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| PATHOPHYSIOLOGY Exam2 Terminology and QuickFacts |
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Definition
also should make cards for "clinical symptoms" or "patient presents", etc.
we should also review normal reference ranges |
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Acute Leukemia
is rapid uncontrolled proliferation of WBC's w/ infiltration and replacement of normal bone marrow cells |
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Acute Myeloid Leukemia
is cancer that starts in the bone marrow, cells of the myeloid lineage, proliferates replacing normal cells
=> Auer rods |
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Acute Lymphoblastic Leukemia
is cancer of WBCs with excessive proliferation of lymphoblasts, filtration and crowding out
=> TdT or CALLA surface antigens
=> Philadelphia Chromosome |
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Chronic Lymphocytic Leukemia
is the most common cancer of WBCs that affects B lymphocytes: lose antibody production, uncontrolled proliferation (monoclonal not polyclonal), infiltration of organs leads to swelling of lymph/spleen/liver
=> Rai classification system |
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Chronic Myeloid Leukemia
is a cancer of WBCs with unregulated growth of cells in the myeloid lineage (immature neutrophils, eosinophils, basophils), which leads to their accumulation in the blood (why it's chronic disease), producing splenomegaly (huge!)
=> Philadelphia Chromosome |
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RBC overproduction (all three lineages) with elevated hematocrit, blood viscosity, splenomegaly, and thrombosis
=> JAK-2 |
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Monoclonal Gammopathy of Undetermined Significance
Plasma cell disorder that resembles multiple myeloma, with production of paraprotein, but MGUS is more benign
=> serum M protein spike |
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Multiple Myeloma
is plasma cell disorder, a more malignant cancer of plasma cells, where abnormal cells can accumulate in bones and cause lesions, paraprotein production, kidney problems, hypercalcemia
=> Bence-Jones protein
=> protein electrophoresis diagnosis |
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Hodgkin's Lymphoma
are a group of cancers of WBCs/lymphocytes, with spread of disease from one lymph node group to another and systemic symptoms … treat with radiation therapy, chemotherapy, or stem cell transplant
=> Reed-Sternberg cells
=> NHL staging |
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Non-Hodgkin's Lymphoma
are a group of cancers of WBC/lymphocytes varies in severity, increased risk in HIV+ pt's … treat with radiation, chemotherapy, monoclonal antibodies, immunotherapy, stem cell transplant
=> HIV
=> NHL staging |
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a rapid deterioration in glomerular filtration with reduction in urine output, and increase in serum creatinine
classified as Pre-Renal, Intra-Renal, Post-Renal |
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| CRF is a progressive deterioration in kidney function (<20% normal) with decreased GFR, increased creatinine … severe end-stage renal disease requires immediate dialysis |
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| Clinical Sx of Acute Renal Failure |
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Definition
changes in urination, swelling, leg/flank pain
Retention => edema, hypertension, metabolic acidosis, skin rashes, itching, hyperkalemia, shortness of breath, anuria (in severe cases)
Uremia => nausea, vomiting, dizziness, metallic taste
Anemia => fatigue, cold, dizziness
Vitamin D deficit => calcium imbalance |
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| Clinical Sx of Chronic Renal Failure |
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Definition
GFR < 20-25% normal
Insufficient Filtration => edema, dehydration, hyperkalemia, metabolic acidosis
Decreased Vitamin D => hypocalcemia, hyperphosphatemia
Decreased erythropoietin => anemia
overt uremia => GI => nausea, vomiting, bleeding, esophagitis
overt uremia => neurological => myopathy, peripheral neuropathy
overt uremia => CV => hypertension, CHF, cardiomyopathy, pulmonary edema, uremic pericarditis |
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Acute Glomerulonephritis
is severe kidney damage results from immune-mediated Ag-Ab immune complexes lodging in glomeruli, usually precipitated by infection
=> Group A beta streptococci infection
=> SLE lupus
=> viral hepatitis |
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Tubular Necrosis
is direct injury to tubular epithelial cells from ischemia or toxins (mercury, lead, tetracyclines, insecticides, cis-platinum) |
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Nephrosclerosis
is the most common form of kidney disease, contributing to chronic RF … as a result of chronic high BP, get lesions and leakage and fiber deposits and wall thickening, then occlusion and destruction and scar formation
=> if it's inside glomerulus, it's glomerulosclerosis |
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Pyelonephritis
is renal injury caused by bacterial infection
vesicoureteral reflex, back up, damage to medulla/interstitium, compromises JG function so you get polyuria
=> UTIs
=> cystitis |
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rapid onset of blood in urine
mild to moderate protein in urine
hypertension |
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high protein in urine
high lipid in urine
lipid in blood
low albumin
severe edema |
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Minimal-Change Disease (Lipoid Nephrosis)
nephrotic syndrome in children (2-3yo)
toxins or antibodies or cytokines damage the podocytes, primary epithelial barrier, see detectable lipid in urine
usually treated with steroids plus BP reducer like ACE inhibitor |
