Exam 2 Patho Etsu
Acute Myeloid Leukemia (AML)
- Too many myeloblasts ( small stem cells) (immature) - hudson says in most often occurs in children? but others say adults
What does cancer staging involve?
- determine the size of the tumor -the degree to which it has locally invaded -the extent to which it has spread (metastasized)
Types of kidney stones
-Calcium oxalate (80%) -Struvite -Uric Acid
Chronic Lymphocytic Leukemia (CLL)
-Too many immature lymphocytes. predominant cell is mature but does not function normally -Most common in older adult - Follows a slow chronic course
Chronic Myelogenous Leukemia (CML)
-both mature and immature granulocytes are present in large numbers in the marrow and blood -3 stages: Chronic (2-5 years) Accelerated ( 6-18 months) Acute ( 3-6 months) -most often occurs in adults
Acute Lymphocytic Leukemia (ALL)
-presence of undifferentiated or immature cells, usually lymphoblast cells -Fast growing - Relapse common
What is leukemia?
A cancer of white blood cells/leukocytes.
hyperopia
A condition in which visual images come to a focus behind the retina of the eye and vision is better for distant than for near objects -- called also farsightedness.
- Arises from skin, joints, and muscles -A delta fibers: pain is sharp and well localized -C fibers: dull, aching, and poorly localized
Acute "Somatic" pain
-Pain in the internal organs and lining of body cavities -Transmitted by C fibers: poorly localized with an aching, gnawing, throbbing, or intermittent cramping quality -Often radiates or is referred
Acute "Visceral" pain
- sudden decline in kidney function with a decrease in glomerular filtration and accumulation of nitrogenous waste products in the blood as demonstrated by an elevation in plasma creatinine and blood urea nitrogen -Renal insufficiency -Renal failure -End stage renal failure
Acute Kidney Injury
Children
Acute Lymphocytic leukemia is most common in ...?
-Protective mechanism ( alerts an individual to a condition or experience that is immediately harmful to the body) - lasts sec. to days or up to 3 months - begins suddenly and relieved after pain stimulus removed
Acute pain
absence of urine
Anuria
- primary condition of bone marrow depression, results in reduction of all 3 hematopoietic cell lines ( red, white, platelets) - Symptoms: fatigue, pallor, petechiae, bleeding (from gums, nose, or GI), infections -Causes: radiation, chemical (chemo), toxins, drugs ( anti retroviral) , idiopathic, cancer -Treatment: bone marrow transplantation, transfusions, steroids
Aplastic Anemia ( Normocytic Normochromic )
10-20
BUN - Blood Urea Nitrogen (mg/dl)
- remain limited to their original location -Grow slowly ( capsulated in sandwich bag) -Well defined capsule -Well invasive -Well differentiated Slow mitosis Localized ( does not get into blood streams)
Benign tumors
8.5-10.5 mg/dL
Calcium levels
-Pre invasive epithelial tumors of granular or epithelial origin - Surveillance for cancer -Detects abnormal growth in epithelial tissue with atypical cells and increased proliferation -These are early stage cancers that have not broken through the basement membrane or invaded the surrounding stroma
Carcinoma in situ
Older adults
Chronic lymphocytic leukemia is most common in...?
-May be persistent or intermittent -May be sudden or develop insidiously -Usually defined as lasting as least 3 to 6 months -Response patterns vary -Produces significant behavior and psychologic changes -Usually do not see physiologic signs as in acute
Chronic pain
0.6-1.2 mg/dL
Creatinine levels
-absorption of folate occurs in the upper small intestine -not dependent on any other factor -treatment: requires daily oral administration of folate
Folate deficiency anemia (MACROCYTIC-NORMOCHROMIC)
-inflammation of the glomerulus -caused by primary glomerular injury: immunologic responses -> post streptococcal glomerulonephritis -or caused by secondary glomerular injury: diabetes, HIV Manifestations: can be sudden or insidious onset can have significant damage before symptoms develop Severe: Oliguria ( less than 30 ml/hr) hypertension renal failure symptoms: hematuria with red blood cell casts proteinuria
Glomerulonephritis
- painless, progressive, rubbery, enlargement of a single node or group of nodes, usually in neck area - REED STERNBERG CELL ONLY IN HODGKINS : distinctive tumor cell found with lymph biopsy -Good prognoisis -Derived from B cells -linked to EBV -Symptoms: fever, weight loss, night sweats, adenopathy, pruritis, mediastinal, mass, splenomegaly, and abdominal mass treatment: Chemo therapy , radiation, surgery
Hodgkin's lymphoma
What is leukemia caused by?
