neutrophils of neutrophils within a crypt are referred to as a crypt abscess and often are associated with crypt destruction.

what are the causes of asthma ? is it for life ?

•Airborne allergens, such as pollen, animal dander, mold, cockroaches and dust mites. •Respiratory infections, such as the common cold. •Physical activity (exercise-induced asthma) •Cold air. Air pollutant yes= sucks to suck

describe Achalasia

an esophageal motility disorder involving the smooth layer of the esophagus and the lower esophageal sphincter (LES). -is characterized by incomplete LES relaxation, increased LES tone, and aperistalsis of the esophagus (inability of smooth to move down the esophuhus

what do Mutations in red blood cell membrane proteins result in ?

an overly rigid, misshapen cell. Instead of a flattened disc shape, these cells are spherical. Dysfunctional membrane proteins interfere with the cell's ability to change shape when traveling through the blood vessels.

what are Pyogenic granulomas what are Cavernous hemangiomas

are capillary hemangiomas that manifest as rapidly growing red pedunculated lesions on the skin, gingival, or oral mucosa =are composed of large, dilated vascular channels. Compared with capillary hemangiomas, cavernous hemangiomas are more infiltrative, frequently involve deep structures, and do not spontaneously regress

what are most sporadic dysplastic nevi regarded as ?

as markers of melanoma risk rather than premalignant lesions. They are characterized by architectural disorder and cytologic atypia. Dysplastic nevi are larger than most acquired nevi (often more than 5 mm across) and may number in the hundreds . They are flat macules to slightly raised plaques, with a "pebbly" surface. They usually have variable pigmentation (variegation) and irregular borders

what is Pemphigus?

associated with IgG autoantibodies to various intercellular desmosome, resulting in bullae that are either sub corneal uncommon autoimmune blistering disorder resulting from loss of normal intercellular attachments within the epidermis and the squamous mucosal epithelium.

what is infetious dermatitis ?

bacterial infections occur in skin. •These range from superficial infections known as impetigo, to deeper dermal abscesses associated with puncture wounds that are caused by bacteria such as Pseudomonas aeruginosa.

what is the pathology of anemia ?

cause -Blood loss (hemorrhage) • Increased red cell destruction (hemolysis) • Decreased and abnormal red cell production .Microcytic (iron deficiency, thalassemia) 2.Macrocytic (folate or vitamin B12 deficiency) 3.Normocytic but with abnormal shapes (hereditary spherocytosis, sickle cell disease) 4.Deformities due to reactive marrow hyperplasia

what causes melanoma ?

caused by UV light-induced DNA damage. Unlike benign nevi, melanomas often exhibit striking variations in pigmentation, including shades of black, brown, red, dark blue, and gray. The borders are irregular and often "notched." at the levels expansile dermal nodules.

what is Lupus vulgaris? what is caused by ?

caused by mycobacterium tuberculosis, it is a painful cutaneous tuberculosis skin lesions with nodular appearance.

what are the sub types of Emphysema? which is the most common?

centriacinar (most common: smoking related), panacinar (seen in α1-anti-trypsin deficiency), distal acinar, an irregular.

what is Erythema Multiforme? how does it present in patients ?

characterized by epithelial injury mediated by skin-homing CD8+ cytotoxic T lymphocytes have wide array of lesions, which may include macules, papules, vesicles, and bullae (hence the term multiforme). Well-developed lesions have a characteristic "targetoid" appearance

what is impetigo? what i the causative organims for this conidtion ?

common and highly contagious skin infection that mainly affects infants and children. The sores burst and develop honey-colored crusts. The causative organism is usually Staphylococcus aureus or, less commonly, Streptococcus pyogenes

what are symptoms of achalasia ?

difficulty swallowing, regurgitation, and sometimes chest pain

what is the difference between ordinary nevi, dysplastic nevi?

dysplastic nevi have a tendency to occur on body surfaces not exposed to the sun as well as on sun-exposed sites. Familial dysplastic nevus syndrome is strongly associated with melanoma, as the lifetime risk for the development of melanoma in affected individuals is close to 100%

what are the symptoms ofCrohn disease?

episodic mild diarrhea, fever, pain; may be precipitated by stress; if colon affected, may have anemia

what is Achalasia?

failure of LES to relax;

what are the major contributers to the development of asthma ?

genetic predisposition to type I hypersensitivity (atopy), acute and chronic airway inflammation, and bronchial hyper responsiveness to a variety of stimulus

what is a pulmonary infection?

lung disease due to inhalation of dust characterize by cough, fibrosis, inflammation Pulmonary infections in the form of pneumonia are responsible for one sixth of all deaths in the United States. Bacterial pneumonia has two patterns of anatomic distribution: lobular Bronchopneumonia and lobar pneumonia

What is celiac disease? what can someone with this disease not eat ?

gluten intolerance -most common , also known as celiac sprue or gluten sensitive enteropathy, is an immune-mediated enteropathy triggered by the ingestion of gluten •cereals, such as wheat, rye, or barley, in genetically predisposed individuals.

what is Takayasu Arteritis? what re signs and symptoms ?

granulomatous vasculitis of medium- and large-sized arteries characterized principally by ocular disturbances and marked weakening of the pulses in the upper extremities reduced upper-extremity blood pressure and pulse strength; neurologic deficits; and ocular disturbances, including visual field defects, retinal hemorrhages, and total blindness. •Distal aorta disease can manifest as leg claudication, and •pulmonary artery involvement can cause pulmonary hypertension. •Narrowing of the coronary ostia can lead to myocardial infarction.

what is Esophagitis?

inflammation of the esophagus ( barretts syndrome ) •GERD/Reflux.(Barrett's) •Barrett's •Chemical Infectious

what is Giant Cell (Temporal) Arteritis? what causes it ? when does it occur ? what are its symptoms ?

is a chronic inflammatory disorder, typically with granulomatous inflammation, that principally affects large- to small-sized arteries in the head. -a result of a T-cell- mediated immune response to an as-yet uncharacterized vessel wall antigen. -Temporal arteritis is rare before 50 years of age. -fever, fatigue, weight loss) or take the form of facial pain or headache, most intense along the course of the superficial temporal artery, which is painful to palpation. Ocular symptoms (associated with involvement of the ophthalmic artery) abruptly appear in about 50% of patients.

what is Fibromuscular dysplasia what does it cause ?

is a focal irregular thickening of the walls of medium- and large-sized muscular arteries It can manifest at any age but occurs most frequently in young women. The focal wall thickening results in luminal stenosis or can be associated with vessel spasm that reduces vascular flow; in the renal arteries, it can lead to renovascular hypertension.

what is a colorectal polyp? what occurs if it is not treated? how are they classified ?

is a polyp (fleshy growth) occurring on the lining of the colon or rectum -Untreated colorectal polyps can develop into colorectal cancer. -•Colorectal polyps are often classified by their behavior (i.e., benign vs. malignant) or cause (e.g., because of inflammatory bowel disease).

