Dr. D.'s Overhead Lecture Notes
Section 5 - REPLACE PAGE NUMBERS WITH PAGES FROM SIXTH EDITION5
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Hiatus hernia (pp. 322, 323)
hernia = abnormal protrusion
of a body part through an opening
hiatus hernia =
abnormal protrusion of the stomach above the diaphragm
sliding hiatus hernia
= having the junction of the esophagus and stomach and part of the
stomach above the diaphragm
(sketch)
- most common
hiatus hernia
rolling hiatus hernia
= having part of the stomach above the diaphragm and next to the
esophagus
(sketch)
Sliding hiatus hernia
- pathogenesis
(sketch)
cause -> anatomical
abnormality -> reflux of stomach HCl and enzymes
- consequences
(sketch)
1. esophagitis (-> pain)
1.
Normal esophagus, gross
2.
Normal esophagus, low power microscopic*
4.
Acute esophagitis, microscopic - sec.
17.
Stomach, scleroderma with fibrosis, Trichrome stain, microscopic*
[XRAY]
2. strictures (-> difficulty swallowing)
3. peptic ulcers (-> pain, strictures)
9.
Herpes simplex ulcers, gross
6.
Herpes simplex esophagitis, gross
7.
Herpes esophagitis, low power microscopic*
Rolling hiatus hernia
- pathogenesis
(sketch)
cause -> anatomical
abnormality = strangulation ->
1. trapping of contents
2. pinching of vessels
- consequences from trapping contents
(sketch)
1. bacteria grow -> (a-c)
a. infection -> ??
b. toxins -> ??
c. gas formation (bloating) -> ??
2. excess digestion ->
a. reverse osmosis from body -> loss of water and salts -> fluid/electrolyte
imbalance -> ??
- consequences
from pinched vessels
(sketch)
- ischemia -> (1-4)
1. infection -> ??
2. necrosis -> ??
3. gangrene -> ??
4. perforation (see perforated peptic ulcers) -> ??
Acute superficial gastritis
definition = short
term inflammation of the inner lining of the stomach
22.
Stomach, normal, gross
23.
Stomach, pylorus, normal, gross
24.
Stomach, fundus, normal, medium power microscopic*
26.
Acute gastritis, gross
27.
Gastric erosions, gross
28.
Acute gastritis, microscopic*
causes (e.g.,
?, ?, ? )
pathogenesis
cause -> cell
injury/cell death -> inflammation of mucosa, necrosis, hemorrhaging
S&S
pain, anorexia,
nausea/vomiting (N/V), endoscopy
treatments
- avoid cause,
antacids, bland diet
consequences
- resolution
Peptic ulcer (pp. 332, 334,
335, 339)
definition = ulcer
caused by gastric juice
29.
Acute gastric ulcer, benign, gross
30.
Gastric ulcer, malignant, gross
31.
Acute gastric ulcer, low power microscopic* - hemorrhaging
33.
Acute gastric ulcer penetrating to artery, low power microscopic*
- hemorrhaging
32.
Acute gastric ulcer, high power microscopic* - perforation
34.
Helicobacter pylori in stomach, Methylene blue stain, microscopic*
- H. pylori
causes
bacteria (H.
pylori), NSAIDs, anti-inflammatory steroids, tobacco juice, bile
reflux, ischemia, stress, excess vagus nerve activity
pathogenesis
(sketch)
cause -> mechanisms
1, 2, or 3 -> entry of HCl -> cell death -> sloughing -> ulcer
mechanisms
of development
1. weak mucosa -> entry of HCl -> ??
2. excess HCl -> entry of HCl -> ??
3. inadequate mucus production -> entry of HCl -> ??
*** 1, 2, or 3 -> entry of HCl -> cell death -> sloughing -> ulcer
Gastric peptic ulcer
definition = ulcer
in the stomach caused by gastric juice
causes
- mechanism
1
- bacteria (H. pylori), NSAIDS, tobacco juice, anti-inflammatory
steroids, bile reflux, ischemia -> weak mucosa -> ??
- mechanisms
2 & 3
- excess vagus nerve activity -> excess HCl -> ??
- excess sympathetic nervous activity -> inadequate mucus -> ??
pathogenesis
cause -> mechanisms 1 (or 2) -> entry of HCl -> cell death -> sloughing
-> ulcer
Duodenal peptic ulcer
definition = ulcer
in the duodenum caused by gastric juice
causes
- mechanisms
1 (rare)
- bacteria (H. pylori), ischemia -> weak mucosa -> ??
- mechanisms
2 & 3 (most common)
- excess vagus nerve activity -> excess HCl -> ??
- excess sympathetic nervous activity -> inadequate mucus -> ??
pathogenesis
cause -> mechanisms 2 & 3 (or 1) -> entry of HCl -> cell death -> sloughing
-> ulcer
Comparing gastric and duodenal peptic ulcers
|
|
|
|
|
|
approx. 20% | approx. 80% |
|
|
pain | pain |
| pain with food | pain w/o food | |
| weight loss | weight gain | |
| X-ray | X-ray | |
| endoscopy (p. 335) | endoscopy | |
| normal HCl | excess HCl |
Stress ulcer
definition = ulcer
in the stomach or duodenum caused by stress
causes
- mechanisms
1 & 2 & 3
- excess adrenal steroid -> weak mucosa -> ??