Increased numbers of abnormal white blood cells are produced
-most common type of anemia worldwide -nutritional iron deficiency or blood loss, metabolic or functional deficiency = blood loss because body uses iron when it bleeds -Manifestations: when serum hgb decreased to 7 or 8 gm/dl - Symptoms: fatigue, weakness, shortness of breath, pale ear lobes and palms, conjunctiva, red sore and painful tongue, spoon shaped nails
Iron deficiency anemia ( MICROCYTIC HYPOCHROMIC ANEMIA)
WBC count is higher than normal - a normal protective physiologic response to physiologic stressors
Leukocytosis
WBC count lower than normal - a low white blood count can make patient vulnerable to infections
Leukopenia
-enlarged lymph nodes that become palpable and tender - local and general -local: drainage of an inflammatory lesion located near the enlarge node -general: not connected nodes, occurs in the presence of malignant or nonmalignant disease such as autoimmune disease infections
Lymphadenopathy
- Large erythrocytes: normal Hgb -pernicious anemia
Macrocytic- Normochromic Anemia ( BIG NORMAL HEMOGLOBIN)
-Grows rapidly -not encapsulated -invasive -poorly differentiated cells -can spread distantly ( metastasis)
Malignant tumors
-red blood cells that are abnormally small and contain reduced amounts of hemoglobin
Microcytic Hypochromic Anemia (SMALL LOW HEMOGLOBIN)
- B cell cancer characterized by malignant proliferation of plasma cells that infiltrate bone marrow and aggregate into tumor masses in skeletal system. - destroys myeloid cells, makes them become cancerous, and attack bone and causes pain Symptoms: (C)alcium elevation (hypercalcemia) (R)enal impairment ( shuts down the renal system and kidneys) (A) anemia (B) bone pain
Multiple Myeloma (MM)
nearsightedness
Myopia
- glomerular inflammation due to the kidney serving as the antigen -causes: post infectious glomerulonephritis acute viral infections -symptoms: hematuria, edema, azotemia, proteinuria, BUN and serum creatinine increased urine output
Nephritic syndrome
-excretion of 3.5g or more of protein in the urine per day -the protein excretion is caused by glomerular injury -symptoms: high blood pressure, cholesterol, swelling (edema) of the eyelids, feet and abdomen, hypoalbuminemia, vitamin D deficiency, proteinuria
Nephrotic syndrome
-Chronic -Amplification of pain without stimulation -Described as burning, shooting, shock-like, or tingling
Neuropathic pain
-HAS NO STERNBERG CELLS - neoplastic disorder of lymphoid tissue - SPREADS FAST AND EARLY -> liver, spleen, and bone marrow -POOR PROGNOSIS
Non Hodgkin's lymphoma
characterized by red blood cells that are relatively normal in size and hemoglobin content by insufficient in number
Normocytic Normochromic Anemias
small amounts of urine, less then 400 mL/day
Oliguria
a malignant tumor of bone in which there is a proliferation of osteoblasts.
Osteosarcoma
occurs if cells crowd bone marrow; decreased production of all normal blood cells
Pancytopenia
- caused by a lack of intrinsic factor from the gastric parietal cells; chronic atrophic gastritis, alcoholism, malnutrition - required for vitamin b12 absorption -results in vitamin b12 deficiency - Symptoms: nerve demyelination -treatment: high doses of vitamin b12
Pernicious anemia ( MACROCYTIC NORMOCHROMIC)
150,000-450,000
Platelet count
excessive urination volume due to diabetes mellitus
Polyuria
3.5-5.0 mEq/L
Potassium levels
-an infection of one or both upper urinary tracts ( ureter, renal pelvis, and insterstitium) -types: acute pyelonephritis chronic pyelonephritis
Pyelonephritis
-substance that produces fever -affects the thermoregulatory system in the brain -2 types: exogenous and endogenous -examples : mold and yeast
Pyrogen
distinctive tumor cell found with lymph biopsy ( found only in Hodgkins)
Reed Sternberg cell
-unpleasant sensations with leg movements that occurs when resting and gets worse at night. - an urge to move the legs for relief -most common in pregnancy, older adults, and iron deficiency
Restless leg syndrome
135-145
Sodium levels
1.010-1.025
Specific gravity of urine
Cancer Stages
Stage 1: No metastasis ( no spreading ) Stage 2: Local invasion Stage 3: Spread to regional structures ( lymph nodes) Stage 4: distant metastasis
(T) Primary Tumor: -TX Primary tumor cannot be evaluated -T0 No evidence of primary tumor -TIS Carcinoma in situ -T1,T2,T3,T4 (N) Regional Lymph Nodes: - NX Regional lymph nodes cannot be evaluated -N0 No regional lymph node involvement -N1, N2, N3 involvement of regional lymph nodes ( number of lymph nodes and/ or extent of spread) (M) Distant Metastasis: -MX Distant metastasis cannot be evaluated -M0 No distant metastasis -M1 Distant metastasis is present
TNM Classifications
-(T) for tumor spread -(N) for node involvement -(M) for the presence of distant metastasis -the prognosis generally worsens with increasing tumor size, lymph node involvement, and metastasis
TNM system
Proprioception
The cumulative sensory input to the central nervous system from all mechanoreceptors that sense body position and limb movement.