Pemphigus vulgaris

is a rare disorder that occurs most commonly in older adults and more often in women than in men. Lesions are painful, particularly when ruptured, and frequently develop secondary infections.

what is syphilis caused by?

is caused by Treponema pallidum

what is Cor pulmonale

is defined as an alteration in the structure and function of the right ventricle (RV) of the heart caused by a primary disorder of the respiratory system. Pulmonary hypertension is often the common link between lung dysfunction and the heart in cor pulmonale.

what is nevus?

is the most melanocytic tumor and never undergoes malignant transformation. Common melanocytic nevi are tan-to-brown, uniformly pigmented, small papules (5 mm or less across) with well-defined, rounded borders

where does Bronchiectasis usually effect ?

lower lobes bilaterally, particularly those air passages that are most vertical.

examples of nonneoplastic polyps

nonneoplastic polyps can be further defined as inflammatory, hamartomatous, or hyperplastic

are cutaneous melanomas asymptomatic,?

usually yes ,although pruritus may be an early manifestation. The most important clinical sign is a change in the color or size of a pigmented lesion.

how do H. pylori infections normaly present ? what does the increased acid production cause ?

presents as an antral gastritis with increased acid production. give rise to peptic ulcer disease of the duodenum or stomach •Causes chronic Atrophic gastritis •Causes gastric carcinomas

what is considered a " false " aneurysm

pseudoaneurysm) results when a wall defect leads to the formation of an extravascular hematoma that communicates with the intravascular space ("pulsating hematoma"). Examples are ventricular ruptures contained by pericardial adhesions and leaks at the junction of a vascular graft with a natural artery. or acquired dilations of blood vessels or the heart

what are Atheromatous plaques

raised lesions composed of soft friable lipid cores (mainly cholesterol and cholesterol esters, with necrotic debris) covered by fibrous caps As they enlarged, atherosclerotic plaques may mechanically obstruct vascular Lumina, leading to stenosis. Of greater concern, however, atherosclerotic plaques also are prone to rupture, an event that may result in thrombosis and sudden occlusion

what does consolidation reffer to ?

refers to "solidification" of the lung due to replacement of the air by exudate in the alveoli. Patchy consolidation of the lung is the dominant characteristic of bronchopneumonia, while consolidation of a large portion of a lobe or of an entire lobe defines lobar pneumonia

what is Thromboangiitis Obliterans (Buerger Disease? symptoms ?

segmental, thrombosing, acute and chronic inflammation of medium- and small-sized arteries, principally the tibial and radial arteries, with occasional secondary extension into the veins and nerves of the extremities -cold-induced Raynaud phenomenon , instep foot pain induced by exercise (instep claudication), and superficial nodular -The vascular insufficiency of Buerger disease tends to be accompanied by severe pain—even at rest—undoubtedly from the neural involvement. Chronic extremity ulcerations may develop, progressing over time (occasionally precipitously) to frank gangrene.

where do the anatomic alterations in sickle cell anemia stem from

severe chronic hemolytic anemia, (2)increased breakdown of heme to bilirubin, and (3)microvascular obstructions, which provoke tissue ischemia and infarction. In peripheral smears, elongated, spindled, or boat-shaped irreversibly sickled red cells are evident. There is a compensatory hyperplasia of erytroid progenitors in the marrow.

what is Polyarteritis nodosa (PAN) what are the symptoms ?

systemic vasculitis of small- or medium-sized muscular arteries; it typically involves the renal and visceral vessels and spares the pulmonary circulation. PAN is primarily a disease of young adults but can occur in all age groups. The clinical course typically is episodic, with long symptom-free intervals. The systemic findings—malaise, fever, and weight loss are nonspecific, and the vascular involvement is widely scattered, so that the clinical manifestations can be varied and puzzling. A "classic" presentation involves involve some combination of rapidly accelerating hypertension due to renal artery involvement; abdominal pain and bloody stools caused by gastrointestinal lesions; diffuse muscular aches and pains.

what is Lymphangiomas

the benign lymphatic counterpart of hemangiomas -•Simple (capillary) lymphangiomas are slightly elevated or sometimes pedunculated lesions up to 1 to 2 cm in diameter that occur predominantly in the head, neck, and axillary subcutaneous tissues. •Histologically,: • lymphangiomas are composed of networks of endothelium-lined spaces that are distinguished from capillary channels only by the absence of blood cells. • Cavernous lymphangiomas (cystic hygromas) typically are found in the neck or axilla of children, and more rarely in the retroperitoneum. Cavernous lymphangiomas can be large (up to 15 cm), filling the axilla or producing gross deformities of the neck. These lesions are composed of massively dilated lymphatic spaces lined by ECs and separated by intervening connective tissue

what is Bronchiectasis? what causes it ?

the permanent dilation of bronchi and bronchioles caused by destruction of smooth muscle and the supporting elastic tissue; it typically results from or is associated with chronic necrotizing infections. •are tumors, foreign bodies, and impaction of mucus. • Congenital or hereditary conditions— •for example: Cystic fibrosis

what is Anisocytosis :

variation in RBC size, RDW is measurement of Anisocytosis

what is Eosinophilic Leukocytosis (Eosinophilia)

•Allergic disorders such as asthma, hay fever, allergic skin diseases (e.g., pemphigus, dermatitis herpetiformis); •parasitic infestations; drug reactions; •Certain malignancies (e.g., Hodgkin lymphoma and some non-Hodgkin lymphomas); •Collagen-vascular disorders and some vasculitides ; atheroembolic disease (transient)

what is Volvulus of the sigmoid?

the twist is counterclockwise in most cases

what are Hemangiomas?

very common tumors composed of blood-filled vessels These lesions constitute 7% of all benign tumors of infancy and childhood; most are present from birth and initially increase in size, but many eventually regress spontaneously

what are Thoracic aortic aneurysms most commonly are associated with ?

with hypertension, bicuspid aortic valves, and Marfan syndrome. Less commonly, disorders caused by mutations in the TGF-β signaling pathway are causative.

describe G6PD deficeny

x G6PD deficeny is associated with transient episodes of intravascular hemolysis caused by exposure to an environmental factor (usually infectious agents or drugs) that produces oxidant stress, medicine or drug• •Oxidized hemoglobin denatures and precipitates, forming intracellular inclusions called Heinz bodies, •Such cells become trapped on recirculation to the spleen and are destroyed by phagocytes (extravascular hemolysis).

what are the three major groups based on their hemodynamic and clinical consequences:

´) malformations causing a left-to-right shunt; ´(2) malformations causing a right-to-left shunt (cyanotic congenital heart diseases); (3) malformations causing obstruction.

what are the caueses SUDDEN CARDIAC DEATH

´350,000 in USA yearly from atherosclerosis NON-atherosclerotic sudden cardiac death includes: ´Congenital coronary artery disease ´Aortic stenosis ´mitral valve prolapse ´Myocarditis ´Cardiomyopathy (sudden death in young athletes)‏ ´Pulmonary hypertension ´Conduction defects ´HTN, hypertrophy of UNKNOWN etiology

what is PDA

´90% isolated ´HARSH, machinery-like murmur ´L->R, possibly R->L as pulmonary hypertension approaches systemic pressure -Patent ductus arteriosus (PDA) persistent communication between the descending thoracic aorta and the pulmonary artery

how does Acute endocarditis present

´Acute endocarditis often manifests with rapidly developing fever, chills, weakness. ´Murmurs are present in 90% of patients with left-sided lesions. In those who are not treated promptly, microemboli are formed, which can give rise to petechia, nail bed (splinter) hemorrhages, retinal hemorrhages (Roth spots), painless palm or sole erythematous lesions (Janeway lesions), or painful fingertip nodules (Osler nodes); ´ ´ ´ diagnosis is confirmed by positive blood cultures and echocardiographic findings.

what is Acute rheumatic fever? where does this occur most often ?

´Acute rheumatic fever is a hypersensitivity reaction classically attributed to antibodies directed against group A streptococcal molecules that cross-react with host myocardial antigens ´ ´In particular, antibodies against M proteins of certain streptococcal strains bind to proteins in the myocardium and cardiac valves and cause injury ´Acute rheumatic fever occurs most often in children; the principal clinical manifestation is carditis.

what is VSD

´By far, most common CHD defect ´Only 30% are isolated ´Often with TETRALOGY of FALLOT ´90% involve the membranous septum ´ If muscular septum is involved, likely to have multiple holes ´ SMALL ones often close spontaneously ´ LARGE one's progress to pulmonary hypertension

what causes OBSTRUCTIVE CHD

´COARCTATION of aorta is predominantly an obstructive type of congenital heart disease. ´ ´ ´ ´ ´ ´Pulmonary stenosis/atresia ´Aortic stenosis/atresia

what is Chronic Ischemic Heart Disease what can a severre case of CAD cause ?

´Chronic IHD, also called ischemic cardiomyopathy, is progressive heart failure secondary to ischemic myocardial damage. In most instances, there is a known clinical history of previous MI. After prior infarction(s), chronic IHD appears when the compensatory mechanisms (e.g., hypertrophy) of residual myocardium begin to fail. ´ In other cases, severe CAD can cause diffuse myocardial dysfunction, and even micro-infarction and replacement fibrosis, without any clinically evident episode of frank infarction.

what does Congenital heart disease repersent

´Congenital heart disease represents defects of cardiac chambers, or the great vessels Present at birth ´ ´it will cause shunting between right and left side or out flow obstruction ´ ´Its severity is between nearly asymptomatic to rapidly fatal . ´Reasons: environmental ( toxic and infection),or Genetic

what is Ischemic Heart disease what is it caused by

´IHD represents a group of pathophysiologically related syndrome resulting from myocardial ischemia ( less blood supply than demand ) ´Majority of Ischemic heart disease is due to coronary artery 1.Atherosclerosis . 2.vasospasm, 3.Vacuities, 4.or embolism are less common 5.Cardiac ischemia is a mismatch in coronary supply and myocardium demands

how do ihds occur

´In most patients, unstable angina, infarction, and sudden cardiac death occur because of abrupt plaque change followed by thrombosis—hence the term acute coronary syndrome ´ Plaques that contain large atheromatous cores or have thin overlying fibrous caps are more likely to rupture and are therefore termed vulnerable

what is Infective Endocarditis ? describe it

´Infective endocarditis (IE) is a microbial infection of the heart valves or the mural endocardium (nonvalvular endocardium) that leads to the formation of vegetations composed of thrombotic debris and organisms, often associated with destruction of the underlying cardiac tissues. The aorta, aneurysmal sacs, other blood vessels, and prosthetic devices also may become infected. ´Fever is the most consistent sign of infective endocarditis. However, in subacute disease (particularly in older adults), fever may be absent, and the only manifestations may be nonspecific fatigue, weight loss, and a flulike syndrome; splenomegaly also is common in subacute cases.

left sided failure affets what

´Low output vs. congestion ´Lungs: pulmonary congestion and edema, heart failure cells ´ ´Kidneys: pre-renal azotemia, salt and fluid retention , renin-aldosterone activation, natriuretic peptides ´ ´Brain: Irritability, decreased attention, stupor->coma ´

what is the most common reason for Left side failure ? what are the symptoms ?

´Most common reason is ischemic heart diseases, hypertension, mitral or aortic valve disease, primary disease of myocardium, ´ ´Symptom : pulmonary Congestion , edema, Secondary to hypo perfusion they shows renal and cerebral dysfunction

what are the 3 types of insufficient blood supply to the heart

´Stable ( chest pain in exertion and stress, reason is poor blood flow) relieved by rest or nitro ´ ´Prinzmetal (variant angina ): Spasm is main feature, responds to nitro, S-T elevation. Often younger with people not much atherosclerotic narrowing.(temporary increase in coronary vascular tone which cause transient blood reduction ) ´ ´Un stable :(Chest pain in rest or exertion and doesn't improve by rest ) the heart doesn't get enough blood flow and oxygen perhaps some thrombosis, perhaps some non trans mural necrosis, perhaps some embolization,

what is ACUTE CORONARY SYNDROMES

´The acute coronary syndromes are frequently initiated by an unpredictable and abrupt conversion of a stable atherosclerotic plaque to an unstable and potentially life-threatening atherothrombotic lesion through superficial erosion, ulceration, fissuring, rupture, or deep hemorrhage, usually with superimposed thrombosis."

right---> L shunt

´With right-to-left shunt, a dusky blueness of the skin (cyanosis) results because the pulmonary circulation is bypassed, and poorly oxygenated blood collected from the venous system enters the systemic arterial circulation. ´ ´Tetralogy of Fallout ´Transposition of great arteries ´Truncus arteriosus ´Total anomalous pulmonary venous connection ´Tricuspid atresia ´These lesions cause early-onset cyanosis and are associated with polycythemia, hypertrophic osteoarthropathy( clubbing and periostitis of small hand joints ),and paradoxical embolization.