- excess vagus nerve activity -> excess HCl -> ??
- excess sympathetic nervous activity -> inadequate mucus -> ??
pathogenesis
stress -> mechanisms 1 & 2 & 3 -> entry of HCl -> cell death ->
sloughing -> ulcer
Complications from peptic ulcers
1. hemorrhage
- slow hemorrhage
-> anemia
- fast hemorrhage
-> shock
31.
Acute gastric ulcer, low power microscopic* - hemorrhaging
33.
Acute gastric ulcer penetrating to artery, low power microscopic*
- hemorrhaging
2. perforation
(sketch)
- perforation
-> contents into body cavity -> (a-c)
32.
Acute gastric ulcer, high power microscopic* - perforation
a. infection (widespread in body cavity) -> ??
b. toxins (widespread in body cavity) -> ??
c. inflammation (peritonitis) -> (1-5)
46.
Normal mesentery, gross
47.
Normal lacteals, gross
82.
Typhlitis with perforation, gross - perforation of large intestine
58.
Peritonitis from bowel perforation, gross - infection
50.
Adhesions, peritoneum, small intestine, gross - adhesion
1. shock -> ??
2. fluid/electrolyte imbalance -> ??
3. paralytic obstruction -> trapped contents -> ?? (see rolling hiatus
hernia)
4. physical obstruction -> trapped contents -> ?? (see rolling hiatus
hernia)
5. adhesions -> ??
c. autodigestion -> ??
3. physical obstruction
- swelling,
spasms, strictures
- obstruction
-> trapped contents -> ?? (see rolling hiatus hernia)
4. intractibility
- requires
radical treatment (e.g., surgery)
Acute ulcer vs. chronic ulcer
Appendicitis (p. 352)
(sketch)
definition
= inflammation of the appendix
83.
Appendix, normal, gross
84.
Acute appendicitis, gross
85.
Acute appendicitis, gross
86.
Acute appendicitis, gross
87.
Acute appendicitis, low power microscopic*
Clinically, the patient often presents with right lower quadrant
abdominal pain. Rebound tenderness is noted on physical examination.
An elevated WBC count is usually present.
88.
Acute appendicitis, medium power microscopic*
causes
(sketch)
1. infected
lymph nodes in appendix -> ??
2. trapped
contents (fecaliths) -> ?? (see rolling hiatus hernia)
pathogenesis
cause -> cell injury/cell death -> inflamed appendix (appendicitis)
S&S
pain, rebound
pain, incr. WBCs, fever, N/V, diarhea/constipation,
incr.
SED rate
consequences
1. septicemia
(sketch)
2. many
from rupture (i.e., perforation)
(sketch)
a. infection (widespread in body cavity) -> ??
b. toxins (widespread in body cavity) -> ??
c. inflammation (peritonitis) -> (1-5)
(sketch)
46.
Normal mesentery, gross
47.
Normal lacteals, gross
82.
Typhlitis with perforation, gross - perforation of large intestine
58.
Peritonitis from bowel perforation, gross - infection
50.
Adhesions, peritoneum, small intestine, gross - adhesion
1. shock -> ??
2. fluid/electrolyte imbalance -> ??
3. paralytic obstruction -> trapped contents -> ?? (see rolling hiatus
hernia)
4. physical obstruction -> trapped contents -> ?? (see rolling hiatus
hernia)
5. adhesions -> ??
Peritonitis
(sketch)
definition
= inflammation of the lining of the abdominal cavity (i.e., peritoneum)
46.
Normal mesentery, gross
47.
Normal lacteals, gross
82.
Typhlitis with perforation, gross - perforation of large intestine
58.
Peritonitis from bowel perforation, gross - infection
50.
Adhesions, peritoneum, small intestine, gross - adhesion
causes
1. physical trauma
2. chemical trauma
3. bacteria
pathogenesis
cause -> cell injury/cell death -> inflamed peritoneum
= peritonitis
consequences
(see perforated peptic ulcer, perforated appendix) (1-5)
1. shock -> ??
2. fluid/electrolyte imbalance -> ??
3. paralytic obstruction -> ??
4. physical obstruction -> ??
5. adhesions -> ??
Intestinal obstruction
definition = blockage
of the intestine preventing forward movement of contents
causes
1. paralytic
obstruction (any irritation)
2. physical
obstruction (e.g., objects, tumors, position, strictures, spasms)
(sketch)
pathogenesis
cause -> trapped
contents (like hiatus hernia) ->
1. bacteria
grow -> (a-c)
(sketch)
a. infection -> ??
b. toxins -> ??
c. gas formation (bloating) -> ??
