Neoplasms to Cancer
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| what is abrasion? | scrape of the skin that occurs when friction denudes part of the epidermis, minimal hemorrhage occurs and blood clots on the skin surface as a thin red brown scab
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| what is healing of abrasion? | healing occurs quickly without scarring by regeneration of the epidermis from persisting basal cells
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| what is a contusion? | bruise caused by rupture of small blood vessels by blunt force
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| what is a laceration? | tear caused by crushing or stretching force sufficient to tear apart tissue
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| what is an incised wound? | cut produced by an object with a sharp edge
margins are smooth with minimal damage or marginal tissue
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| what are the major complications of thermal burns? | shock, burn wound infection and smoke inhalation pneumonia
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| what is shock from thermal burns? | caused mainly by the loss of fluid as inflammatory edema into the burn wound
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| what is burn wound infection from thermal burns? | occurs by growth of bacteria and or fungi in and under the eschar of a third degree burn
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| what is smoke inhalation pneumonia caused by thermal burns? | caused by a chemical injury of the lungs by toxic components of inhaled smoke
often produces fatal pulmonary edema
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| what is anoxia or hypoxia? | deficiency of oxygen in the tissue
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| where are first degree burns mostly seen? | upper part of epidermis, acute inflammation
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| what are second degree burns? | most of the epidermis
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| what is the depth of thermal necrosis in third degree burns? | entire epidermis (full thickness burn) most the skin appendages and the upper dermis
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| what are the clinical features of third degree burns? | skin surface is converted into a born, dry, leathery dead material known as an eschar
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| what is anoxic anoxia? | characterized by deficient oxygenation of the arterial blood
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| what are the causes of anoxic anoxia? | disease of the respiratory tract such as emphysema, pneumonia and pulmonary edema
depression of the respiratory center of the brain caused by drugs, anesthesia
lack of oxygen in the environment as with flying or drowning
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| what is anemic anoxia? | caused by a decreased oxygen carrying capacity of the blood as in severe anemia or carbon monoxide poisoning
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| what is stagnant anoxia? | caused by slowing of the rate of blood flow and occurs with cardiac arrest
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| what are the major effects of anoxia? | brain singularly susceptible, neurons of the brain are irreversibly injured within 10 minutes of the onset of severe anoxia
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| what are the direct effects on many organs and tissues of ethanol? | liver injury ranging from potentially reversible fatty degeneration to irreversible cirrhosis, gastritis, pancreatitis, anemia, decreased resistance to bacterial infections and heart damage
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| what are the tobacco related diseases? | chronic periodontitis, stomatitis, carcinoma of mouth, larynx, lung, urinary bladder, esophagus, chronic bronchitis and obstructive emphysema
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| what is humoral immunity? | mediated by B lymphocytes and plasma cells
B lymphocytes respond to free molecular antigens and produce reactant protein molecules known as antibodies or immunoglobulins
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| what is cellular immunity? | mediated by T lymphocytes that respond to antigens (peptides) fixed on the surface of cells rather than to free molecular antigens
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| what are macrophages? | assist the lymphoid cells at several steps in both humoral and cellular immunity
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| what are the characteristics of allergic diseases mediated by humoral immunity? | occur promptly after a sensitized person encounters the antigen
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| what are some examples of humoral immunity? | hay fever, bronchial asthma, urticaria
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| what are the characteristics of hypersensitivity mediated by cellular immunity? | develop gradually over several days as T lymphocytes kill cells exhibiting the offending allergen
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| what is an example of hypersensitivity mediated by cellular immunity? | contact hypersensitivity dermatitis like poison ivy
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| what is systemic lupus? | person form autoantibodies against components of their own cell nucli and these antinuclear antibodies combine with nuclear antigens to form complexes that are deposited in many organs or tissues causing cellular injury or inflammation
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| what population is systemic lupus found most in? | more frequent in women than men
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| what are the major sites of injury for systemic lupus? | kidneys with reneal glomerular injury causes protein loss in the urine and eventual glomerular scarring with renal failure
most frequent cause of death
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| what are the treatment methods of systemic lupus? | immunosuppressive therapy causes clinical improvement, most treated patients survive more than 10 years
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| where is staphylococcus aureus found? | skin surface, nose
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| where is streptococcus pyogenes found? | nose, pharynx
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| where is streptococcus viridans found? | nose, pharynx
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| where is streptococcus mutans found? | mouth
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| where is diplococcus (streptococcus) pneumonia found? | pharynx
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| where is hemophilus influenza found? | pharynx
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| where is Escherichia coli found? | colon