what is Angina Pectoris

´chest pain due to inadequate profusion , ( usually atherosclerosis with more than 70% stenosis ) ( not myocardium death but shows infarction risk ) Paroxysmal (sudden)‏ Recurrent 15 sec.-> 15 min. Reduced perfusion, but NO infarction

what is the ´is most common and typically associated with ASD,VSD,PDA( Acyanotic )

´left-to-right shunts increase blood flow into the pulmonary circulation and are not associated with cyanosis.(Acyanotic ) ´ ´Shunting results in right-sided volume overload ´ ´These lesions result chronic right-side pressure and volume overload that eventually cause pulmonary hypertension

what does Ischemia cause

´loss of function in 1-2 minute but necrosis after 20-40 minute ´Diagnostic tests: EKG, Serum CK-MB, troponin

what is adiagnosis of acute rheumatic fever based on

´made based on serologic evidence of previous streptococcal infection in conjunction with two or more of the Jones criteria: ´(1) carditis; ´(2) migratory polyarthritis of large joints; ´ (3) subcutaneous nodules; ´(4) erythematous annular rash (erythema marginatum) in the skin; ´(5) Sydenham chorea, a neurologic disorder characterized by involuntary movement ( rapid, irregular, aimless movements)

what do Cardiac muscle rely on

´oxidation phosphorylation on their energy needs , then myocytes have high density mitochondria ( 20-30% of cells volume) ´ ´They require constant supply of oxygenated blood,( it explain heart volubility to ischemia ). ´ ´Nutrition and oxygen delivered through coronary arteries

what does Coordinate contraction of cardiac muscle depend on

´propagation of electronic impulse accomplished through specialized excitory and conducting myocytes within cardiac conduct system that regulate heart rate and rhythm . ´ ´The rate frequency of electronic impulse is sensitive to neural impulses. cardiac conduction system are the SA node, AV node, bundle of His, bundle branches, and Purkinje fibers.

what is Ischemic Heart disease a consequence of?

´reduced coronary blood flow secondary to obstructive atherosclerotic vascular ´ ´ Thus, unless otherwise specified, IHD usually is synonymous with coronary artery disease (CAD)disease

what causes Acute myocardia infarction?

´usually due to thrombosis or plug disruption which is cardiac muscle death due to prolong hypoxia( myocardium Necrosis )

when does Heart failure ( CHF) occurs

´when the heart is unable to provide adequate perfusion to meet the metabolic requirements of the peripheral tissues, inadequate cardiac output is usually accompanied by increased congestion of venous circulation (CHF occurs when the heart cannot generate sufficient output to meet the metabolic demands of the tissues) ´ ´Left side failure Right side failure

describe acute gastritis what are its symptoms ? what is its morphology ?

•(NSAIDs), particularly aspirin •Excessive alcohol consumption •Heavy smoking •Severe stress (e.g., trauma, burns, surgery) •Ischemia and shock Morphology : transient acute inflammation of the gastric lamina propria Symptom: nagging pain that doesn't last long

what is Neutropenia/Agranulocytosis?

•A reduction in the number of granulocytes in blood is known as neutropenia or, when severe, agranulocytosis. Neutropenic persons are susceptible to severe, potentially fatal bacterial and fungal infections. Reasons : 1.Decreased granulocyte production. (caused by marrow hypoplasia as occurs transiently with cancer chemotherapy and chronically with aplastic anemia or extensive replacement of the marrow by tumor) ● 2. Increased granulocyte destruction. This can be encountered with immune-mediated injury (triggered in some cases by drugs) or in overwhelming bacterial, fungal, or increased peripheral use or Splenomegaly

what is is gastritis what are the two types ?

•ACUTE •CHRONIC •AUTOIMMUNE: Antibodies to parietal cells and intrinsic factor that can be detected in serum and gastric secretions

describe ARDS

•ARDS can be thought of as NON-cardiac pulmonary edema, or, more correctly, edema related to alveolar INJURY.more protein than cardiac pulmonary edema ARDS is a clinical syndrome of progressive respiratory insufficiency caused by diffuse alveolar damage in the setting of sepsis, severe trauma, or diffuse pulmonary infection.

what is Alpha-1 antitrypsin deficiency? what are the symptoms ?

•Alpha-1 antitrypsin deficiency is a genetic disease, •α₁-antitrypsin is a protein •It is a protease inhibitor; This deficiency can cause serious lung or liver disease. •Symptoms often include trouble breathing and jaundiced, or yellow, skin. •It will cause recurrent infections and with other irritants, like tobacco smoke, there are lung break down •The symptoms will start from 20s or 30s. •The symptoms start with Emphysema like or Asthma like complain and SOB

more info about celiac disease

•Also called SPRUE •Also called NON-tropical SPRUE •Also called GLUTEN-SENSITIVE ENTEROPATHY •Sensitivity to GLUTEN, a wheat protein, gliadin •Immobilizes T-cells •Also in oat, barley, rye •Progressive mucosal "atrophy", i.e. villous flattening •Relieved by gluten withdrawal

Anemia of the blood loss, Hemorrhage can be divided into what ?

•Anemia of blood loss can be divided into anemia caused by acute bleeding (hemorrhage) and anemia caused by chronic blood loss • •The effects of acute bleeding are mainly due to the loss of intravascular volume, which if massive can lead to cardiovascular collapse, shock, and death • •With chronic blood loss, iron stores are gradually depleted.

what are Aplastic Anemia's clinical features?

•Aplastic anemia affects persons of all ages and both sexes. The slowly progressive anemia causes the insidious development of weakness, pallor, and dyspnea. Thrombocytopenia often manifests with petechiae and ecchymoses. Neutropenia may set the stage for serious infections. • WPD

what is Aplastic Anemia?

•Aplastic anemia is a disorder in which multipotent myeloid stem cells are suppressed, leading to bone marrow failure and pancytopenia. •Caused by bone marrow failure (hypo cellularity) resulting from diverse causes, including exposures to toxins and radiation, idiosyncratic reactions to drugs and viruses. •Pathogenesis The pathogenesis of aplastic anemia is not fully understood, but two major etiologies have been invoked: • • an extrinsic, immune-mediated suppression of marrow progenitors, •an intrinsic abnormality of stem cells •

when checking if a patient has melanoma what do you check ?