2. excess
digestion ->
(sketch)
a. reverse osmosis from body -> loss of water and salts -> fluid/electrolyte
imbalance -> ??
reasons for death
1. fluid/electrolyte
imbalance (from reverse osmosis, N/V)
2. toxins
absorbed (from bacteria)
3. perforation
(from bacteria, toxins, ischemia)
S&S
pain, N/V,
constipation, abdominal distention, X-ray
Special terms
appendicitis - inflammation of the appendix
peritonitis - inflammation of the peritoneum (lining of the abdominal cavity)
paralytic obstruction - having no peristalsis
adhesion - abnormal connection of parts be scar tissue
volvulus - twisted and kinked
intestine (p. 353)
(sketch)
53.
Cecum, volvulus, gross
intussusception - telescoping or slipping of one part on the intestine into the adjoining part (p. 353) (sketch)
strangulated hernia - abnormal protrusion and pinching of a body part through an opening (p. 353) (sketch)
Large intestine (Chap. 26)
Ulcerative colitis (p. 364,
Plate 27)
definition = ulceration
and inflammation of the lining of the large intestine
(sketch)
Go
to Tutorial on Inflammatory Bowel Diseases
77.
Normal colonic mucosa, medium power microscopic*
124.
Chronic ulcerative colitis, gross
125.
Chronic ulcerative colitis, gross
126.
Chronic ulcerative colitis, gross
127.
Chronic ulcerative colitis, gross
128.
Chronic ulcerative colitis, low power microscopic*
130.
Chronic ulcerative colitis with crypt abscesses, medium power microscopic*
132.
Chronic ulcerative colitis with dysplasia, medium power microscopic*
- pre-cancerous dysplasia
causes
- ? autoimmune
response ?
pathogenesis
cause -> patchy
necrosis & patchy inflammation -> bleeding and exudation
- chronic
flairs and remissions -> scar tissue
consequences (1-6) (p.
363)
1. fluid/electrolyte
imbalance -> ??
2. anemia
-> ??
3. disrupted
life (pain, diarrhea) -> ??
4. abcesses
-> ??
5. obstruction
(scarring -> strictures) -> ??
6. predisposes
to colon cancer -> ??
S&S
pain, bloody
diarrhea, mucus in feces, radiograms, endoscopy
Carcinoma of the colon (colon cancer)
- most common cancer of the digestive
system
- benign
90.
Colon, adenomatous polyp (tubular adenoma), gross
92.
Colon, adenomatous polyp on long stalk, gross
91.
Colon, adenomatous polyp (tubular adenoma), low power microscopic*
96.
Colon, adenomatous polyp (tubular adenoma) compared to normal mucosa, medium
power
microscopic*
93.
Colon, multiple adenomatous polyps, gross
94.
Colon, familial adenomatous polyposis, gross
95.
Colon, familial adenomatous polyposis (Gardner's syndrome), gross
- malignant
99.
Colon, adenocarcinoma, gross [XRAY]
100.
Colon, descending, adenocarcinoma, gross [MRI]
101.
Colon, adenocarcinoma, gross
102.
Colon, adenocarcinoma arising in villous adenoma, gross
predisposing factor (risk factors)
1. specific
gene (95% risk)
2. family
history
3. high fat
diet
4. low fiber
diet (less scraping of abnormal cells, slow peristalsis -> accumulation
of carcinogens)
5. ulcerative
colitis
warning signs
- altered
bowel habits, blood in feces
48.
Normal terminal ileum, gross
49.
Normal small intestinal mucosa, medium power microscopic*
Diverticulosis and diverticulitis
definitions
diverticulosis
= having abnormal outpocketings in the large intestine
(sketch)
diverticulitis
= having inflamed abnormal outpocketings in the large intestine
(sketch)
110.
Sigmoid colon, diverticulosis, gross
111.
Colon, diverticulosis, gross
112.
Colon, cut surface, diverticulosis, gross
113.
Colon, cut surface, diverticulosis, gross
114.
Colon,, diverticulosis, low power microscopic*
115.
Colon, diverticulitis, gross
116.
Colon, diverticulitis with perforation, gross
117.
Colon, diverticulitis with perforation, gross
causes
1. colon spasms
2. chronic
constipation
pathogenesis
(sketch)
diverticulosis
cause -> incr. incr. pressure in bowel
-> bulges at weak spots = diverticulosis
diverticulitis
(sketch)
feces trapped in diverticuli -> inflamed diverticuli = diverticulitis
S&S
pain, diarrhea,
constipation, bloody feces, X-ray, endoscopy
consequences
1. fluid/electrolyte
imbalance
2. anemia
3. obstruction
(strictures)
4. abcesses
5. perforation
(see perforated appendix)
Hemorrhoids (pp. 360,
368)
definition = varicose
veins in anal area
(sketch)
external vs
internal hemorrhoids
(sketch)
causes
1. forced
bowel movements
2. "bathroom
bookworm"
3. chronic
cough
4. portal
hypertension
5. childbirth
pathogenesis
cause -> chronic
passive congestion of hemorrhoidal veins -> hemorrhoids
S&S
pain, bleeding,
palpation, observation
consequences
pain, infection,
fissures, abcesses
Liver
functions (pp.
