Search for notes by fellow students, in your own course and all over the country.
Browse our notes for titles which look like what you need, you can preview any of the notes via a sample of the contents. After you're happy these are the notes you're after simply pop them into your shopping cart.
Title: Pathology Comprehensive
Description: Pathology review of several components, with review questions, and case studies
Description: Pathology review of several components, with review questions, and case studies
Document Preview
Extracts from the notes are below, to see the PDF you'll receive please use the links above
Pathology Final Exam Review
Hemodynamics
Case Study #1
A 73-‐year-‐old male with a history of coronary artery disease is seen by his local doctor for
difficulty breathing in bed (orthopnea)
...
The patient is treated with digoxin (increases contractility of muscle
fibers in heart) and told to sleep with his head elevated
...
He is treated with 100% oxygen to relieve his
dyspnea, and his digoxin dosage is increased
...
Over the next
several days, his condition improves, and he is released from the hospital
...
(His lungs filled up with fluid while lying down because of high hydrostatic pressure, which makes
fluid build up in the alveoli
...
)
Questions
1
...
This causes fluid to build-up
...
Why did he develop pulmonary edema? Digoxin did not work and his condition kept getting
worse
...
Why was his digoxin dosage increased? The increase in digoxin would cause an increase in
the amount of contractility of muscle fibers in the heart
...
4
...
5
...
The diameter of the coronary artery narrows
...
(So if the diameter is half
its original size, then 4x less blood flows through)
Cardiac Dilation on Ultrasound
-‐ This heart is enlarged not as efficient in pumping blood
-‐ An enlarged heart can result from CAD, which makes matters worse
...
Most heart problems start in the left ventricle
...
Damage to the brain
causes death
...
Case Study #2- A 73 year old female is admitted to the hospital with hemoptysis (coughing up
blood)
...
She is placed on Coumadin
(an anti-‐coagulant), but continues to have episodes of hemoptysis
...
Following the procedure, she is released from
the hospital, but receives weekly blood clotting tests to maintain proper Coumadin dosage
...
Pieces break off and travel to the heart and lungs, which
pose a danger
...
Where there is no dye, is where a clot is formed
...
}
Questions
1
...
2
...
3
...
It buys more time for Coumadin to work
...
Why did she need to receive weekly blood clotting tests? It maintains Coumadin dosage
...
For all
practical purposes, the term “clot” is synonymous
...
(#2
cause of death)
Pathogenesis
Three primary factors
-‐ Endothelium-‐ Both pro and anti-‐thrombotic properties
-‐ Alterations in blood flow—Turbulence induces endothelial damage and stasis
contributes to venous thrombi
-‐ Increased coagulablity of the blood (not as common, certain tumors that secrete a
factor that increases factors that clot blood)
Thrombosis thrombus formation may be followed by:
-‐ Embolization
-‐ Dissolution (lysis by the thrombolytic system)
-‐ Organization and recanalization (clot can stay there, but it becomes thicker and vessels
grow in the clot, capillaries form within the clot)
Thrombosis-‐ heart-‐ Pre-‐disposing factors
-‐ Endocarditis a virus in the heart damages endothelial cells, exposes basement
membranes, and clots form on top of basement membrane
-‐ Myocardial infarction Heart attack causes stasis, exposure in underlying
membrane
-‐ Atrial Fibrillaton Serious, give anti-coagulants or electric shock
-‐ Cardiomyopathy Enlargement of heart can be caused by coronary artery disease;
decreases deficiency of blood flow
...
Marantic Endocarditis-‐-‐> As we get older, our valves don’t close properly
...
Bacteria can spread to other parts of the body when
embolism occur
...