•Asymmetric shape •Border irregular •Color change •Diameter greater than 6 mm •Expanding or evolving lesion

examples of Leukocytosis

•Basophilic Leukocytosis (Basophilia) •Rare, often indicative of a myeloproliferative neoplasm (e.g., chronic myeloid leukemia) • •Monocytosis: Chronic infections (e.g., tuberculosis), bacterial endocarditis, rickettsiosis, and malaria; collagen vascular diseases (e.g., systemic lupus erythematosus); and inflammatory bowel diseases (e.g., ulcerative colitis) • • Lymphocytosis: chronic immunologic stimulation (e.g., tuberculosis, brucellosis); viral infections (e.g., hepatitis A, cytomegalovirus, Epstein-Barr virus);

what are the berry aneurysms

•Berry aneurysms are thin-walled arterial outpouchings in cerebral vessels, classically at branch points around the circle of Willis; they occur where the arterial media is congenitally attenuated and can spontaneously rupture be causing fatal intracerebral hemorrhage • • Arteriovenous (AV) fistulas are abnormal connections between arteries and veins without an intervening capillary bed. They occur most commonly as developmental defects but can also result from rupture of arterial aneurysms into adjacent veins, from penetrating injuries that pierce arteries and veins, or from inflammatory necrosis of adjacent vessels.

what is PNEUMOCONIOSIS?

•COAL MINERS LUNG" •DUST OR CHEMICALS OR ORGANIC MATERIALS Coal (anthracosis) Silica Asbestos HAY, INSECTICIDES, etc

what are the possible patholgies for the small and large INTESTINE?

•CONGENITAL •ENTEROCOLITIS: DIARRHEA, INFECTIOUS, OTHER •MALABSORPTION: INTRALUMINAL, CELL SURFACE, INTRACELL. •IBD: CROHN DISEASE and ULCERATIVE COLITIS •VASCULAR: ISCHEMIC, ANGIODYSPLASIA, HEMORRHAGIC •DIVERTICULOSIS/-ITIS •OBSTRUCTION: MECHANICAL, PARALYTIC (ILEUS) (PSEUDO) •TUMORS: BENIGN, MALIGNANT, EPITHELIAL, STROMAL

desribe vascular organization

•Capillaries have lumen diameters slightly smaller than those of red blood cells (7 to 8 µm). These vessels are lined by ECs and partially surrounded by SMC-like cells called pericytes. Collectively, capillary beds have a very large total cross-sectional area and a low rate of blood flow. •Veins receive blood from the capillary beds as postcapillary venules, which anastomose to form collecting venule and progressively larger veins. The vascular leakage (edema) and leukocyte emigration characteristic of inflammation occurs preferentially in postcapillary venules •Compared with arteries at the same level of branching, veins have larger diameters, larger Lumina, and thinner walls with less distinct layers, all adaptations to the low pressures found on the venous side of the circulation

anatomy of gastric path way

•Cardia (esoph), Fundus (diaph), Body (acid), Antrum, Pylorus •Greater/Lesser Curvatures •1500-3000 ml •Rugae •INNERVATION: VAGUS, Sympathetic •VEINS: Portal •Blood Supply: RG, LG

what is Immuno-hemolytic Anemia caused by ?

•Caused by antibodies against either normal red cell constituents or antigens modified by haptens (such as drugs) •Antibody binding results in either red cell extravascular hemolysis or(uncommonly) complement fixation and intravascular hemolysis

what is megaloblastic anemia caused by ? what does it result in ?

•Caused by deficiencies of folate or vitamin B12 that lead to inadequate synthesis of thymidine and defective DNA replication • •Results in enlarged abnormal hematopoietic precursors (megaloblasts), ineffective hematopoiesis, macrocytic anemia, and (in most cases) pancytopenia

Anemia of Chronic Inflammation is caused by?

•Caused by inflammatory cytokines, which increase hepcidin levels and it inhibits iron release from macrophages, and also suppress erythropoietin production. •Often referred to as the anemia of chronic disease, anemia associated with chronic inflammation is the most common form of anemia in hospitalized patients. Its suppression of erythropoiesis by systemic inflammation. • •

what is Immuno-hemolytic Anemia

•Immunohemolytic anemia is caused by antibodies that bind to determinants on red cell membranes. These antibodies may arise spontaneously or be induced by exogenous agents such as drugs or chemicals. • Immunohemolytic anemia is uncommon and is classified based on •(1) the nature of the antibody •(2) the presence of predisposing conditions

Anemia pathogenesis where does chronic anemia normaly occur ?

•Chronic blood loss is the most important cause of iron deficiency anemia in the Western world bleeding are the gastrointestinal tract (e.g., peptic ulcers, colon cancer, hemorrhoids) and the female genital tract (e.g., menorrhagia, metrorrhagia, endometrial cancer). •In the developing world, low intake because of predominantly vegetarian diets are the most common causes of iron deficiency. •In most instances, iron deficiency manifestations, such as weakness, listlessness, and pallor, may be present in severe cases. With long-standing anemia, abnormalities of the fingernails, including thinning, flattening, and "spooning,"

what are RESTRICTIVE (INFILTRATIVE) lung disseases ?

•Chronic interstitial diseases are a heterogeneous group of disorders characterized by bilateral, often patchy, pulmonary fibrosis mainly affecting the walls of the alve -Diffuse interstitial fibrosis of the lung gives rise to restrictive lung diseases characterized by reduced lung compliance and reduced forced vital capacity (FVC).

describe Iron Deficiency Anemia

•Deficiency of iron is the most common nutritional deficiency in the world and results in clinical signs and symptoms that are mostly related to anemia. • •Iron is transported in the plasma bound to the protein transferrin. In normal persons, transferrin is about 33% saturated with iron, yielding serum iron levels that average 120 µg/dL in men and 100 µg/dL in women. Thus, normal total iron-binding capacity of serum is 300 to 350 µg/dL.

describe hital hernia

•Diaphragmatic muscular defect •WIDENING of the space which the lower esophagus passes through •IN ALL cases, STOMACH above diaphragm

describe White Blood cells disorders

•Disorders of white cells include deficiencies (leukopenia)& proliferations, which may be reactive or neoplastic. • •Reactive proliferation in response to a primary, often microbial, disease is common. Neoplastic disorders are less common.

describe the Endothelial Layer

•Endothelium is a continuous sheet of cells lining the entire vascular tree that regulates many aspects of blood and blood vessel function In most regions, the inter endothelial junctions normally are impermeable. However, these junctions open under the influence of hemodynamic stress (e.g., high blood pressure) and/or vasoactive agents (e.g., histamine in inflammation), flooding the adjacent tissues with electrolytes and protein. Vacuolar transcytosis also permits the movement of large amounts of solutes

what are cancer risk factors ?

•Family history •Age (rare <50) •LOW fiber, HIGH meat, LONG transit time, refined carbs (These carbs that get absorbed slowly into our systems) , From existing ADENOMATOUS POLYPS • •Dysplasia malignancy

what is Folate (Folic Acid) Deficiency Anemia?