373, 374, 375)
1. Produce bile
-> fat digestion, removal of organic waste
2. Conjugate and excrete
bilirubin -> removal of waste from Hb (p. 391)
(Unconjugated bilirubin IS NOT water soluble for excretion and IS toxic)
3. Detoxify chemicals
(e.g., NH3 from proteins, alcohol) -> conversion and removal
of toxins (e. g., produces urea from NH3)
4. Produce balance of
organic molecules -> nutritional homeostasis
5. Produce blood proteins
-> proper COP for capillary exchange
6. Produce clotting factors
-> hemostasis
7. Inactivate hormones
-> hormone homeostasis
8. Phagocytize particles
-> defense and clean-up (e.g., RBCs)
9. Store blood ->
homeostasis of blood pressure and flow
Cirrhosis
definition = liver
disease with chronic inflammation and scar formation (fibrosis) around
lobules
1.
Normal liver in situ, gross
2.
Normal liver, external, gross
3.
Normal liver, cut surface, gross
4.
Normal liver zones, microscopic*
16.
Cirrhosis of liver, microscopic*
17.
Micronodular cirrhosis and fatty change of liver, microscopic*
18.
Mallory's hyaline, liver, microscopic*
causes
1. alcohol
(most common cause)
- toxic to cells
12.
Micronodular cirrhosis of liver, gross [MRI] - from alcoholism
13.
Micronodular cirrhosis and fatty change of liver, gross [CT]
- from alcoholism
14.
Micronodular cirrhosis and fatty change of liver, gross - from
alcoholism
15.
Micronodular cirrhosis and fatty change of liver, gross - from
alcoholism
2. other toxins
(e.g., industrial, medications)
- toxic to cells
60.
Necrosis with acetaminophen overdose, liver, microscopic*
3. blocked
bile ducts (e.g., gall stones)
(sketch)
- bile injures cells
19.
GIF animation showing complications of biliary tract lithiasis
29.
Cholestasis of liver, microscopic* - from blocked ducts
30.
Cholestasis of liver, microscopic* - from blocked ducts
4. hepatitis
(viral infraction)
- virus injures cells
9.
Macronodular cirrhosis of liver, gross - from hepatitis
10.
Macronodular cirrhosis of liver, gross - from hepatitis
11.
Macronodular cirrhosis of liver, gross - from hepatitis
53.
Viral hepatitis C, liver, low power microscopic* - from hepatitis
54.
Viral hepatitis with collapse, liver, Trichrome stain, microscopic*
- from hepatitis
5. malnutrition
- deficiencies weaken cells
pathogenesis
5.
Fatty metamorphosis of liver, gross
6.
Fatty metamorphosis of liver, gross
7.
Fatty metamorphosis of liver, microscopic*
8.
Fatty metamorphosis of liver, microscopic*
16.
Cirrhosis of liver, microscopic*
17.
Micronodular cirrhosis and fatty change of liver, microscopic*
18.
Mallory's hyaline, liver, microscopic*
| cause -> |
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decr. liver functions (1-8 above) |
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decr. liver functions (1-9 above) | |
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decr. liver functions (2 & 9 above) | |
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vessels & bile ducts (p. 392) -> |
decr. liver functions (2 & 9 above) |
consequences
1. jaundice(p.
391)
a. decr. conjugation of bilirubin ->
decr.
secretion of bilirubin ->
b. blocked bile ducts -> decr. elimination
of bilirubin ->
a & b -> incr. incr.
incr. bilirubin -> brain cell injury
29.
Cholestasis of liver, microscopic* - from blocked ducts
30.
Cholestasis of liver, microscopic* - from blocked ducts
2. edema
a. decr. protein synthesis -> decr.
COP ->
b. decr. inactivation of steroid hormones
-> incr. H2O retention ->
incr.
blood volume ->
a & b -> edema -> fluid/electrolyte (F/E) imbalance, pulmonary edema
-> ??
3. ascites
(accumulation of fluid in abdominal cavity)
(sketch)
a. decr. protein synthesis -> decr.
COP ->
b. decr. inactivation of steroid hormones
-> incr. H2O retention ->
incr.
blood volume ->
c. blocked vessels -> portal hypertension ->
(sketch)
a & b & c -> transudate into abdominal cavity = ascites -> decr.
BP, F/E imbalance -> ??
4. gastrointestinal
varices & hemorrhoids (p. 392)
a. blocked vessels -> portal hypertension -> varicose veins -> bleeding,
hemorrhoids -> ??
21.
Esophageal varices with portal hypertension, gross - esophageal
varices
5. splenomegaly
(sketch)
a. blocked vessels -> portal hypertension -> splenomegaly -> decr.
function (RBCs, BP, lymphatics) -> ??
22.