-‐ Primarily due to sluggish blood flow
-‐ Most often the result of prolonged immobilization
-‐ May cause swelling of the leg, or may be completely asymptomatic
-‐ Pulmonary Embolism may occur
Thombosis- High Risk Patients
- Tissue Damage
-‐ Prolonged Immobilization
-‐ Myocardial Infarction
-‐ Neoplasms—Solid or hematopoetic
-‐ Trosseu syndrome—pancreatic adenocarcinoma
-‐ Prosthetic heart valve
-‐ DIC (also increased risk of hemorrhage)
-‐ Pregnancy/ postpartum (amniotic fluid can trigger)
-‐ Oral BCPs
-‐ Smokers
-‐ Hyperlipidemia high cholesterol
-‐ Sickle Cell disease RBCs change shape
-‐ Atrial fibrillation
Case Study #3— A 75 year old man is playing golf on a very hot day and suddenly becomes dizzy
and collapses
...
An IV line is inserted in his arm and
intravenous saline is administered
...
(death of cells—He is in a shock state) He is placed on
dialysis, and his renal function gradually increases over the next few weeks
...
0 mg per dl (most of it is being removed, which is good: If it is higher than
One, than there is an indication of a dysfunctional kidney), he is released from the hospital
...
Dialysis is an “artificial
kidney”
Questions and Answers
1
...
He was
sweating so much, his blood pressure falls, which made him dizzy
...
Why did he develop myoglobinuria? Muscle tissue underwent ischemia, which caused the
release of myoglobin
...
3
...
Why was he placed on dialysis? The dialysis machine detoxified the circulatory system, which
removed the myoglobin
5
...
6
...
0 mg per dl? Serum
Creatinine indicates his kidneys were working again
...
Embolisms
Embolism Embolism is the passage through the venous or arterial circulations of any material
capable of lodging in a blood vessel and thereby obstructing the lumen
...
Cholesterol Crystallizes
Bone Marrow Embolism occurs when you break bones, you see segments of bone marrow in the
blood
Infarction Total occlusion of an artery leads to an area of coagulate necrosis (when cells
degenerate) called an infarct
Partial Occlusion may cause infarction, but more often leads to atrophy (some blood get passed;
you get ischemia but not full necrosis
...
Extravascular fluid Hydrostatic Pressure (increased)—fluid inside vessel pushing on the wall of
vessel causing fluid to leak out, while oncotic pressure (decreased) pulls fluid from surrounding
volume and puts in back into vessels (in a systematic way)
Pathogenesis of Edema
-‐ Non-‐inflammatory edema
-‐ Pulmonary edema due to heart failure
-‐ Increased hydrostatic pressure—changes in cardiac output
-‐ Nephrotic Syndrome
-‐ Decreased oncotic pressure—less protein inside vessels kidney disease
leakage of proteins out of circulatory system
-‐ Inflammatory edema
-‐-‐ Tissue injury
-‐ Transient increase in vascular permeability
Non-‐Inflammatory Edema due to increased Hydrostatic Pressure
There is a large increase in hydrostatic pressure, which causes cardiac problems
...
Blood isn’t pumping fast enough, and gets trapped in venous system
...
He denies any history of chest pain
...
He is given all anti-‐coagulant and undergoes coronary angioplasty with insertion of a stent
...
The shortness of breath is caused by the heart pumping harder due to not enough contraction, you
get a compromised ventricle, to get more oxygen you need to breathe faster
...
20-‐30% occlusions won’t cause symptoms
...
Anti-‐coagulants lower risk of vessel blockage
...
The
surgery consists of a catheter, which inflates a balloon to compress occlusion to the wall and open
vessel
...
This allows better blood supply to the heart
...
In a younger person, it indicates asthma or
anxiety
...
Questions and Answers
1
...
Blood doesn’t flow out at the same rate; his tissues are not getting
enough oxygen, he has to breathe faster
...
What caused the occlusion of his left main coronary artery? Atherosclerosis, Inflammation
and injury to blood vessels, which narrows the vessels due to cholesterol deposits that
mediate in inflammatory response, which cause fibroblasts to initiate wound healing,
which leads to the formation of cholesterol with clusters surrounded by fibrous capsule,
which is a lesion of Atherosclerosis, which causes occlusion which can be accelerated by
genetics or poor diet
...
Why was he treated with an anticoagulant? To avoid the possibility of a clot forming of the
artherosclerotic plaque, which would cause a huge infarction
...
