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pathophy Flashcards

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1
Q

testicular torsion

A

abnormal attachment of testes dt redundant tunica vaginalis – excessive mobility – twisting of spermatic cord – decreased blood supply, venous congestion – ischemia, necrosis

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2
Q

inguinal hernia incarceration

A

pressure on herniated viscera causes impaired lymphatic and venous drainage – swelling, compression – decreased blood supply – ischemia, necrosis

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3
Q

congenital inguinal hernia

A

patent processus vaginalis causes weakness in the abdominal wall musculature, leading to herniation

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4
Q

undescended testis

A
  • hormonal imbalance (insulin-like factor 3, testosterone)
  • failure of gubernaculm to guide descent
  • failure of processus vaginalis to involute
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5
Q

hydrocele

A

accumulation of fluid in tunica vaginalis dt defect in procesus vaginalis OR
acquired dt inflammatory conditions (trauma, torsion, epididymitis)

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6
Q

Classic CAH

A

deficiency of 21-hydroxylase - substrate in synthesis of aldosterone and cortisol, shunting 17-hydroxyprogestrone to androgen synthesis

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7
Q

CDH

A
  • defect between the abdominal and thoracic cavities with or without herniation of bowel loops into chest cavity
  • Herniated abdominal contents compress the lungs and result in pulmonary hypoplasia
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8
Q

STI

in females

A

increase in estrogen leads to changes in the vaginal epithelium, leading to decreased pH and increased susceptibility to organisms

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9
Q

T1DM, DKA

A
  • autoimmune damage to pancreatic B cells leads to low or absent endogenous insulin
  • decreased gluc utilization in ms and fat; increased production in liver
  • causing hyperglycemia which causes osmotic diuresis and ketone body formation
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10
Q

acute pancreatitis

A

initial insult (injury, infection) causes increase in proenzymes leading to pancreatic autodigestion

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11
Q

acute appendicitis

A

phlegmon or lymphoid hyperplasia causes obstruction, leading to congestion, edema, ischemia, and necrosis

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12
Q

necrotizing enterocolitis

A

dysbiosis due to prematurity, early enteral nutrition causes bacterial overgrowth, leading to inflammation, intestinal ischemia and necrosis

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13
Q

pertussis

A

oragnism and pertussis toxin induces inflammatory response – inflammation, epithelial damage – respiratory sx

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14
Q

kawasaki

A

acute systemic vasculitis of medium-sized vessels

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15
Q

TB meningitis

A

TB bacilli enters CNS, forms casseous lesion, releases gelatinous exudates, causing inflammation, obstruction, infarction, leading to CNS dysfunction

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16
Q

PSGN

A
  • molecular mimicry between antibodies elicited by strep antigen and gbm and
  • direct deposition of strep ag in glomeruli causes complement activation and immune complex formation
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17
Q

HUS

A

infection triggers endothelial injury, leading to platelet aggregation; endothelial injury causes destruction of RBCs and glomerular thrombosis – decreased glomerular filtration

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18
Q

HSP/ IgA Vasculitis

A

IgA deposition in small vessels causes necrotizing vasculitis in end organs such as kidneys

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19
Q

SLE

A

autoantibodies against self antigens form immune complexes and deposit in end-organs, causing inflammation and tissue damage

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20
Q

Septic arthritis

A

hematogenous seeding of synovial space

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21
Q

Intussusception

A

intussusceptum telescopes into intussuscipiens, pulling its mesentery along and causing venous congestion, edema, and bleeding from mucosa, causing bloody stool

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22
Q

RDS

A

surfactant deficiency and/or prematurity causes increased surface tension and alveolar collapse, leading to hypoxia and respiratory distress

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23
Q

SSPE

A

altered measles virus seeds in CNS and reactivates 7-13 years after initial infection, causing behavioral changes, neuro sx

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24
Q

EBV

A

virus enters respi epith, spreads to salivary glands, travels to reticuloendothelial system - causing lymphadenopathy, hepatosplenomegaly