Metastasis
The spread of cancer cells to different locations beyond their original site in the body -invades blood and lymphatic systems
- decrease in number of circulating platelets - platelet count <150,000 - <50,000= hemorrhage from minor trauma -<15,000= spontaneous bleeding w/o trauma -<10,000=severe bleeding -Causes: hypersplenism, autoimmune diease, hypothermia, viral or bacterial infections that causes DIC, heparin induced thrombocytopenia, HIV, drugs
Thrombocytopenia
30 ml/hr
Urine output
Condition of dizziness, "room spinning"
Vertigo
5,000-10,000
WBC Count
inflammation of the urinary bladder
What is cystitis?
Cachexia
a condition of physical wasting away due to the loss of weight and muscle mass that occurs in patients with diseases such as advanced cancer or AIDS - most severe form of malnutrition -Symptoms: Anorexia, weight loss, anemia, asthenia , taste alteration
Neutropenia
a decreased number of neutrophils
presbycusis
a gradual loss of sensorineural hearing that occurs as the body ages
petechiae
a small red or purple spot caused by bleeding into the skin.
Bence Jones protein
a special protein found in the blood and urine, indicative of multiple myeloma
decreased erythrocyte life span, ineffective bone marrow response to erythropoietin, altered iron metabolism
anemia of chronic inflammation
function of platelets
blood clotting
Ecchymosis
bruising
Cataracts
clouding of the lens
hypoxemia
decreased level of oxygen in the blood
A clot that breaks lose and travels through the bloodstream.
embolus
bleeding from the nose
epistaxis
red blood cell production
erythropoiesis
What is presbyopia?
farsightedness associated with aging -hard to focus on close objects -with age the lens grow harder and less elastic
What are nociceptors?
free nerve endings in skin, muscles, joints, arteries, and the viscera that responds to chemical, mechanical, and thermal stimuli -Can detect a wide range of stimuli: A-delta myelinated fibers and Unmyelinated C polymodal fibers
Conductive hearing loss
hearing impairment caused by interference with sound or vibratory energy in the external canal, middle ear, or ossicles
the normal formation and development of blood cells in the bone marrow
hematopoiesis
cancer risk factors
heredity, chemicals, radiation, physical irritation, diet & viruses
blood in the urine
hermaturia
Tumor markers include....
hormones, enzymes, genes, antigens, antibodies
Glaucoma
increased intraocular pressure results in damage to the retina and optic nerve with loss of vision
Where is erythropoietin made?
it is produced by the kidneys
vitamin K
necessary for synthesis and regulation of prothrombin
Vitamin K deficiency causes
poor blood clotting
presence of protein in the urine
proteinuria
What is Tumor Debulking?
removing a tumor during surgery
M protein
resists phagocytosis Streptococcus pyogenes
the most common form of hearing loss, also called nerve deafness; caused by damage to the cochlea's receptor cells or to the auditory nerves
sensorineural hearing loss
production of abnormal hemoglobin within RBCs
sickle cell anemia
functional incontinence
state in which a person experiences an involuntary, unpredictable passage of urine
pee when sneeze, cough, smile
stress incontinence
What are tumor markers?
substances produced by benign and malignant cells that are either present in or on tumor cells or found in blood, CSF, or urine
chemotherapy induced alopecia
temporary hair loss from chemotherapy
purpura
the appearance of multiple purple discolorations on the skin caused by bleeding underneath the skin ( hemorrhages)
function of erythrocytes
transport oxygen and carbon dioxide
have to pee like right now can't wait -sudden urge
urge incontinence
How is EPO released?
when oxygen levels are low EPO is released by the kidneys