Why was a stent inserted into his coronary artery following angioplasty? To maintain patency
(opening) of the area where balloon dilated vessel, blood will continue to flow
...
If a clot
should form here, it would takeout major blood supply
...
Endothelial Injury causes the extracellular matrix to be exposed and there is reflex
vasoconstriction
...
(Vasoconstriction)
2
...
(Primary hemostasis)
3
...
Platelets and fibrin
come together
...
4
...
Thromboplastins from amniotic fluid can also intiate the clotting cascade
...
Pathology of DIC—Many venules, capillaries, and arterioles contain multiple, small, fibrin/platelet
thrombi
-‐-‐ The meshwork of fibrin may fragment red blood cells, forming schistocytes
-‐-‐ Widespread ischemic changes in many organs occur, leading to multi-‐organ failure
Microthrombi in Glomerulus clots in glomerulus will cause kidney infection or renal faillre
...
You see this more with aortic Atherosclerosis
...
What is passive congestion? (venous) Engorgement of an organ by venous blood, usually
the result of left ventricular heart failure, which leads, in turn, to right ventricular failure
(caused by disease)
2
...
What changes occur in the liver as a result of passive congestion? Fluid builds up in the
alveoli, so there is a buildup of passive congestion in the lung, that worsens when the
patients lies down
Thrombosis
1
...
For all practical terms, it’s a damn clot
...
What are the complications associated with thrombosis? Clots block blood flow, they can
form emboli, cause heart attacks, cause stroke, fibrillation, enlargement of the heart,
swelling of the leg
3
...
What is recanalization? Formation of new canals or paths, especially blood vessels, through
an obstruction such as a clot
...
What is an embolus? Embolism is the passage through the venous or arterial circulations
of any material capable of lodging in a blood vessel and thereby obstructing the lumen, it
can causes infarctions
...
What causes emboli? Blood clots, breaking bones (fat or bone marrow embolism),
atherosclerotic plaques, amniotic fluid post-pardon, foreign body in the blood (coke)
3
...
What complications can arise from mural thromboses?
Infarction
1
...
What are the differences between red and pale infarctions? Red infarct occurs in organs with
a dual blood supply (lung, liver) and Pale infarct occurs in organs with end arteries
(kidneys)
Edema
1
...
What are the differences between non-‐inflammatory and inflammatory edema? The Non-
inflammatory edema has nothing to do with the inflammatory process
...
Shock
1
...
2
...
In Irreversible phase of shock, there is arteriolar vasodilation—pooling and stagnation,
increased capillary hydrostatic pressure (interstital edema), decreased function of vital
organs, metabolic acidosis
...
Hemostasis
1
...
The platelet plug forms
...
Platelets become stimulated when they encounter a damaged blood vessel, and flock to the site
...
Platelets also release
substances that start the chemical reaction of blood clot formation
...
Chemical reactions grow the blood clot
...
(Most of the proteins have Roman numerals for
names, including factors V, VII, VIII, IX, X, and XI)
...
This results in a rapid chemical chain reaction whose
end product is fibrin, the main protein forming blood clots
...
3
...
Once formed, the blood clot must be
prevented from growing and spreading through the body, where it could cause damage
...
The anti-‐clotting enzymes neutralize excess clotting factors, preventing them
from extending the blood clot farther than it should go
...
The body slowly breaks down the blood clot
...
An enzyme called plasmin is responsible for dissolving
the tough fibrin strands in a blood clot
...
2
...
Thrombomodulin blocks the coagulation cascade
3
...
Platelets and clotting factors are consumed by massive intravascular
coagulation, often within capillary beds
...
The central event in the initiation of DIC is the activation of the intrinsic or extrinsic
clotting cascades within the vascular compartment by tissue injury, or damage to endothelium, or
both
...
Atherosclerosis
1
...
It has two morphological components, the fibrous cap caused by
wound healing, and the soft center, which is the cholesterol component
...
What are the complications associated with atherosclerosis? Thrombosis, Neovascularization
(canals develop within clot), thinning of underlying media (weakening of middle layers),
calcification, (calcium deposits in plaque) and ulceration (clots can break apart exposing
underlying cholesterol)
3
...