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| where is bacteroides fragilis found? | colon, vagina
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| what is the cause of lobar pneumonia? | diplococcus (streptococcus) pneumoniae
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| what are the predisposing factors for lobar pneumonia? | influenza, viral upper respiratory infections, and alcoholism
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| what do the bacteria do when they are aspirated into the lung in the case of lobar pneumonia? | proliferate and produce an abundant protein rich inflammatory exudate and spread quickly through an an entire pulmonary lobe by a firbrin rich intraalveolar exudate
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| what is an acute fibrinous inflammation? | lobar pneumonia when bacteria produce fibrin rich intraalveolar exudate
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| what is the most common complication in an untreated lobar pneumonia patient? | collection of pus in the ipsilateral pleural cavity (pleural empyema)
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| what is the cause of bronchopneumonia? | most cases are mixed infections involving streptococci, staphylococci, pneumococci of less virlent types
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| what are the predisposing factors for bronchopneumonia? | loss of the gag reflex, dysphagia, emesis, tracheostomy, endotracheal intubation, use of mechanical ventilators, pulmonary edema, bronchitis, impaired cough
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| what is the most common complication of bronchopneumonia? | progression to one or more lung abscesses
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| what are the clinical features of bronchopneumonia? | moist rales, low fever, cough productive o mucopurulent sputum, lung bases without signs of consolidation
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| what is the pathogenesis of acute appendicitis? | appendix is obstructed by a fecalith in lumen, istention of the appendiceal lumen by mucosal secretions, slowing of circulation with ischemia causes mucosal injury, bacterial invasion
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| what does an acutely inflamed appendix look like? | sections reveal a dilated lumen containing pus (and often a fecalith) and an ulcerated mucosa
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| what is the major complication of acute appendicitis? | perforation of the appendix resulting in acute peritonitis either localized next to the appendix or less often generlized
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| what is often the most common cause of common cold? | rhinovirus
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| what are the clinical features of acute appendicitis? | pain in lower right quadrant with deep tenderness and mild fever and leukocytosis, anorexia, nausea,
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| how are venereal diseases spread? | direct person contact, usually coitus (heterosexual or homosexual) occasionally kissing or other contact
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| what is the source of infection for venereal diseases? | exudate from obvious or concealed (often asymptomatic lesions of the skin and or mucus membrane of infected person
transmission via fomites is mythical
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| what are fungal diseases usually? | opportunistic infections with one or more predisposing factors which impair resistance to infection or enhance growth
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| what is the major lesion in males for a gonococcal infection? | acute purulent urethritis, gonorrhea
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| what is the major lesion in females for a gonococal infection? | endocervicitis (often asymptomatic)
ascending infection of the genital tract may produce salpingitis with resultant sterility or tubal pregnancy
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| what is the major lesion in males for a trichomoniasis infection? | asymptomatic urethritis
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| what is the major lesion in females for a trichomoniasis infection? | vaginitis with pruritus and a frothy yellow discharge
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| what is the major lesion in females for a gardnerella infection? | vaginitis with pruritus and a milky discharge
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| what are the predisposing factors fungal infection? | AIDS, diabetes mellitus, certain cancers, immunosuppressive therapy and antibiotic therapy especially treatment with multiple or wide spectrum antibiotics which suppress the competing bacterial flora
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| what is an example of superficial infections of mucosal surfaces? | candidosis including thrush of the mouth and vaginitis
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| what is AIDS? | chronic viral infection characterized by selective infection and destruction of a subset of T lymphocytes with resultant severe depression of both cellular and humoral immunity
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| what is the cause of AIDS? | human immune deficiency virus (HIV) an RNA retrovirus
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| how is AIDS transmitted | requires intimate mucosal contact during coitus (homosexual or heterosexual) or parenteral introduction of the virus during drug abuse
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| what is the most common opportunistic infection for AIDS patients? | pneumonia caused by pneumocystic jiroveci and disseminated infections caused by a variety of bacteria, fungi, viruses and protozoa
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| what are the major clinical features of AIDS? | generalized lymphadenopathy,AIDS encephalopathy, opportunistic infections, malignant neoplasms
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| what is the most common cause of carcinoma of the larynx? | smoking cigarettes
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| where does carcinoma of the larynx usually arise from? | usually arises from the anterior part of one vocal cord as a firm gray nodule
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| what type of microorganism is carcinoma of the larynx? | sluggishly growing squamous carcinoma
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| when does bronchial asthma usually begin? | in childhood
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| what is bronchial asthma mediated by? | humor immunity
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| what are the causative agents of bronchial asthma? | inhaled substances such as pollens, animal dander, mold spores, mouse and roach products and house dust
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| Why do the lumens of bronchi become narrowed in bronchial asthma? | lumens of the medium sized bronchi become narrowed by constriction of bronchial smooth muscle, by bronchial mucosal edema and by an intraluminal accumulation of viscid mucin
