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CR5 Pathology, image - Coggle Diagram

- - - - Restrictive Lung Disease
        
        reduction in lung volumes
        
        both FEV1 and FVC is reduced, ratio can remain same or increased
        
        Types
        
        Allergic Rhinitis
        
        Diffuse Parenchymal Lung Diseases
        
        Sarcoidosis
        
        Interstitial Lung Disease
        
        Clinical Manisfestations
        
        Clubbing
        
        Unexplained Weight Loss
        
        Non-Productive Cough
        
        Lung Cancer*
        
        bronchial carciod
        
        Carcinoid tumor
      - Changes in Lung Compliance
        
        Increase
        
        loss of elastic fibers
        
        rmb elasticity is inversely related to compliance
        
        emphysema
        
        old age
        
        Decrease
        
        increases tendancy for lung to collaspe
        
        fibrosis
        
        the ability for lung to take in volume without much change to its pressure
        
        surface tension
        
        loss of surfactant
        
        Atelectasis
        
        Pulmonary Oedema
        
        lack of surfactant
        
        infants
        
        neonatal ARDS
        
        increase surface tension increases lung compliance
        
        surface tension makes it harder for alveoli to open
        
        changes the ability for the lung to stretch
      - Obstructive Lung Disease
        
        Types
        
        COPD
        
        COPD
        
        Occur in Alveolis
        
        Emphysema
        
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        Chronic Bronchitis
        
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        how do you know who is more likely to get what?
        
        Occur in Bronchi and Bronchioles
        
        Bronchiectasis
        
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        Pneumonia
        
        Pneumonia
        
        Classification
        
        Method of Transmission
        (How did the pathogen get there?)
        
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        Anatomical Part
        (Which part of the lung is affected?)
        
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        Location
        (where did they get it from?)
        
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        High Risk Individuals
        (Who is most likely to get it?)
        
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        Clinical Manifestations
        (What is the effect of getting it?)
        
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        Inflammation of the alveolar spaces or interstitial spaces leading to scarring of the parenchyme of the lung
        
        General Pathology
        
        Failure of Control of Respiration (Reflexes)
        
        Pathogen infiltration
        
        Mismatch perfusion to ventilation
        
        Hypoxia
        
        Causative Agents
        
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        Diagnosis
        
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        Asthma
        
        Check overview copy
        
        Lung Cancer*
        
        Small Cell Carcinoma
        
        Large Cell Carcinoma
        
        obstruction to air flow
        
        FEV1 is reduced. Ratio FEV1/FVC is decreased
      - Lung Cancer
        
        Classification
        
        Non-small Cell Carcinoma
        
        Squamous Cell Carinoma
        
        Pathogenesis
        
        Pseudostratified Columnar Epithial
        
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        Risk Factor
        
        Gene mutation of CDKN2A and TP53
        
        Strongest association to smoking
        
        Adenocarcinoma
        
        Etiology
        
        Gene mutation of EGFR and KRAS
        
        more common in woman and non-smokers
        
        Pathogenesis
        
        "Adeno" means derived from gland
        
        Large Cell Carcinoma
        
        Small Cell Carcinoma
        
        Risk Factor
        
        Gene mutation of TP53 and RB
        
        ?????
        
        Strongest association to smoking
        
        Risk Factors
        
        Promoters
        
        polycyclic aromatic hydrocarbons
        
        Initiators
        
        Morphology
        
        General Pathogenesis
        
        Problem with epithelial lining of lung
      - consolidation is the process of things becoming of more solid, hence it is considered as a description of restrictive lung disease
      - Tuberculosis
        
        Classification
        
        Primary
        
        Morphology
        -Ghon focus in mid-lower lobe
        -Ghon complex: ghon focus + hilar lymphadenopathy
        
        Risk Factor: travel to country with TB
        
        Secondary
        
        Morphology
        -Cavities in upper lobe
        -Miliary Systematic TBC (yellow spots)
        -unilateral Pleural Effusion
        -lymphadenitis
        
        Miliary TBC name comes from the appearance looking like Millet seeds
        
        Why upper lobe explained:
        