Blood tests reveal a decreased red blood cell count and an increase in mean
corpuscalr volume, consistent with megaloblastic anemia
...
It shows marked hypercellularity, with numerous immature, enlarged cells
(megaloblasts)
...
B-‐12 is appropriate in DNA synthesis in bone marrow
...
Questions and Answers
1
...
2
...
3
...
Why was she treated with injections of vitamin B12? Intrinsic Factor brings B12 from gut to
circulation—Better if b12 is injected, this woman was missing the intrinsic factor
-‐-‐-‐-‐-‐Problem is a genetic deficiency
...
So no matter how much you give, it wont be absorbed
...
COPD is the 4th leading cause of death
...
-‐ Polycyclic hydrocarbons
-‐ Naphthylamine
-‐ Nitrosamines
-‐ Most of these carcinogens are formed by pyrogenic synthesis during the combustion of
the tobacco
...
Irritants and Toxins—cause low grade inflammation
-‐ Ammonia
-‐ Formaldehyde
-‐ Oxides of nitrogen
-‐ Carbon Monoxide
Centrilobular Emphysema Central lobules are where holes lie in lung
...
Risks of Smoking to Fetus
-‐Low Birth weight
-‐ Prematurity
-‐ Spontaneous abortion
-‐ Still birth
Risks of Passive Smoking
-‐ Increases the risk of lung carcinoma by a factor of 1
...
Ethanol acts primarily as a CNS
depressant
-‐ In most states, one is considered legally intoxicated when the blood ethanol concentration
is >100 mg/dl
...
Alcoholic Liver Disease
-‐ Chronic Ethanol toxicity is characterized by fatty liver and focal liver cell necrosis
...
Water Soluble Vitamins
-‐ dissolve in water
-‐ generally are readily excreted
-‐ subject to cooking losses
-‐ Function as a coenzyme-‐ they bind to enzymes and activate them
-‐ participate in energy metabolism
-‐ 50-‐90% of b vitamins are absorbed
-‐ marginal deficiency is more common
Thiamine (B1)
-‐ Functions as a coenzyme
-‐ Synthesis of neurotransmitters,
-‐ Remove carbon dioxide from amino acids
-‐ Convert pyruvate to acetyl-‐coA
Deficiency of Thiamine
-‐ Occurs where polished rice is the only staple
Dry Beriberi lack of neurotransmitters, which causes weakness, nerve degenertion, irritability,
poor arm/ leg coordination, loss of nerve transmission
Wet Beriberi Severe deficiency, pulmonary edema, enlarged heart, heart failure
Wernicke Encephalopathy
-‐ Mainly in Alcoholics
-‐ Alcohol diminished thiamine absorption
-‐ Alcohol increases thiamine excretion
-‐ Poor quality diet
-‐ Involuntary eye movement, double vision
-‐ Staggering poor muscle coordination, mental confusion
Riboflavin (b2)
-‐ Coenzymes (FMN and FAD)
-‐ Involved in ETC, citric acid cycle, catabolism of fatty acids
-‐ Deficiency causes glottis (inflammation of tongue), dermatitis (inflammation of skin), eye
disorders, nervous system disorders
-‐ Usually occurs in combination with other deficiences, all the B-‐vitamins are in the same
food
...
Megaloblastic blood cells are arrested at an immature stage of development
...
Food Sources of Folate
-‐ Grains
-‐ Fortified breakfast cereals
-‐ Veggines
Vitamin B12 (Cyancobalamin)
-‐ Folate Metabolism
-‐ Maintence of myelin sheaths
-‐ RBC formation
-‐ Fatty Acid Metabolism
Therapy for Ineffective Absorption
-‐ Monthly injections of vitamin B12
-‐ Vitamin b12 nasal gel
-‐ Megadoses of vitamin b12 allow for passive diffusion
Deficiency of B12
-‐ Megaloblastic anemia
-‐ nerve degeneration
Food Sources of B12
-‐ Organic meats
-‐ Seafood
-‐ Dairy Products
Vitamin C-‐ helps collagen crosslink
-‐ Synthesized by most animals (not humans)
-‐ Antioxidant function
-‐ Enhances iron absorption
-‐ immune functions
-‐ Collagen synthesis
-‐ Cancer Prevention
Antioxidant Functions
-‐ donate and accepts hydrogen atoms readily
-‐ Protects cell membranes from damage by free radicals
Deficiency of Vitamin C
-‐ Scurvy
-‐ Fatigue
-‐ Bleeding gums, joints
Fat Soluble Vitamins
Case Study #2-‐ A 63 year old woman is seen by her local doctor for back pain
...