•Folate deficiency is usually the result of inadequate dietary intake, sometimes poor diet (the economically deprived, the indigent, and the elderly) or those with increased metabolic needs (pregnant women and patients with chronic hemolytic anemia, such as sickle cell disease).

what are Atherosclerosis risk factors

•Genetics. Family history is the most important independent risk factor for atherosclerosis. (e.g., familial hypercholesterolemia) •Age. Atherosclerosis usually remains clinically silent until lesions reach a critical threshold in middle age or later. Thus, the incidence of myocardial infarction increases 5-fold between 40 and 60 years of age. Death rates from IHD continue to rise with each successive decade. •Gender. All other factors being equal, premenopausal women are relatively protected against atherosclerosis (and its consequences) compared with age-matched men. Thus, myocardial infarction and other complications of atherosclerosis are uncommon in premenopausal women in the absence of other predisposing factors such as diabetes, hyperlipidemia, or severe hypertension. After menopause, however, the incidence of atherosclerosis-related disease increases and can even exceed that in men. Inflammation.

wwhat is Sickle Cell Anemia caused by ?

•Hemoglobinopathies are a group of hereditary disorders caused by inherited mutations that lead to structural abnormalities in hemoglobin. • mutation in β-globin that creates sickle hemoglobin (HbS). •protective effect against Plasmodium falciparum malaria

what are the clincial features of G6PD deficeny

•Hemolysis typically develops 2 or 3 days after drug exposure and is of variable severity. Because G6PD is X-linked, the red cells of affected males are uniformly deficient and vulnerable to oxidant injury

what is hemolytic anemia ? whats the difference between Extravascular vsIntravascular?

•Hemolytic anemia are a diverse group of disorders that have as a common feature accelerated red cell destruction (hemolysis). •Extravascular hemolysis is caused by defects that increase the destruction of red cells by phagocytes, particularly in the spleen. •spleen contains large numbers of macrophage. •Intravascular : •result from mechanical forces (e.g., turbulence created by a defective heart valve) or biochemical or physical agents that severely damage the red cell membrane • Hemoglobinemia, hemoglobinuria, and hemosiderin-uria. • Hemoglobin released into the circulation is small enough to pass into the urinary space.

what is Spherocytosis?

•Hereditary spherocytosis is caused by inherited defects in the membrane skeleton, a network of proteins that stabilizes the lipid bilayer of the red cell • The common feature of the pathogenic mutations is that they weaken vertical interactions between the membrane skeleton and intrinsic red cell membrane proteins.

what are Modifiable Major Risk Factors?

•Hyperlipidemia—and, more specifically, hypercholesterolemia—is a major risk factor for development of atherosclerosis and is sufficient to induce lesions in the absence of other risk factors. High dietary intake of cholesterol and saturated fats Lipoprotein(a) levels: Lipids:

what is a Hemorrhoid: what are the diefrent types ?

•INTERNAL &EXTERNAL -Hemorrhoids are dilated anal and perianal collateral vessels

Inflammatory Dermatosis is mediated by what ?

•IgE antibodies (urticaria), antigen-specific T cells (eczema, erythema multiforme, and psoriasis), or trauma (lichen simplex chronicus).

what do children typicaly have ? what does Vascular congestion, thrombosis, and infarction affect ?

•In children, there is moderate splenomegaly (hypoxic damage and infarcts), which reduces the spleen to useless fibrous tissue with time. This process, referred to as auto-splenectomy, is complete by adulthood. • •Vascular congestion, thrombosis, and infarction can affect any organ, including the bones, liver, kidney, retina, brain, lung, and skin.

what is THROMBOCYTOPENIA

•Isolated thrombocytopenia is associated with a bleeding tendency and normal coagulation tests. A count less than 150,000 platelets/µL generally is considered thrombocytopenia. However, only when platelet counts fall to 20,000 to 50,000 platelets/µL is there an increased risk of posttraumatic bleeding, and spontaneous bleeding • • Most bleeding occurs from small, superficial blood vessels and produces petechiae or large ecchymoses in the skin, the mucous membranes of the gastrointestinal and urinary tracts

what are the three types of Arteries based on their size and structure

•Large elastic arteries (e.g., aorta, arch vessels, iliac and pulmonary arteries). In these vessels, elastic fibers alternate with SMCs throughout the media, which expands during systole (storing some of the energy of each cardiac contraction), and recoils during diastole to propel blood distally. With age and/or diseases, such as diabetes and hypertension, the elasticity is lost; the vessels become "stiff pipes" that transmit high arterial pressures to distal organs. • Medium-sized muscular arteries (e.g., coronary and renal arteries). Here, the media is composed primarily of SMCs, with elastin limited to the internal and external elastic lamina. The medial SMCs are circularly or spirally arranged around the lumen, and regional blood flow is regulated by SMC contraction (vasoconstriction) and relaxation (vasodilation) controlled by the autonomic nervous system and local metabolic factors. • Small arteries (2 mm or less in diameter) and arterioles (20 to 100 µm in diameter) lie within the connective tissue of organs. The media in these vessels is mostly composed of SMCs. Arterioles are where blood flow resistance is regulated. As pressures drop during passage through arterioles, the velocity of blood flow is sharply reduced, and flow becomes steady rather than pulsatile.

what are the NONNEOPLASTIC DISORDERS OF WHITE CELLS

•Leukopenia: Leukopenia results most commonly from a decrease in granulocytes, the most numerous circulating white cells • •Neutropenia :A reduction in the number of granulocytes in blood is known as neutropenia

what is the most common site for all metastatic tumors ? and why?

•Lung is the Most common site for all metastatic tumors, regardless of site of origin •It is the site of First choice for metastatic sarcomas for purely anatomic reasons!

what do Lymphatics do

•Lymphatics are thin-walled, endothelium-lined channels that drain lymph (water, electrolytes, glucose, fat, proteins, and inflammatory cells) from the interstitium of tissues, eventually reconnecting with the blood stream via the thoracic duct. Lymphatics transport interstitial fluid and inflammatory cells from the periphery to lymph nodes, thereby facilitating antigen presentation and cell activation in the nodal tissues—and enabling continuous monitoring of peripheral tissues for infection.

what is 1.ULCERATIVE COLITIS?

•MUCOSAL, THICK MUCOSA •LIMITED to COLON •NO GRANULOMAS •FISTULAE RARE •TERMINAL ILEUM NEVER •NO SKIP AREAS •"CRYPT" ABSCESSES COMMON •PSEUDOPOLYPS •NO MALABSORPTION

what are the Gastric Mucosa secretions?

•MUCUS •CHIEF: PEPSINOGEN •PARIETAL: ACID, IF •ENTEROENDOCRINE: HISTAMINE, • SOMATOSTATIN, ENDOTHELIN

what is the norma; RBC count for men and women ?

•Male : 4.5-6*10 tera /L • Female : 4-5 *10 tera/L •Male = 14-17 gr/dL Female =12-15 gr/dL

what does MCV measure ? what does MCH? MCHC?