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        Risk Fact: More common in Immunosuppressant + older people + substance abuse
        
        why HIV ppl are more susceptible to secondary TBC
        
        Basically patient with a CD4 count of less than 500 cells/microL are more likely to develop 2ndary TBC
        
        Localized TBC
        
        Mostly asymptomatic
        
        Systematic
        
        Symptoms and Clinical Manisfestation:
        -Productive cough with hemoptysis (the blood vessel becomes eroded and it gets coughed up in the bronchioles)
        -Low grade fever with night sweats
        -Weight loss
        -Pyuria: white blood cell in urine
        
        Pathogenesis
        
        Primary TBC
        
        Mycobacterium enters lung thru inhalation
        
        macrophage engulfs TB bacteria
        
        Inside the Macrophage:
        
        Bacteria secretes protein called sulfatides to prevent the fusion of lysosomes together in order to kill the bacteria
        
        bacteria form cord factors to prevent them from being acidified inside the macrophage
        
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        enters into middle-lower lobe of lung
        
        Pathogen
        
        Diagnosis
        
        Tuberculin Skin Test
        
        positive if in healthy patient more than 15mm induration
        
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        watch the lecture its good
      - ARDS
        
        Risk factors
        
        ARDS in Premature infants are common because they may have surfactant deficiency because the foetus begin to produce the surfactant at around 26 weeks, so premature infants did not get the opportunity to full develop them yet
        
        Infections like sepsis
        
        Complications
        
        Hypoxia
        
        due to ventilation-perfusion mismatch
        
        this is because there is reduced lung compliance and imbalance in alveolar ventilation, pulmonary oedema likely to be present as well as hypoxic pulmonary vasoconstriction and resulting shunting of blood, a ventilation perfusion ratio mismatch is the likely cause of hypoxia
        
        Seriously Fatal: death is common because it has systematic effects
        
        Interstitial Lung Disease (DPLD)
        
        bc ILD is scarring between the alveolis, and ARD can lead to scarring after the macrophages come and release fibroblasts
        
        Pathogenesis
        
        Inflammatory Response
        
        increased pulmonary capillary hydrostatic pressure
        
        Fluid in the alveolis
        
        Alveolar collaspe
        
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        protein rich exudate enters the alveolis
        
        formation of pink hyaline membranes
        
        thickened interstitium
        
        many macrophages but few neutrophils
        
        It is not a disease but it is a syndrome
        
        Prenatal labratory tests
        
        Lechithin:sphingomyelin ration int he amniofluid should be less than 2
        
        very related to lung compliance bc surfactant provides elasticity. so in ARDS lung compliance reduces
    - - Hypoxia
        
        Types
        
        depends on which process it disrupts
        
        Hypoxic Hypoxia
        
        Area Impacted
        
        Ventilation and Gas Exchange between alveoli and lung
        
        Causes
        
        Commonly due to V/Q mismatch
        
        High altitudes
        
        Anaemic Hypoxia
        
        Area Impacted
        
        Oxygen and Blood Supply
        
        Causes
        
        CO poisoning
        
        wrong type of Fe (Fe3+ instead of Fe2+) found in Hb
        
        Fe3+ does not bind to O2
        
        Stagnant Hypoxia
        
        Cause
        
        Commonly due to a Heart Problem
        
        Atherosclerosis or Heart Failure
        
        Area Impacted
        
        Oxygen and Blood Supply
        
        Histotoxic Hypoxia
        
        Area Impacted
        
        Gas Exchange between blood and cells
        
        Cause
        
        Cyanide Poisoning
        
        Effects Complex IV in ETC to not allow O2 to be the last electron acceptor
        
        Respiratory Failure
        
        Types
        
        Respiratory Failure I
        
        Reduced O2 but Normal CO2
        
        Respiratory Failure II
        
        Reduced O2 and Increased CO2
        
        Increased CO2 becomes toxic to brain causing person to be
        
        Effect of Hypoxia on Body
        
        Skin
        
        Cyanosis
        
        Brain
        
        Trigger CNS to respire faster and more deeply (hyperventilation)
        
        can lead to alkalosis (bc CO2 is getting washed out)
        