Blood tests reveal an increse in
calcium and a decrease in vitamin D
...
The
results of a bone density scan are consistent with the presence of osteoporosis
...
Following removal of the tumor, her blood values of
calcium, vitamin D, and PTH return to normal, and her bone density gradually increases
...
Why did this woman have back pain? Collapsed vertebrae
2
...
Why was her calcium level increased? Since there were high levels of PTH, calcium was being
“leeched” from bones, and was found in the blood
...
Why was her Vitamin D levels decreased? Vitamin D was inhibited by the PTH
5
...
Why did removal of her parathyroid adenoma reverse the loss of blood density? Calcium was no
longer being leeched from the bones, so density returned to normal This hormone tends to
mobilize calcium from bones to blood
...
Bones are now more susceptible to fracture
•
•
•
•
•
•
•
•
•
•
Back pain is not specific symptom either
...
>>Physician must narrow it down
1st thing to do is an XRAY to look for structural problems in bone
...
Notice you might be getting
shorter so you lose inches
...
Blood test show in calcium = its being circulated in blood
o Vitamin D levels
...
This is highly active so you get calcium and vitamin D
Could be due to problem w/ kidneys for letting out too much calcium
Could be a PT benign tumor
...
Due an MRI and see if PT gland is enlarged
...
It comes across your trachea
...
Size of small pea
...
Found an adenoma, not major, just cut it out
...
After removing the tumor
...
o Narrowing is abt 1 cm, but several collapsed adds up to loss in height
...
• Microscopically:
o Bone spicules (pieces of bone in the spine) normally they are thicker and stick
together
Bc this person is sick, they are thinner ∴ weaker ∴ more prone to
collapse
...
which is important for light to transmit to be
able to see
Deficency of Vitamin A
-‐ Infectious Diseases
-‐ Night blindness
-‐ Blindness
-‐ Keratinization—rough, bumpy, or dry skin
Vitamin A Toxicity
-‐ Birth defects
-‐ Acne
Vitamin D or Calciferol
Roles
-‐ Maintains blood concentration of calcium
-‐ Bone growth and remodeling
-‐ Acts on bone, kidney, and small intestine to help regulate blood calcium
levels
Vitamin D and PTh have to be balanced
...
Vitamin E grabs free radical before affects lipids
...
• What other diseases are associated with cigarette smoking? Cardiovascular disease,
respiratory disease, asthma, COPD, coronary artery disease, lung, mouth, larynx,
esophageal cancer, cerebral vascular disease, atherosclerosis
• How can cigarette smoking affect pregnancy? Low birth weight, prematurity,
spontaneous abortion, still birth
Alcohol Abuse:
• What morphological changes occur during the early stages of alcoholic liver disease?
Fatty liver and focal liver cell necrosis
• What other morphological changes occur as alcoholic liver disease progresses?
Cirrhosis
Water-‐Soluble Vitamins:
• What is a coenzyme? Coenzymes bind to and activate enzymes in the body
• What diseases are associated with a deficiency of thiamine (B1)? Dry and Wet Beriberi,
which is weakness, nerve degeneratin, irritablilty, poor coordination, ( all caused by
lack of NTs, Wet is much more severe marked by edema, and enlarged heart
...
His average value over the past 2 years is 6
...
However, his current result
was 7
...
Instead of increasing his medication (Glucotrol), the doctor tells the man to come back in 2 months
to repeat the measurement
...
6, and the doctor decides not to
increase the Glucotrol dosage
...