Splenomegaly with portal hypertension, gross - splenomegaly
6. bleeding
tendencies
a. decr. production of clotting factors
-> decr. clotting ->
b. decr. inactivation of hormones ->
weak vessels ->
a & b -> incr. bleeding, incr.
bruising -> ??
7. spider
nevi
a. decr. inactivation of hormones ->
weak vessels -> vessel dilation -> ??
8. low
hematocrit
a. decr. balance of nutrients -> decr.
RBC production -> anemia -> ??
9. hepatic
coma (p. 396)
a. decr. detoxification of chemicals
(NH3) -> incr. incr.
NH3 -> brain cell injury ->
brain malfunction (e.g., stupor, tremors, delirium) -> coma -> death
Cholelithiasis
definition = having
gall stones
1.
Normal gallbladder, gross
12.
Normal common bile duct, gross
5.
Cholelithiasis, gallbladder, gross [CT]
6.
Cholelithiasis, gallbladder, gross
7.
Cholelithiasis with chronic cholecystitis, gallbladder, gross
8.
Porcelain gallbladder, gross
13.
Biliary tract lithiasis, diagram
19.
GIF animation showing complications of biliary tract lithiasis
18.
Intrahepatic lithiasis, liver, gross
16.
Cholestasis of liver, microscopic*
15.
Obstructive jaundice, medium power, microscopic*
causes
(sketch)
1. incr.incr.
cholesterol secretion -> incr.incr.
concentration
2.
Cholesterolosis, gallbladder, gross
4.
Cholesterolosis and cholelithiasis, gallbladder, gross
3.
Cholesterolosis, gallbladder, microscopic*
2. decr.decr.
emptying of gall bladder ->
incr.incr.
concentration
3. infection
in gall bladder -> altered conditions ->
pathogenesis
cause -> gall
stone formation
S&S
indigestion,
pain, pain after eating fats, X-ray
consequences
(sketch)
1. cirrhosis
2. infection
of gall bladder
3. perforation
of gall bladder
4. pancreatitis
(from blocked pancreatic duct)
Pancreatitis
definition = inflammation
of the pancreas
1.
Normal pancreas, gross
2.
Normal pancreas, high power microscopic*
3.
Acute pancreatitis, gross - acute
4.
Acute pancreatitis, gross - acute
6.
Acute pancreatitis with fat necrosis, high power microscopic* - acute
8.
Acute pancreatitis, low power microscopic* - acute
10.
Acute pancreatitis with fat necrosis, gross - acute
12.
Chronic pancreatitis, low power microscopic* - chronic
13.
Chronic pancreatitis, low power microscopic* - chronic
causes
1. blocked duct (e.g.,
gall stones, alcohol) -> retention and activation of enzymes
(sketch)
2. alcoholism -> toxic,
block ducts, incr. incr.
enzymes ->
3. trauma
4. medications
5. idiopathic
pathogenesis
cause -> cell
injury/cell death -> inflammation (pancreatitis)
consequences
1. diabetes
mellitus ( from decr. insulin production)
2. malabsorption
(from decr. enzyme production)
3. tetany
(sketch)
leaking enzymes -> enzymatic fat necrosis -> binding calcium ->
tetany
6.
Acute pancreatitis with fat necrosis, high power microscopic* - acute
10.
Acute pancreatitis with fat necrosis, gross - acute
4. infection
(from injured and killed cells, autodigestion)
5. peritonitis
(sketch)
leaking enzymes -> autodigestion -> peritonitis -> (1-6)
1. shock -> ??
2. fluid/electrolyte imbalance -> ??
3. paralytic obstruction -> ??
4. physical obstruction -> ??
5. adhesions -> ??
6. abdominal
organ digestion
(sketch)
leaking enzymes -> autodigestion -> organ failure
Special terms
Laennec's cirrhosis =
cirrhosis from alcoholism
cholecystitis =
inflammation of the gall bladder
Reproductive System Lecture Notes
Page Index
Sexually transmitted
diseases
Reasons for epidemic
proportions
Bacterial types
syphilis
gonorrhea
Chlamydia
Viral types
Herpes
- HSV II
papilloma
AIDS
Prostatic hypertrophy
Toxemia of pregancy
Endometriosis
Placenta privea
Tumors
Sexually transmitted diseases
Reasons for epidemic
proportions
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1. ease of
transmission
2. mild or
absent signs and symptoms
3. ineffective
immune response
4. resistant
strains
5. difficult
diagnostic procedures
6. relaxed
sexual mores
7. ignorance
8. denial
9. unprotected
sex
Bacterial types - can be
cured with antibiotics
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of Page
syphilis (pp,
1007, 1008, Plate 30)
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of Page
- results in four
stages if unchecked
- chancre in primary stage
- rash in secondary stage
- no S&S in latent stage
- gummas (scar tissue) in tertiary stage -> (1-3)
1. atherosclerosis (80%-85% of cases with gummas) -> ??