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| what is an attack of bronchial asthma characterized by? | Severe dyspnea, a sense of suffocation and clearly audible high pitched wheezing, more marked during expiration
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| what is COPD caused by? | obstructive emphysema is caused by chronic bronchitis and the usual cause of chronic bronchitis is chronic or repetitive inhalation of irritant
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| what is the most important irritant in chronic bronchitis? | cigarette smoke
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| what do the lungs look like in COPD? | large, overdistended and fluffy, resembling cotton candy and the delicate alveolar septa that normally separate alveoli are reduced to threadlike remnants. bronchi have thick walls and lumens usually contain viscid mucin pus
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| what is expiratory bronchiolar collapse? | bronchioles lack cartilage and this loss of tractinal support allows expiratory bronchiolar collapse which impedes expiration and renders cough ineffective and predisposes to secondary bacterial infection of bronchi and lungs
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| what are the clinical features of COPD? | persistent cough, productive of mucinous sputum, dyspnea on exertion and recurrent attacks of acute bacterial infection of the bronchi and lungs
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| where does carcinoma of the lung usually arise from? | epithelium lining a large or medium sized bronchus and is often termed bronchial carcinoma
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| what is the most common cause of bronchial carcinoma? | tobacco smoking, especially cigarette smoking with deep inhalation and the great majority of lung cancer patients have been heavy smokers for over 20 years
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| what are the other causes of bronchial carcinoma? | variety of histological types (squamous carcinoma, adenocarcinoma, undifferentiated carcinoma) and some tumors contain a mixture of histologic types
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| what are the metastases in bronchial carcinoma? | develop early and are usually widespread
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| what is the main cause of carcinoma of the lip? | chronic solar irradiation, sunlight damages the vermilion border of the lip and in most cases of lip cancer the entire lower lip shows evidence of chronic solar damage and is dry, scaly, white and opaque (leukoplakia) with microscopic changes of dysplasia
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| what is the primary lesion of carcinoma of the lip? | occurs on the lower lip as firm nodule that slowly enlarges. microscopic study reveals a squamous carcinoma. metastases occur late in the cervical lymph nodes in only a few patients
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| where does intraoral carcinoma arise from? | lateral borders of the tongue
arise in the floor of the mouth or from the bucal mucosa
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| what are the predisposing factors of intraoral carcinoma? | chewing tobacco, dipping snuff, smoking tobacco (especially cigars and pipes) and oral infection by human papillomavirus
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| what is the primary lesion of intraoral carcinoma? | firm gray white mass and ulceration
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| what does microscopic study reveal on intraoral carcinoma? | squamous carcinoma
metastases occur first in the cervical lymph nodes
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| what is the primary lesion of esophageal carcinoma? | arises most often from the middle third or the distal end of the esophagus and forms a firm gray white mass with esophageal obstruction and variable ulceration
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| what does microscopic study reveal about carcinoma of the esophagus? | squamous carcinoma or adenocarcinoma
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| what is the clinical feature of esophageal carcinoma? | progressive dysphagia, resultant weight loss and final cachexia
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| where does chronic peptic ulcer occur more often in? | duodenum than the stomach
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| what does typical chronic peptic ulcer look like? | solitary ulcer in either the dotal (pyloric) part of the stomach or the first part of the duodenum
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| what are the major clinical features of a chronic peptic ulcer? | gnawing or burning epigastric pain appearing several house after eating and relieved by ingestion of food or antacids
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| what has happen to the number or carcinoma of the stomach cases? | in the US its incidence has markedly decreased since 1940 probably reflecting an increased dietary intake of fresh fruits and vegetables
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| what increases the incidence of gastric carcinoma? | consumption of smoke, cured, and salted meats and fish
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| what decreases the incidence of gastric carcinoma? | fresh fruits and vegetables
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| what does microscopic study reveal about gastric carcinoma? | adenocarcinoma
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| where does metastases occur from gastric carcinoma? | occur early in the regional lymph nodes, liver, and peritoneum
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| what is the survival rate for gastric carcinoma? | overall 5 year survival rate of about 15%
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| what are the inflammatory bowel diseases and how are they caused? | crohn's disease and chronic ulcerative colitis
uncertain cause
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| what is crohn's disease characterized by? | segmental lesions with sharply delimited "skip areas" of normal intestine
lesions are most frequent and most severe int he distal ileum but may also involve the colon
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| what is chronic transmural inflammation of the intestine? | Crohn's disease, produces firm thick walled segments of bowel "garden hose bowel"
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| what is chronic ulcerative colitis characterized by? | diffuse acute and chronic mucosal inflammation of the large intestine most severe in the rectum and gradually decreasing in incidence and severity proximally
skip areas do not occur and small intestine not involved