126 or more is considered diabetic
...
In the hemoglobin test, blood sugar binds to protein, and builds up over a few months
...
The normal value is 5-‐6, a diabetic person has something higher
...
Questions and Answers
1
...
The most likely reason is the 7
...
2
...
When using machinery, there is always a margin of error
...
3
...
Long Term complications of Diabetes
-‐ Macrovascular Disease (complications related to acclerated atherosclerosis in large to medium
sized arteries) accounts for most of excess mortality associated with diabetes
...
(Limp amputation can
occurO
-‐ You can also get microvascular diseases, such as those associated with blindness
...
Red blood cells float in the eye, and blind spots can form
...
(aneurysm)
Diabetic Nephropathy
-‐ Extracellular matrix material is deposited in the lobules of the glomeruli
...
Hyelinization can occur, and proteins and polysaccarides build up
in the glomerulus
...
The Diagnosis of DM-‐ Most patients diagnosed on basis of symptoms, examination and random
or fasting plasma glucose
...
Accuracy the agreement between the measured quantity and its true value
-‐ Reference method-‐ “gold standard”
-‐ Accuracy is affected by systemic error of bias
-‐ Test interference by drugs or metabolites may cause inaccurate results
Precision agreement between repetitive measurements performed in the same way
-‐ Is a measure of test reproducibility
-‐ Precise tests have little variation of measurement of the same sample is repeated
-‐ Precision is affected by random error
(you don’t want your test results to fluctuate)
Confidence Intervals
-‐ By convention, 95% confidence intervals, represented by the mean plus or minus two
standard deviations (x plus or minus 2s), are used to determine whether the difference in two
results can be accounted for solely by the imprecision of the test
...
Normal Values—Reference Intervals—2 standard deviations
-‐ A reference interval is defined by a specified proportion (usually 95%) of the ranges of
values found in a healthy reference population
...
-‐ In practice, the two most important factors are gender and age
...
Sensitivity refers to the percentage of positive test results in patients with a particular disease
-‐ A sensitivity of 95% means that 95% of patients with the disease will be detected by the
test and 5% of patients with the disease will have false negative results
...
Specificity refers to the percentage of negative test results in patients without a particular
disease
a specificity of 95% means that 95% of patients without the disease will have a negative
test and 5% of patients without the disease will have false +
Prevalence defined as the percentage of the general population who have the disease
-‐-‐ it is equivalent to the prior or pretest possibility of disease
-‐-‐ expressed as a percentage or as the number of people with disease per 100,000 people
Screening is only useful for prevalent diseases, why screen everybody in the country for a disease
that affects one in a million
...
Common Lab Tests
-‐ CBC (complete blood count)
-‐ CBC with differential white count (WBC)
-‐ Serum Chemistry, including therapeutic drug levels (measures electrolytes)
-‐ Coagulation studies
-‐Platelets, Prothromabin Time, PTT (partial thromboplatic time), bleeding time
-‐ Urinaylsis
CBC Hemoglobin, Hematocrit, (RBC volume-‐-‐decreased in anemias, blood loss, cancer, transplant)
RBC
Differential White blood Count
-‐ Normal WBC-‐ 5000-‐10000
-‐ elevated in infections and myeloproliferative diseases
Granulocytes (neutrophils, bands) 36-‐66% Indicator of ability to manage infection (neutrophils
gobble up bacteria)
Lymphocytes: 24-‐44%-‐-‐> indicator of immune system status (a lot of these will appear if one has an
autoimmune disease
Other cells Eosinophils, basophils, (asthma allergic rxns) monocytes
WBC Indicators of Immune System Status
-‐ CD4 T helper cells >400/cumm -‐-‐-‐ depressed in HIV
-‐ CD8 T suppressor cells—200-‐800/cumm
CD4:CD8 ration should be 2:1, if its less than 2, the immune system is suppressed
Coagulation Studies
-‐ Bleeding Time—3-‐9 minutes, measures all phases of coagulation
-‐ Prothrombin Time (P
...