2. in brain -> dementia
3. in joints -> arthritis
- infective in primary,
secondary, and first part of latent stage
- newborns
- passes through placenta (after 4th month) -> abortions, birth defects,
stillbirths, syphilis, blindness
gonorrhea
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- results
- inflammation -> creamy discharge, pain, scar tissue
- may result in abscesses
(sketch), pelvic inflammatory disease
(PID)
(sketch), strictures
(e.g., sterility, tubal pregnancy)
(sketch)
GIF
animation, ovulation, fertilization, implantation, diagram
GIF
animation, ectopic pregnancy, diagram
Ectopic
pregnancy, fallopian tube, ruptured, gross
Ectopic
pregnancy, fallopian tube, ruptured, gross
Ectopic
pregnancy, fallopian tube, low power microscopic *
Ectopic
pregnancy, fallopian tube, medium power microscopic *
- newborns
- transmissible during birth -> blindness
Chlamydia - (most common
STD)
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- results
- inflammation -> discharge, pain, scar tissue
- may result in PID, cancer, strictures (e.g., sterility, tubal pregnancy)
- newborns
- transmissible during birth -> eye and lung infection in newborns, premature
birth
Viral types - cannot be cured
with antibiotics
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Herpes - HSV II (p.
1012, Plate 40)
Go
to Tutorial on HIV
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-
results
- inflammation -> rash, pain, burning (may be disabling during flares),
embarrassment, psychological health, social interactions, employment
Herpes
simplex esophagitis, gross.
Herpes
simplex esophagitis, low power microscopic. *
Herpes
simplex esophagitis, high power microscopic. *
Herpes
simplex keratitis, cornea sgross, fluorescein stain. *
Herpes
simplex keratitis, cornea high power microscopic. *
Herpes
simplex encephalitis, acute, with hemorrhage, gross.
Herpes
simplex encephalitis, remote, gross.
Herpes
simplex, skin, vesicle, low power microscopic. *
-
newborns
- transmissible during birth -> inflammation, organ damage, Caesarian sections
required
papilloma - (fastest spreading
STD) (p. 1012)
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- results
- genital warts, promotes cancer (penis, vagina, cervix)
Koilocytosis,
cervix, low power microscopic *
Koilocytosis,
cervix, high power microscopic *
- newborns
- transmissible during birth -> same results
AIDS(pp.
176, 177, 179, 182, 183, Plates 1-3)
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-
infection
into blood vessels -> kills T-helper cells (i.e., CD4 cells)
-> weak immune responses
Human
immunodeficiency virus, electron micrograph. *
Human
immunodeficiency virus, electron micrograph. *
Human
immunodeficiency virus, electron micrograph. *
Human
immunodeficiency virus within lymphoid tissues, diagram.
Schematic
diagram of CD4 receptor and chemokine coreceptor.
Human
immunodeficiency virus, life cycle, diagram.
Human
immunodeficiency virus, process of infection, diagram.
Life
cycle of HIV, with the points of pharmacologic agent effectiveness, diagram.
- results
in progressive stages if unchecked
- mild fever, malaise, swollen glands (2-12 weeks)-> seroconversion ->
ARC
(fever, weigh loss, swollen glands, night sweats, diarrhea, psychological
disturbances {depression, anxiety, withdrawal, delusions}) -> AIDS (infections,
cancer, dementia {ARD}) -> death
- ARC = AIDS-related complex
- ARD = AIDS-related dementia
- causes of death
- cancer, infections, extreme muscle weakness (e.g., -> starvation, aspiration,
decubiti)
-
newborns
- passes through placenta -> AIDS
Go
to Tutorial on AIDS
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of Page
- infections accompanying AIDS
- Pneumocystis carinii
- parasite causing pneumonia
Pneumocystis
carinii, appearance of organisms, diagram.
Pneumocystis
carinii pneumonia, gross.
Pneumocystis
carinii pneumonia with cavitary change, gross.
Pneumocystis
carinii pneumonia, low power microscopic. *
Pneumocystis
carinii pneumonia, medium power microscopic, GMS stain. *
Pneumocystis
carinii pneumonia, high power microscopic, GMS stain. *
Pneumocystis
carinii, kidney disseminated , gross.
Pneumocystis
carinii, spleen, disseminated, CT scan.
Pneumocystis
carinii, exudate with calcification, medium power microscopic.
*
Pneumocystis
carinii pneumonia, interstitial fibrosis, medium power microscopic.
*
Cytomegalovirus
- virus causing pnuemonia, blindness, and damage to the brain and the digestive
system
Cytomegalovirus,
appearance of organisms, diagram.
Cytomegalovirus,
ulcers in cecum, gross.
Cytomegalovirus
pneumonia,
microscopic. *
Cytomegalovirus
pneumonia,
microscopic. *
Cytomegalovirus
pneumonia,
microscopic. *
Cytomegalovirus
pneumonitis,
immunoperoxidase stain, medium and high power microscopic. *
Cytomegalovirus
adrenalitis,
microscopic. *
Cytomegalovirus,
liver,
microscopic. *
Mycobacteria
- tuberculosis in many body parts
Mycobacterium
tuberculosis, lung, gross.