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Renal Cell Carcinoma
is the most common form of kidney cancer in adults
mainstay treatment is nephroctomy |
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leukemia
is uncontrolled clonal proliferation of WBCs, particularly the immature precurs (called blasts), infiltration, displacement, blood dyscrasias … either acute or chronic |
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lymphoma
is a tumor of the lymph nodes, with malignant clonal expansion of lympocytes (either T or B), either Hodgkin's or Non-Hodgkin's |
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| group of cells produced from a single ancestral cell be repeated replication |
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leukostasis (aka symptomatic hyperleukocytosis)
is abnormally high WBC count
intravascular aggregation and clumping |
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Auer rods
are clumps of granular material forming elongated needles that
can be seen in myeloid blasts of AML acute myeloid leukemia |
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Philadelphia Chromosome
is a specific chromosomal abnormality (translocation) associated with CML chronic myeloid leukemia |
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Lymphadenopathy
is synonymous with "swollen/enlarged lymph nodes" that could be due to infection, auto-immune disease, or malignancy |
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Adenocarcinoma
is a cancer of an epithelium that originates in glandular tissue
cell biopsy can provide definitive diagnosis |
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Granulocyte Colony-Stimulating Factor
is a growth factor and cytokine that stimulates production of granulocytes and stem cells, neutrophil precursors |
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Human Leukocyte Antigen system
is the name of the major histocompatibility complex MHC in humans, that contains a large number of genes related to immune system function in humans |
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cytogenetics
is a branch of genetics concerned with the study of the structure and function of the cell, especially the chromosomes
includes other techniques like fluorescent in situ hybridization (FISH) |
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flow cytometry
is a technique for counting and examining microscopic particles, such as cells and chromosomes, by suspending them in a stream of fluid and passing them by an electronic detection apparatus
multiparametric analysis
routinely used in blood cancers |
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Reed-Sternberg cells (aka lacunar histiocytes)
are different giant cells found in biopsies of patients with Hodgkin's Lymphoma, primarily due to EBV; they are usually derived from B lymphocytes |
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ABVD
is a chemotherapy regimen used in first-line treatment of Hodgkin's Lymphoma, includes the drugs:
Adriamycin (Doxorubicin/Hydroxydaunorubicin)
Bleomycin
Vinblastine
Dacarbazine (similar to Procarbazine) |
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Rai classification
is a staging system used to classify CLL chronic lymphocytic leukemia (CLL) |
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Hypogammaglobulinemia
is a primary immune deficiency disease with a reduction in all types of gamma globulins (M,G,A,E) |
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| leukocyte alkaline phosphatase |
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Leukocyte Alkaline Phosphatase
is found within WBCs
higher levels are seen in polycythemia vera, essential thrombocytosis
lower levels are found in CML chronic myeloid leukemia and AML acute myeloid leukemia |
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Janus Kinase 2
is a protein, member of the interferon family
JAK2 gene fusions have been found in leukemia patients
mutations in JAK2 have been implicated in polycythemia vera, essential thrombocythemia, myelofibrosis, and other myeloproliferative disorders |
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Bence-Jones protein
is a monoclonal globulin protein found in blood or urine
suggestive of MM multiple myeloma |
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| uses patient's own bone marrow or peripheral stem cells (preferred for lymphoma) |
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| uses marrow/blood/stem cells donated from the pt's identical twin |
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| uses stem cells from a donor (preferred for leukemia) |
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Graft-Versus-Host-Disease
can occur after a stem cell transplant (allogenic)
when the transplanted immune cells attack the host's body cells |
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low urine output (300-500)
may be from dehydration, renal failure, shock, MOF, UTI |
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no urine output (<50)
may be from kidney obstruction, stones, or tumors |
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azotemia
is abnormally high levels of nitrogen, urea, creatinine, waste products, et.al. in the blood
usually related to insufficient filtering of blood by the kidneys |
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uremia
loosely describes the illness accompanying kidney failure, high levels of urea (but not uricemia)
secondary complications include neural, muscular, endocrine, metabolic, GI, CV |
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excessive urine output (>3L)
most common cause is diabetes mellitus, causing osmotic diuresis |
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pee pee in the night
could be harmless, or could be sleep apnea, hyperparathyroidism, chronic renal failure, bladder infection, cystitis, diabetes, CHF or prostate cancer |