        If Hypoxia Prolonged
        
        Confusion and Dizziness
        
        the brain is sensitive to PCO2 (it is the drive for respiration), however too much PCO2 causes damage to brain cells
        
        Cells
        
        Anaerobic respiration leads to increase production of lactic acid leading to acidosis
        
        Bone Marrow
        
        Erythropoiesis
        
        Polycythemia
        
        Kidney
        
        Hypoxic kidney will tell bone marrow to make more erythropoietin (85%)
        
        Liver
        
        hypoxic liver cell will tell bone marrow to secrete erythropoietin (15%)
        
        Lungs
        
        vasoconstriction of pulmonary capillaries in lungs
        
        pulmonary hypertension
        
        Cor Pulmonale
- - - - Congestive Heart Failure
        
        Congestive Heart Failure
        
        Generalized
        
        Causes
        
        CAD, Hypertension, Diabetes Mellitus
        
        Result
        
        Left sided can cause right sided heart failure and visa versa because they work in the same circulatory system
        
        Complications
        
        congestion in other places of the body
        
        pleural effusion with transudate
        
        Pathophysiology
        
        Starling's Law
        
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        "congestive" because it results in overcrowding of blood somewhere else in the body
        
        Systolic
        
        Specific Causes
        
        Dilated cardiomyopathy
        
        Arrhythmia
        
        MI
        
        Characteristics
        
        Low Ejection factor (EF)
        
        Can't pump blood hard enough
        
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        specifically smth wrong w numerator (SV)
        
        Diastolic
        
        Characteristics
        
        Ejection factor may be normal
        
        smth wrong with denominator (EDV) in EF formula
        
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        decreased end diastolic volume
        
        Can't fill in enough blood
        
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        Specific Causes
        
        Restrictive cardiomyopathy
        
        Aging
        
        Fibrosis
        
        Hypertrophic Cardiomyopathy
      - Cardiomyopathy
        
        Cardiomyopathy
        
        Disease of the cardiac muscle
        
        causes
        
        most common cause is genetics
        
        viral infection: Coxsakie
        
        Pregnancy
        
        Chronic alcoholic
        
        Malnutrition: Beri-beri (VitB1)
        
        plays a role in cardiac muscle function
        
        Types
        
        Restrictive (least common)
        
        affects EDV
        
        Dilated (most common)
        
        affects systolic
        
        cause mostly due to genetics
        
        Complications
        
        thromboembolism due to the static blood in the ventricles
        
        Hypertrophic
        
        affects EDV
        
        thickened IVS and ventricular wall
        
        Types
        
        Complications
        
        sudden death
        
        Clinical Features
        
        cannot be differentiated between the three types of cardiomyopathies
        
        clinical symptoms similar to heart failure
      - Congenital Heart Disease
      - Valvular Heart Disease
        
        Valvular Heart Disease
        
        components of the valve
        
        how does different valves differentiate with eachother
        
        importance of valve
        
        its connection with heart flow in the circulation. they are very important to regulate the heart flow throughout the cycle.
        
        Which are more prone to diseases
        
        left sided valves
        
        which is why we commonly would just learn the left valve heart disease rather than the right in our lectures
        
        Which valvular heart disease can be aquired/congenital
        
        aquired: rheumatic heart disease
        
        can a patient have both stenosis and regurgitation at once?
        
        yes, it is actually common for patients to have a combination of them
        
        Complications
        
        heart failure, IHD
        
        Types
        
        Stenosis
        
        what and how
        
        failure of blood to open completely: less blood flow: pressure buildup
        
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        Effect
        
        leads to pressure overload
        
        Sounds
        
        due to intrinsic heart disease
        
        Mitral stenosis
        
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        Types
        
        Mitral stenosis
        
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        Aortic stenosis
        
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        Regurgitation
        
        what
        
        failure of blood to close completely: insufficiency
        
        how
        
        dilatation of the valve (it cannot close properly)
        
        disruption from supporting structures doesn't allow it to close properly
        
        Effect
        
        Volume overload: dilatation of the heart: muscle gets thicker: heart failure or IHD
        
        Sounds
        
        Functional Regurgitation
        
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        Types
        
        Myxomatous Mitral Valve
        
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        Types of Murmurs