Mycobacterium
tuberculosis, lung, AFB stain, microscopic. *
Mycobacterium
avium complex (MAC), macrophages filled with mycobacteria, spleen,
AFB stain, microscopic. *
Mycobacterium
avium complex (MAC), spleen with miliary granulomas, gross.
Mycobacterium
avium complex (MAC), mesenteric lymph nodes, gross.
Fungal
infections
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- often Candida in the mouth, esophagus, and respiratory system. Other
dangerous fungi affect the meninges and respiratory system
Candida
albicans, lung, gross. *
Candida
albicans, invasive in bronchus, H&E stain, microscopic.
*
Candida
albicans, invasive in esophagus, PAS stain, microscopic. *
Cryptococcus
neoformans (without capsules), meninges, GMS stain, microscopic.
*
Histoplasma
capsulatum, granulomas in liver, gross.
Histoplasma
capsulatum, liver, H and E stain, microscopic. *
Histoplasma
capsulatum, liver, PAS stain, microscopic. *
Coccidioides
immitis, lung, H&E stain, microscopic. *
Coccidioides
immitis, liver, H&E stain, microscopic. *
Toxoplasmosis
- protozoan parasite, often in the brain
Toxoplasma
gondii, organizing cerebral abscess, gross.
Toxoplasma
gondii, pseudocysts, microglial nodule, microscopic. *
Toxoplasma
gondii, myocardium, microscopic. *
Toxoplasma
gondii, lung, immunoperoxidase stain, microscopic. *
Herpes
simplex virus
- Herpes simplex virus in the digstive system and the skin
Herpes
simplex virus, esophagus, microscopic. *
Herpes
simplex virus, esophagus, microscopic. *
Protozoan
parasites
- often cause severe diarrhea
Gastrointestinal
protozoa, diagram. *
Cryptosporidia,
electron micrograph. *
Cryptosporidiosis,
small
intestine, H and E stain, microscopic. *
Cryptosporidiosis,
stool
specimen, AFB stain,microscopic. *
Miscellaneous
infections
- respiratory infections, often in children with AIDS
Lymphoid
interstitial pneumonitis (LIP) of lung, low power microscopic.
*
Lymphoid
interstitial pneumonitis (LIP) of lung, low power microscopic.
*
Lymphoid
interstitial pneumonitis (LIP) of lung, medium power microscopic.
*
Lymphoid
interstitial pneumonitis (LIP) of lung, high power microscopic.
*
Progressive
multifocal brain leukoencephalopathy (PML), gross.
Progressive
multifocal leukoencephalopathy (PML), Luxol fast blue stain, low
power microscopic. *
Progressive
multifocal leukoencephalopathy (PML), high power microscopic.
*
Progressive
multifocal leukoencephalopathy (PML) JC viral particles in nucleus,
electron micrograph. *
- cancers
with AIDS
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of Page
Kaposi's
sarcoma (KS) on the skin and the visceral organs
Kaposi's
sarcoma,
skin, gross.
Kaposi's
sarcoma, skin, patch stage, microscopic. *
Kaposi's
sarcoma, skin, nodule, microscopic. *
Kaposi's
sarcoma, skin, extravasation of RBC's, microscopic. *
Kaposi's
sarcoma, skin, hemosiderin and hyaline globules, microscopic.
*
Kaposi's
sarcoma, skin, hyaline globules, PAS stain, microscopic. *
Kaposi's
sarcoma, oral cavity, immunoperoxidase with antibody to CD34, microscopic.
*
Kaposi's
sarcoma, stomach, gross.
Kaposi's
sarcoma, liver, gross.
Malignant
lymphomas
Malignant
lymphoma, lymph node, gross.
Malignant
lymphoma, small intestine, gross.
Malignant
lymphoma, liver, gross.
Malignant
lymphoma, brain, low power microscopic. *
Malignant
lymphoma, brain, high power microscopic. *
Prostatic hypertrophy
(sketch)
definition = non-neoplastic
enlargement of the prostate gland
Prostate,
nodular prostatic hyperplasia, gross
Prostate,
nodular prostatic hyperplasia, gross
Prostate
with nodular hyperplasia, and bladder with hypertrophy and calculus
Bladder,
with hypertrophy, gross
Prostate,
normal, high power microscopic *
Prostate,
nodular prostatic hyperplasia, low power microscopic *
Prostate,
nodular prostatic hyperplasia, high power microscopic *
Prostate,
intraepithelial neoplasia (PIN), high power microscopic *
Prostate,
"chips" from transurethral resection of prostate (TURP), gross
Go
to Tutorial on Prostate Pathology
causes
- not known
- possibly from altered ratios of sex steroids (estrogen and testosterone)
- possibly from increases in testosterone receptors on prostate cells
pathogenesis
(sketch)
cause -> enlargement
of prostate (hyperplasia of cells -> hypertrophy of gland) -> compression
of urethra -> urine retention -> abnormal micturition & renal diseases
consequences
difficulty
starting or stopping urine flow, pain, urinary incontinence, bladder decompensation,
(i.e., dilation, hypertrophy), urinary tract infections, hydropnephrosis
S&S
difficulty
starting or stopping urine flow, pain, urinary incontinence urinary tract
infections, palpation during rectal exam
treatments
catheterization
to relieve pressure, surgical reduction of the prostate gland (e.g., TURP
= transurethral prostetectomy)
Toxemia of pregancy
definition = hypertension
associated with liver failure, kidney failure, and brain damage
causes
- unknown
- possibly from secretions from the uterus causing abnormally high sensitivity
to angiotensin
pathogenesis
cause -> (1
& 2 )
1. high sensitivity to angiotensin -> vasoconstriction -> incr.