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25
Dengue
virus enters bloodstream via bite from mosquito vector, toxins trigger inflammatory cytokines and complement cascade, causing increase vascular permeability
26
leptospirosis
leptospira enter body via mucous membranes, break in the skin, or ingestion; cause **endothelial damage to small bv** and end-organ ischemia
27
bronchiolitis
viral infection causes inflammation and obstruction of small airways with edema, mucus, and cellular debris
28
Acute bacterial meningitis
bacterial colonization of nasopharynx and subsequent bacteremia causes organism to cross BBB and enter CNS, causing **inflammation, injury and meningial irritation**
29
Japanese encephalitis
virus enters CNS and causes direct neurotoxic effects
30
COVID
Viral spike protein binds to Angiotensin Converting Enzyme 2 (ACE-2) receptors in airway epithelial and endothelial cells which: 1. Reduces ACE2 expression in the lungs resulting in acute lung injury, 2. Causes dysregulation of the reninangiotensin system resulting in hemodynamic instability
31
Malaria
plasmodium enters bloodstream, enters liver and releases merozoites
32
TTN
- delayed fluid resorption dt lack of maternal squeeze and catecholamine surge - increased lung compliance and resistance - impaired gas exchange, acidosis
33
MAS
- partial airway obstruction leading to ball-valve effect which allows inflow of air but causes air trapping - inhibition of surfactant and inflammation and obstruction of small airways - all leading to hypoxemia, hypercapnia, acidosis
34
Hirschsprung
absence of ganglion cells in mucosa and submucosa causing inadequate relaxation of bowel wall
35
Diphtheria
diphtheria exotoxin inhibits protein synthesis, causes local tissue necrosis and inflammation → formation of gray-brown, leather-like adherent PSEUDOMEMBRANE
36
Bronchial asthma
chronic airway inflammation, airway hyperresponsiveness and variable airflow limitation cause respiratory sx (cough, wheezing, DOB)
37
TOF
anteriorly and superiorly deviated infundibular septum leading to PROV (pulmonary stenosis, RVH, overriding of the aorta, VSD)
38
ARF
- cytotoxic toxins damage cardiac cells - cross-reactivity bet GAS epitopes and cardiac cells (molecular mimicry) - M protein binds to collagen type IV and causes inflammation in cardiac cells
39
Tet spells
- decrease in SVR (dt crying, feeding, defecatin) leads to increased venous return, and increased R to L shunting - causes acidosis, hyperpnea, further increase in SVR
40
pericarditis
fluid within the pericardial layers increases dt infection/inflammation, leading to compression of the chambers and impaired cardiac filling
41
typhoid
- typhoid toxin penetrates intestinal lumen, causes **necrosis of peyers patches**, leading to inflammation and gastroenteritis; - spreads via lymphatics to liver, spleen, BM
42
tetanus
spores enter via **traumatic injury** and release **tetanospasmin** which **inhibits release of glutamate and gaba** in NMJ, causing sustained **maximal contraction and spastic paralysis**
43
botulism
ingested spores produce **neurotoxin** which irreversibly **block presynaptic release of acetylcholine**, inhibiting NM transmission, causing **muscle paralysis**
44
rabies
virus enters the body via a bite or scratch from infected animal, replicates in ms or skin then enters CNS via retrograde axonal transport, infects brainstem and spinal cord, causing CNS dysfunction
45
poliomyelitis
virus enters body via **feco-oral route**, replicates in small intestine, **seeds in CNS** - causes **inflammation, edema, neuronal damage, causing flaccid paralysis**
46
pulmonary TB
- tubercle bacilli enter the body via **inhaled respiratory droplets**, cause local inflammatory reaction - macrophages phagocytose bacteria, tubercle bacilli multiply within macrophage and form **casseous lesions which spread via lymphatics** - casseous foci in lungs cause inflammation and obstruction, leading to respiratory sx
47
anaphylaxis
IgE and other immunnologic mediators, cause **mast cell and basophil degranulation** - causing **release of histamine, prostaglandin, and other mediators** - cause cutaneous, respi, GI manifestations
48
osteomyelitis
- low velocity blood flow in metaphysis leads to bacterial invasion - causing inflammation, proteolysis and osteolysis
49
JIA
- **immunologic susceptibility** triggered by **environmental factor** (infection) causes **synovitis of peripheral joints** with swelling and effusion
50
Myasthenia gravis
- **antibodies to Ach receptors** lead to impaired NM transmission, causing **asymmetric descending muscle weakness**
51
Rh incompatibility
- mother with Rh- blood develops antibodies after exposure to Rh+ blood from delivery of 1st bb - maternal antibodies to Rh+ blood are passed on via placenta during succeeding pregnancies - causes RBC destruction in infant, causing hemolysis and jaundice
52
Breastfeeding jaundice
- decreased milk production leads to **dehydration** and **hemoconcentration** of bilirubin, causing less BM and **increased enterohepatic circulation**
53
Breastmilk jaundice
- **beta glucoronidase** in breastmilk **deconjugates** bilirubin and leads to **increased enterohepatic circulation**
54
ABO incompatibility
- maternal antibodies against ABO factors in fetus form antigen-antibody complexes, causing hemolysis and jaundice
55
G6PD
- glucose 6 phosphate dehydrogenase catalyzes initial step in HMP which protects RBC from oxidative injury - deficiency of G6PD makes **RBCs more prone to oxidative stress and injury, leading to hemolysis**
56
Biliary atresia
- **failure of dev or progressive injury** of portion or entire biliary system, causing **obstructive jaundice**
57
Functional constipation
- children develop **intentional or subconscious withholding of BM** due to a social stressor, toilet training, school entry, or change in diet - **stool becomes firm and difficult to pass** and passage of BM **becomes painful** - causing **voluntary withholding of stool to avoid discomfort**
58
AOM
- viral URTI causes inflammation of respiratory mucosa - increased secretions causes obstruction bacterial overgrowth - infection and inflammation of middle ear
59
AOE
- irritation from excess moisture leads to inflammation and increased secretions
60
pnemothorax
- loss of negative pressure in intrapleural space - causes lung collapse - leading to hypoventilation and hypoxemia

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