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| what are the major clinic features of chronic ulcerative colitis? | dysentery with blood and pus int he stool, abdominal cramps, tenesmus, fever, weakness, weight loss and anemia
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| what is the most common visceral cancer? | carcinoma of the large bowel is the most common visceral cancer and is second only to carcinoma of the lung as a cause of death from cancer
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| what is the cause of carcinoma of the large bowel? | uncertain but is closely related to the refined, low residue, high fat diet which accompanies economic development
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| what do most carcinoma sod the large bowel probably arise from? | malignant change of a preexistent adenoma
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| what are the precursors of carcinoma of the large bowel? | polyps
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| where can carcinoma of the large bowel arise from? | any part of the large bowel and the sites of predilection are the rectum, sigmoid colon and cecum
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| what is jaundice? | liver normally excretes bilirubin but if the liver cells are damaged, bilirubin accumulates int he blood and stains the tissues yellow
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| what are abnormalities of protein metabolism in hepatic failure? | liver normally synthesizes plasma albumin and multiple clotting factors and hepatic failure often causes hypoalbuminemia
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| what is hepatic coma? | liver incorporates ammonia into urea which is excreted in the urine and hepatic failure often causes hyperammonemia with resultant hepatic coma
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| what is hyperestrinism? | liver normally catabolizes estrogen and men with hepatic failure may develop signs of hyperestrinism such as testicular atrophy, gynecomastia, spider telangiectases of the skin and pectoral alopecia
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| what do regenerative cells in cirrhosis cause? | produces bulging nodules of regenerating liver cells surrounded by septa of fibrous tissue
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| what is portal venous hypertension? | increased venous pressure in the portal vein and its tributaries
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| what are the major effects of portal venous hypertension in cirrhosis? | chronic passive congestion of the spleen which is enlarged and firm
ascites caused by transudation of fluid from congested capillaries into the peritoneal cavity
collateral circulation between port vein tributaries and systemic veins
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| what is the most important collateral channels? | large, dilated, thin walled veins which bulge into the lower esophagus and may rupture to cause massive hemorrhage into the alimentary tract with hematemesis
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| what are the clinic features of cirrhosis? | begin insidious, manifestations of the causative condition e.g. alcoholism or chronic viral hepatitis, manifestations of chronic hepatic failure such as jaundice and hepatic coma and manifestations of portal venous hypertension (ascites, hematemesis)
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| what happens in acute viral hepatitis? | only a few scattered liver cells undergo necrosis, most cases resolve spontaneously and regeneration of liver cells reestablishes normal hepatic structure and function often with lifelong immunity to reinfection by the same virus (NOT C)
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| what hepatitis can you not have lifelong immunity to reinfection by the same virus? | NOT C
only A &B
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| what hepatitis can you not get chronic viral hepatitis? | NOT A
B and C
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| what is cholelithiasis? | presence of gallstones in the gallbladder
usually multiple and consists of cholesterol and bile pigments
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| what is hepatitis A spread by? | intestinal oral route
lifelong immunity follows recovery
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| is there a carrier state with hepatitis A? | NO
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| what is the epidemiology of hepatitis B? | IV drug abuse
acquired immunity usually follows recovery
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| is there a carrier state with hepatitis B? | 10% of all infections
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| what are the effects of gallstones? | irritation of the gallbladder by gallstones
obstruction of the biliary tract causes distention of part of the tract proximal to the obstruction
acute cholecystitis, obstruction of the common bile duct, obstructive jaundice
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| what is pancreatitis caused by? | escape of large amounts of digestive enzymes of the pancreas from the pancreatic ducts with resultant enzymatic auto digestion of the pancrease
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| what are the major predisposing fractures for acute pancreatitis? | chronic alcoholic, gallstones and obesity
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| what is chronic pancreas? | result of multiple attacks of acute pancreatitis from each of which the patient recovers with additional scarring of the pancreas
always caused by chronic alcoholism
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| has carcinoma of the pancreas increased or decreased? | increasing
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| what does microscopic study reveal about carcinoma of the pancreas? | adenocarcinoma
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| what are the signs of carcinoma of the head of the pancreas? | early obstruction of the common bile duct with obstructive hand ice and epigastric or right subchondral pain
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| what are the signs of carcinoma of the body of the pancreas? | dull boring epigastric or left subchondral pain, worse at night profound depression, weight loss and ascities (caused by peritoneal implantation metastases)
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| what characterizes cystic fibrosis of the pancreas? | dysfunction of exocrine gland
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| how do you get cystic fibrosis of the pancreas? | autosomal recessive trait, homozygotes have severe disease and usually die early in life, both sexes are effected
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| what is the basic metabolic abnormality of cystic fibrosis of the pancreas? | defect of chloride and water transport by the epithelium of small exocrine gland ducts and the secretory product of these glands is abnormally scant and viscid
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