incr. BP -> organ/system failure
2. increased clotting factors from placenta -> systemic intravascular
clotting -> organ/system failure
consequences (1-5)
1. liver damage
(necrosis, liver failure) -> ??
2. kidney
damage (like glomerulonephritis + hypertensive kidney) -> renal failure
-> ??
3. brain damage
(like ischemic and hemorrhagic strokes) -> ??
4. placental
damage (hemorrhage = placenta abruptio -> ??
5. other organ
failure (e.g., heart, lungs) -> ??
S&S
preeclampsia
- incr. incr. BP, edema, azotemia,
proteinuria, rapid weight gain (fluid retention)
eclampsia
- same as preeclampsia + convulsions, coma
treatments
rest
dietary management
Endometriosis
definition = metaplasia
of endometrium (normal cells in abnormal locations)
(sketch)
GIF
animation, endometriosis, diagram
Endometriosis,
low power microscopic
Endometriosis,
medium power microscopic
Endometriosis,
uterine serosa, gross
Endometriosis,
uterine serosa, gross
Endometriosis,
ovary, gross
Endometrial
hyperplasia, gross
Endometrial
polyp, gross
causes
unknown
- possible from displacement of endometrium up oviducts or through circulation
pathogenesis
cause -> endometrium
cells in abnormal locations -> menstrual cycles of metaplastic endometrium
-> hemorrhage -> Hb cell injury/cell -> inflammation ->
(sketch)
consequences
pain, PID
(pelvic inflammatory disease), adhesions, strictures
S&S
pain during
menstruation, hematuria, blood in feces
treatments
hormonal suppression
of menstrual cycles, surgery
Placenta privea
definition = growth
of placenta near or over the lower uterine opening
(sketch)
GIF
animation, ovulation, fertilization, implantation, diagram
causes
low implantation
of embryo
pathogenesis
low implantation
-> placenta near uterine opening -> weakening of placenta as uterus stretches
-> hemorrhaging ->
consequences
shock, death
of mother and child
S&S
uterine bleeding
as pregnancy progresses
treatments
rest, pre-pregnancy
surgery to secure uterine opening, stopping the bleeding
Tumors
definition = neoplasia
in reproductive structures
Go
to Female Genital Tract Pathology
Go
to Male Genital Tract Pathology
Go
to Tutorial on Breast Cancer
causes
diverse for
different types of neoplasia
pathogenesis
diverse for
different types of neoplasia
consequences
diverse for
different types of neoplasia (see effects from neoplasia)
(sketch)
1. block tubes
2. compress tubes
3.pressure on structures
4. infection
5. inflammation
6. hemorrhage
7. compete for nutrients
8. disrupt tissue and organ structure
9. excess secretion of substances (e.g., hormones
10.
become malignant
11.
cosmetic
S&S
abnormal lump
or thickening (palpation)
altered bladder
or bowel habits
abnormal bleeding
mammograms
sonograms
Pap smear Go
to Tutorial on Cytopathology (Pap Smears)
Normal
cervix, gross
Normal
cervical squamous epithelium, microscopic *
Pap
smear, dysplasia, microscopic *
Dysplastic
and normal cervical squamous epithelium, low power microscopic *
Dysplastic
and normal cervical squamous epithelium, high power microscopic *
Dysplastic
vulvar epithelium, low power microscopic *
treatments
- "wait and
watch", hormonal, radiation, chemotherapy, surgery, immunotherapy
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© Copyright 2002 - Augustine G. DiGiovanna - All rights reserved.
All rights reserved. Except as permitted under the United states Copyright
Act of 1976, no part of this page may be reproduced or distributed in any
form or by any means, or stored in a data base or retrieval system, without
the prior written permission of Augustine G. DiGiovanna.
Do Not Print This Page
Print the Sec05-w.htm version only.
Do Not Print This Page
Print the Sec05-w.htm version only.
© Copyright 2002 - Augustine G. DiGiovanna - All rights reserved. All rights reserved. Except as permitted under the United states Copyright Act of 1976, no part of this page may be reproduced or distributed in any form or by any means, or stored in a data base or retrieval system, without the prior written permission of Augustine G. DiGiovanna.