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| anti-glomerular basement membrane antibody |
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cystitis
is urinary bladder inflammation commonly caused by bacterial infection (UTI)
present with painful urination, frequent urination, hematuria, fever, pain |
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| when amyloid proteins are abnormally deposited in organs and/or tissues |
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podoctes
wrap around the capillaries of the glomerulus
disruption of podocytes leads to massive proteinuria |
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ascites
is fluid accumulation in the peritoneal cavity, most commonly due to cirrhosis |
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| when lipiduria occurs and contains numerous fat droplets, these cells are called oval fat bodies |
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atherosclerosis
is a thickening of artery walls with accumulation of fatty materials like cholesterol
the atheroma is major risk for infarction, stroke, thrombosis, fatality |
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| formation of a blood clot obstructing the flow of blood |
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| lodging of an embolus mass into a narrow capillary vessel of an arterial bed which causes a blockage in a distant part of the body |
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localized, blood-filled balloon-like bulge in the wall of a blood vessel
significant risk of rupture, resulting in hemorrhage |
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fistula
is an abnormal connection or passageway between two epithelium-lined organs or vessels that normally do not connect |
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dysplasia
is abnormal development, expansion of immature cells, with a corresponding decrease in number and location of mature cells
dysplasia is often indicative of an early neoplasm |
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reduction in elevation
a depression, formed through erosion |
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| monckeberg medial calcific sclerosis |
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Monckeberg's arteriosclerosis
is a form of arteriosclerosis where calcium deposits are found in the muscular middle layer of the walls of arteries (media) |
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| vasodilators & vasoconstrictors |
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vasodilators => NO, histamine, prostaglandins, bradykinin, substance P, ANP atrial natriuretic peptide, heparin
vasoconstrictors => Ach, Epi, Norepi, endothelin, Angiotensin, vasopressin, thrombin, insulin, hypoxia |
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vasoconstrictor
raises BP, contributes to heart disease |
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Platelet-Derived Growth Factors
regulates cell growth and division, especially blood vessel formation (angiogenesis) |
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vascular smooth muscle cells
contract or relax to both change the volume of blood vessles and the local blood pressure |
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afterload
is the tension or stress developed in the wall of the LV during ejection
the pressure that the chambers of the heart must generate in order to eject blood out of the heart, and thus is a consequence of the aortic pressure (for LV) and pulomary arterial pressure (for RV) |
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preload
is the end volumetric pressure that stretches the RV or LV of the heart to its greats geometric dimensions
the initial stretching of a single cardiomyocyte in filling |
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aldosterone
is a steroid hormone that acts mainly on the distal tubules and collecting ducts of the nephron to cause conservation of sodium, secretion of potassium, icnreased water retention, and increased blood pressure
RAAS system works to maintain blood volume, therefore BP |
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seen on chest radiographs with interstitial pulmonary edema
suggestive for CHF congestive heart failure |
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nesiritide
is human recombinant B-type natriuretic peptide
counterregulates RAAS system, produces smooth muscle relaxation
side FX obviously include hypotension, slow heart rate |
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pressure measured by wedging a pulmonary catheter with an inflated balloon into a small pulmonary arterial branch
provides an indirect measure of left atrial pressure |
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unable to do exercise
or experiences severe post-exercise pain, fatigue |
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Left Ventricular Hypertrophy
is thickening of the walls of the LV
marker of disease
causes of increased afterload that can cause LVH include aortic stenosis, aortic insufficiency, hypertension |
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adiponectin involved in regulating glucose levels, fatty acid breakdown exclusively secreted from adipose tissue inversely correlated with body fat % (decreased in obesity) weight loss increases circulating levels
may act in a protective manner by suppressing the action of inflammatory mediators like TNF-alpha |
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adhesion molecules
are proteins located on the cell surface involved with binding with other cells or the extracellular matrix |
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ICAM-1 (aka CD54)
is a protein typically expressed on endothelial cells of the immune system, member of the immunoglobulin family
intercellular adhesion stimulated by IL-1 and TNF-alpha |
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