): 10-‐13 sec (Extrinsic) Measures extrinsic clotting pathway, increased
by administration of Coumadin (measures efficency)
-‐ Partial Thromboplastin Time (PTT): 25-‐35 seconds (intrinsic) Measures intrinsic pathway,
increased by administration of heparin
-‐ Platelet Count: 150,000-‐450000 leukemias, anemias can make this numbers lower
Serum Chemistries
-‐ Potassium (K) 3
...
3 mEg/L
-‐ Abnormal levels associated with myocardial dysfunction
-‐ Elevated in adrenal insufficeny, renal failure
-‐ Depressed in malabsorption, starvation, diuretics
-‐ Sodium (Na) 135-‐148 mEq/L
-‐ Elevated in dehydration, hyperaldoesteroinsim,
-‐ Decreased in sweating
-‐ Chloride (Cl) 97-‐107 mEq/L
-‐ Elevated in dehydration
Problems with all of these can lead to interruption in electric signaling in the heart
-‐ Carbon Dioxide (CO2) 22-‐32 mEg/L lung disease
-‐ Elevated in emphysema
-‐ Depressed in starvation, diarrhea, diabetic acidosis,
-‐ Blood Urea nitrogen (BUN)—7-‐22 mg/ml
-‐ Elevated in impaired renal function
-‐ Depressed in liver damage
-‐ Creatine
...
5 mg/dl
-‐ Elevated in impaired renal function
-‐ Glucose (Glu) 70-‐110 mg/dl
-‐ Elevated in diabetes mellitus
-‐ Depressed in pancreatic disorders, endocrine disease, liver disease
-‐ low values are acute medical emergency
-‐ high values may better tolerated—less of an emergency depending on patients usual levels
Liver Enzymes
-‐ Elevations associated with liver damages (hepatitis, cirrhosis)
-‐ Lactate dehydrogenase (LDH) 0-‐625 U/L
-‐ Alkaline Phosphatase (alk phos:) 0-‐100 U/L
-‐ Aspartate aminotransferase (AST) 0-‐60 U/L
-‐ Alanine aminotransferase (ALT) 0-‐60 U/L
Urinalysis May be useful to assess renal function
-‐ Specific Gravity: 1
...
030 (weight of urine)
-‐ pH 4
...
5
-‐ Appearance: clear
-‐ Color: varieties of lighter yellow
-‐ Red and brown are indicators of pathology of bladder or kidney
-‐ Microscopic: should be negative for cells, etc
...
Multiple Resistance
-‐ cross resistance-‐-‐-‐ single mechanisms—closely related antibiotics (one class of antibiotics)
-‐ Multiple resistance—Multiple mechanisms—unrelated antibiotics (many classes of antibiotics)
much worse
Antimicrobial Drug Resistance Mechanisms bacteria becomes resistant easily, its harder to treat
certain strands
-‐ Altered target site
-‐ Penicillin binding proteins (penicillins)
-‐ RNA polymerase (rifampin)
-‐ 30S ribosome (streptomycin)
-‐ Replacement of a sensitive pathway
-‐ Acquistion of a resistant enzyme (sulfonamides, trimethoprim) *involves enzymes*, enzymes
alter its shape
...
What is meant by sensitivity? Sensitivity refers to the percentage of positive test results in
patients with a particular disease
2
...
What are confidence intervals? a type of interval estimate of a population parameter and is
used to indicate the reliability of an estimate
4
...
What tests are useful in monitoring diabetes? Hemoglobin A1c, and Daily monitoring of blood
glucose levels
6
...
What tests are useful in monitoring renal disease? Urinalysis and Electrolytes
8
...
What tests are useful in monitoring liver disease? Liver Enzymes and Coagulation studies
10
...
What is a gram stain? A method of differentiating bacterial species into two large groups
(Gram-positive and Gram-negative)
12
...
What are different components that are isolated from whole blood? Packed red cells, plasma,
platelets, cyroprepitate
14
...
Which component is useful in treating clotting disorders? cyroprecipitate
Title: Pathology Comprehensive
Description: Pathology review of several components, with review questions, and case studies
Description: Pathology review of several components, with review questions, and case studies