•Mean cell volume (MCV): the average volume per red cell, expressed in femtoliters (cubic microns) • Mean cell hemoglobin (MCH): the average mass of hemoglobin per red cell, expressed in picograms • Mean cell hemoglobin concentration (MCHC): the average concentration of hemoglobin in a given volume of packed red cells, expressed in grams per deciliter

what is megaloblastic anemia ?

•Megaloblastic anemia stems from metabolic defects that lead to inadequate biosynthesis of thymidine, one of the building blocks of DNA. • •folate and vitamin B12 are both essential factors for the synthesis of thymidylate, This maturational derangement contributes to the anemia in several ways.

whats is Myelophthisic Anemia caused by ?

•Myelophthisic anemia is caused by extensive marrow infiltration by tumors or other lesions. •Caused by replacement of the bone marrow by infiltrative processes such as metastatic carcinoma and granulomatous disease

what are some of the Clinical Consequences of Abdominal Aortic Aneurysm?

•Obstruction of a vessel branching off the aorta (e.g., the renal, iliac, vertebral, or mesenteric arteries), resulting in ischemia of the kidneys, legs, spinal cord, or gastrointestinal tract, respectively •Embolism of atheromatous material (e.g., cholesterol crystals) or mural thrombus •Impingement on adjacent structures (e.g., compression of a ureter or erosion of vertebrae by the expanding aneurysm) •An abdominal mass (often palpably pulsating) that simulates a tumor •Rupture into the peritoneal cavity or retroperitoneal tissues, leading to massive, often fatal hemorrhage

Lichen Planus what is it ?

•Pruritic, purple, polygonal, planar papules, and plaques" The lesions may result from a CD8+ T cell-mediated cytotoxic response against antigens in the basal cell layer •Cutaneous lesions of lichen planus consist of pruritic, violaceous, flat-topped papules that may coalesce focally to form plaques It is a condition that can cause swelling and irritation in the skin, hair, nails and mucous membranes. usually appears as purplish, itchy, flat bumps that develop over several weeks

describe Glucose-6-Phosphate Dehydrogenase Deficiency what is it caused by ?

•Red cells are constantly exposed to both endogenous and exogenous oxidants, which are normally inactivated by reduced glutathione (GSH). Abnormalities affecting enzymes responsible for the synthesis of GSH leave red cells vulnerable to oxidative injury and hemolysis. •The X-linked disorder is caused by mutations that destabilize G6PD, making red cells susceptible to oxidant damage

What causes esophagitis?

•Reflux of gastric contents into the lower esophagus is the most frequent cause of esophagitis. The associated clinical condition is termed gastroesophageal reflux disease (GERD). Esophagitis can result from chemical or infectious mucosal injury. Infections are most frequent in immunocompromised individuals.

what are the symptpms of a Thoracic Aortic Aneurysm?

•Respiratory or feeding difficulties due to airway or esophageal compression, respectively, because of encroachment on mediastinal structures •Persistent cough from irritation of the recurrent laryngeal nerves •Pain caused by erosion of bone (i.e., ribs and vertebral bodies) •Cardiac disease due to valvular insufficiency or narrowing of the coronary ostia; heart failure induced by aortic valvular incompetence •Aortic dissection or rupture

what is scabies ?

•Scabies is caused by sarcoptes scabies. intensely itchy rash caused by a mite known as Sarcoptes scabies. • • •Cutaneous larva migrans is caused by toxocara Canis

what is Hyperhomocysteinemia.

•Serum homocysteine levels correlate with coronary atherosclerosis, peripheral vascular disease, stroke, and venous thrombosis. Homocystinuria, due to rare inborn errors of metabolism, causes elevated circulating homocysteine (greater than 100 µmol/L) and is associated with early-onset vascular disease.

what is Hemophilia B—Factor IX Deficiency?

•Severe factor IX deficiency is an X-linked disorder that is indistinguishable clinically from hemophilia A but is much less common. The PTT is prolonged. The diagnosis is made using specific assays of factor IX. It is treated by infusion of recombinant factor IX.•

what is sickle cell anemia caused by ?

•Sickle cell anemia is caused by a single amino acid substitution in β-globin that results in a tendency for deoxygenated HbS to self-associate into polymers.

what is CROHN DISEASE (granulomatous colitis)?

•TRANSMURAL, THICK WALL •NOT LIMITED to COLON •GRANULOMAS •FISTULAE COMMON •TERMINAL ILEUM OFTEN •SKIP AREAS •"CRYPT" ABSCESSES NOT COMMON •NO PSEUDOPOLYPS •MALABSORPTION

what is Thalassemia?

•Thalassemia is inherited disorders caused by mutations in globin genes that decrease the synthesis of α- or β-globin • Thalassemia • Autosomal co-dominant disorders caused by mutations in α or β-globin that reduce hemoglobin synthesis, resulting in a microcytic, hypochromic anemia. In β-thalassemia, unpaired α-globin chains form aggregates that damage red cell precursors and further impair erythropoiesis.

what is the morphology of megablastic anemia

•The bone marrow is markedly hyper cellular and contains numerous megaloblastic erytroid progenitors. Megaloblasts are larger than normal erythroid progenitors • • (The granulocytic precursors also demonstrate nuclear cytoplasmic asynchrony, giant metamyelocytes. • • Megakaryocytes may also be abnormally large and have bizarre multilobed nuclei. In the peripheral blood the earliest change is the appearance of hyper segmented neutrophils -The red cells typically include large, egg-shaped macro ovalocytes; the MCV often is greater than 110 fL (normal, 82-96 fL

what role does the spleen play in Spherocytosis?

•The critical role of the spleen in hereditary spherocytosis is illustrated by the beneficial effect of splenectomy; although the red cell defect and spherocytosis persist, the anemia is corrected • Autosomal dominant disorder caused by mutations that affect the red cell membrane skeleton, leading to loss of membrane •On smears, spherocytes are dark red blood cells & lack central pallor

what are some important facts about basal cell carcinoma?

•This is the most common type of skin cancer •It is the least dangerous because of rare metastatic •Arises from stratum basalis •Appears first as a small shiny bump •Later will have central depression and beaded pearly edge

what are the symptoms of hital hernia

•Ulceration, bleeding, perforation, strangulation Gastroesophageal reflux •GERD is chyme reflux from the stomach results heartburn

What is Urticaria

•Urticaria ("hives") is a common disorder mediated by localized mast cell degranulation, which leads to dermal microvascular hyperpermeability. •In most cases, urticaria stems from an immediate (type 1) hypersensitivity reaction • lesions usually develop and fade within hours, but episodes can persist for days or even months. • Lesions range in size and nature from small, pruritic papules to large, edematous, erythematous plaques.

what are some Benign Tumors and Tumor-Like Conditions?

•Vascular Ectasias: Ectasia is a generic term for any local dilation of a structure, while telangiectasia is used to describe a permanent dilation of preexisting small vessels (capillaries, venules, and arterioles, usually in the skin or mucous membranes) that forms a discrete red lesion. These lesions can be congenital or acquired and are not true neoplasms. Nevus flammeus (a "birthmark"), the most common form of vascular ectasia, is a light pink to deep purple flat lesion on the head or neck composed of dilated vessels. Most ultimately regress spontaneously.

what is VASCULITIS? what is Noninfectious Vasculitis?

•Vasculitis is a general term for vessel wall inflammation. The two most common pathogenic mechanisms of vasculitis are immune-mediated inflammation and direct vascular invasion by infectious pathogens. -The main immunologic mechanisms underlying noninfectious vasculitis are as follows: • Immune complex deposition •Anti-neutrophil cytoplasmic antibodies •Anti-EC antibodies •Autoreactive T cells Immune Complex-Associated Vasculitis This form of vasculitis is seen in immunologic disorders such as systemic lupus erythematosus that are associated with autoantibody production.

what is Vitamin B12 (Cobalamin) Deficiency Anemia?

•Vitamin B12 is widely present in foods, is resistant to cooking and boiling, and is even synthesized by gut flora. •On entering the duodenumB12, which attaches to intrinsic factor secreted from the parietal cells of the gastric fundic mucosa. • The intrinsic factor-B12 complexes pass to the distal ileum and attach to receptor for intrinsic factor, and are taken up into enterocytes

what are Angiosarcomas?

•are malignant endothelial neoplasms ranging from highly differentiated tumors resembling hemangiomas to wildly anaplastic lesions. • Older adults are more commonly affected, without gender predilection; lesions can occur at any site, but most often involve the skin, soft tissue, breast, and liver. Clinically, angiosarcomas are aggressive tumors that invade locally and metastasize. Current 5-year survival rates are only about 30%.

what is Dermatitis herpetiformis?

•associated with IgA autoantibodies to transglutaminase, and also is characterized by subepidermal blisters. autoimmune blistering disorder associated with gluten sensitivity( celiac) that is characterized by extremely pruritic grouped vesicles and papules. The disease affects predominantly males, often in the third and fourth decades of life.

What is bullous pemphigoid?

•associated with IgG autoantibodies to basement membrane proteins (part of the hemidesmosome) and produces a subepidermal blister. tense subepidermal bullae filled with clear fluid

when doe a aortic dissection occur ? what are the clinical consequqences ?

•dissection occurs when blood splays apart the laminar planes of the media to form a blood-filled channel within the aortic wall •Pathogenesis Hypertension is the major risk factor for aortic dissection. -•The clinical manifestations of dissection depend primarily on the portion of the aorta affected; the most serious complications occur with dissections involving the proximal aorta and arch. Thus, aortic dissections generally are classified into two types

what is a Hiatal Hernia?( Sliding , Para esophagus Hiatal hernia)

•due to diaphragm weakness . ( part of stomach entered the thorax )

what is Barrett esophagus? what is the greatest concern regarding this condition ?

•esophagus is a complication of chronic GERD that is characterized by intestinal metaplasia within the esophageal squamous mucosa. -The greatest concern in Barrett esophagus is that it confers an increased risk for development of esophageal adenocarcinoma.

what is Atheroscleros characterized by?

•intimal lesions called atheromas (or atheromatous or atherosclerotic plaques) that impinge on the vascular lumen and can rupture to cause sudden occlusion. It underlies the pathogenesis of coronary, cerebral, and peripheral vascular disease, and causes more morbidity and mortality

what is considered "True" aneurysms

•involve all three layers of the artery (intima, media, and adventitia) or the attenuated wall of the heart; these include atherosclerotic and congenital vascular aneurysms, as well as ventricular aneurysms resulting from transmural myocardial infarctions.

what is Hirschsprung disease?

•is the result of defective neural crest cell migration from cecum to rectum. It gives rise to functional obstruction.

when does Esophageal obstruction occur ?

•may occur as a result of mechanical or functional anomalies. Mechanical causes include developmental defects, fibrotic strictures, and tumors.

where do Aneurysms occurring as a consequence of atherosclerosis form?

•most commonly in the abdominal aorta and common iliac arteries and may also involve the aortic arch and descending thoracic aorta. Abdominal aortic aneurysms (AAAs) occur more frequently in men and in smokers and rarely developbefore 50 years of age.

Diffuse pulmonary diseases can be classified into what two categories?

•obstructive (airway) disease, characterized by an increase in resistance to air flow caused by partial or complete obstruction at any level. •(2) restrictive disease, characterized by reduced expansion of lung parenchyma and decreased total lung capacity.

Abdominal herniation occurs where ?

•occur through any weakness , or defecting the wall of the peritoneal cavity, including inguinal and femoral canals, umbilicus, and sites of surgical scarring. hernia sac is a contribution of the peritoneum of the abdomen . And its content are intestine, omentume, or other abdominal content

what is Actinic Keratosis?

•premalignant lesion caused by UV-induced DNA damage that is associated with mutations in TP53 and other genes that also are frequently mutated in squamous cell carcinoma of the skin. • Actinic keratosis present on sun-exposed skin, these lesions show cytologic atypia in lower parts of the epidermis and infrequently progress to carcinoma in situ. •Although both of these lesions(actinic keratoses, Seborrheic Keratosis ) are associated with oncogenic mutations, malignant transformation is exceedingly rare in seborrheic keratoses and occurs in only a small subset of actinic keratoses.

jhow does melanoma progress?

•progresses from an intraepithelial (in situ) to an invasive (dermal) form. •Characteristics of the dermal tumor such as depth of invasion and mitotic activity correlate with survival.

what are verrucae ?

•proliferative lesions of squamous epithelial cells that are caused by human papillomavirus (HPV). Pathogenesis: • Cutaneous warts are mainly caused by low-risk HPV subtypes that lack transforming potential. Like high-risk HPV, low-risk viruses express viral E6 and E7 oncoproteins that lead to dysregulated epidermal cell growth and increased survival.

what is Roseola:? who does it usualy effect ?

•red rash after several days of high fever (It is usually marked by several days of high fever, followed by a distinctive rash just as the fever breaks.it affects young kids between 6 months and 2 years old

where does Esophageal adenocarcinomas occur ? where do half of squamous cell carcinomas occur ?

•usually occurs in the distal third of the esophagus and may invade the adjacent gastric cardia -•occur in the middle third of the esophagus

describe the chicekn pox?

•vesiculopustular rash on the trunk spreads to face and limb (A viral infection that causes fever and an itchy rash with spots all over the body.)