» Cancer Lecture
Episode 24: Doctor Dan gives part 2 of his Cancer lecture series available in full at www.Medical-Mastermind-Community.com.
» Vesiculobullous Diseases
General Information group of conditions associated with blister formation Blister = fluid-filled raised area Ø Vesicle = < 5 mm in diameter Ø Bulla = > 5 mm in diameter Ø Pustule = blister filled with pus Acantholysis = loss of the cohesion between the keratinocytes due to disruption of intercellular bridges Ballooning degeneration Dyskeratosis [...]
» Transfusion Medicine
Blood Collection Only 8 out of 100 million eligible blood donors actually donate We use a VOLUNTARY donor system Ø paid donors associated with higher rick of passing on transmissible diseases Blood is a “drug”Þ regulated by the FDA How do we select blood donors? Ø there is a uniform donor “screening” process Ø process [...]
» Soft Tissue Tumors
Introduction to Soft Tissue Tumors soft tissue = complex of non-epithelial extraskeletal structures of the body soft tissue includes: fibrous (Connective) tissue, adipose tissue, skeletal muscle, blood and lymph vessels, and peripheral nerves Derivation of most of the soft tissue – mesoderm Exception – neuroectodermal for peripheral nerves Age has a bearing on type of [...]
» Skin Neoplasms
Epidermal Tumors – Benign Seborrheic Keratosis “stuck-on” flat topped papules or plaques exceedingly common on the trunks of individuals over the age of 40 keratosis = presence of hyperkeratosis (thickened stratum corneum) Seborrheic = lesions more common in areas with numerous sebaceous glands Cream to brown colored (more white on distal extremities) MICRO: linear base; [...]
» Papulosquamous Diseases
General Information on Papulosquamous Diseases the papulosquamous diseases are generally scaly, like the eczematous diseases difference from the eczemas 1) epidermis is generall thicker 2) more clinically elevated scaly condition 3) better described as a plaque than a patch 4) eventually develop acanthosis and hyperkeratosis to a greater degree 5) more sharply defined some diseases [...]
» Myeloproliferative Disorders & Plasma Cell Dyscrasias
Definition – group of diseases having as a common denominator the proliferation of one, or usually more than one, of the bone marrow-derived cell lines. The proliferation may be medullary or extramedullary Classification of Diseases 1) Chronic myelogenous leukemia – CML 2) Agnogenic myeloid metaplasia (myelofibrosis) – AMM 3) Polycythemia rubra vera – PRV 4) [...]
» Lymphomas
Definition malignant disorders of the immune system involving the uncontrolled proliferation of lymphocytes most patients present with lymphadenopathy, but sometimes they present with symptoms related to the growth of an extranodal lymphoma. Etiology Unknown Proposed – clonal expansion of lymphoid cells that have undergone a maturation arrest at some point in their ontologic development. The [...]
» Leukemias
Definitions 1) Leukemia – malignant neoplasm of hematopoietic stem cells 2) Lymphoma – malignant neoplasm of lymphocytes which usually arises in lymph nodes but can arise from lymphoid tissue anywhere in the body 3) Leukocytosis – increased numbers of WBCs in the peripheral blood 4) Granulocytopenia – absolute decrease in the number of neutrophils in [...]
» Joint Pathology
Review of Normal Structure Joints are Classified as: 1) Solid (non-synovial) these joints provide the structural rigitidy minimal movement no joint space grouped according to the type of connective tissue that connects the ends of the bones Ø Examples 1. fibrous synarthroses – cranial sutures 2. cartilagenous synarthroses – symphyses 2) Cavitated (synovial) these are [...]
» Hemolytic Anemias
RBCs are incapable of surviving the normal 120-day life span Can be due to 1)intrinsic defects in RBC structure/function or 2) a hostile environment Definitions 1) Hemolysis – any cond. char. by a sig. decreased RBC life span 2) Compensated Hemolytic state – the resulting increased RBC production is able to keep up with the [...]
» Hemoglobinopathies and Thalassemias
Definition 1) Hemoglobinopahty – genetic defect that results in an abnormal structure of one of the globin chains of the hemoglobin molecule 2) Thalassemia – a genetic defect that results in production of an abnormally low quantity of a given hemoglobin chain or chains; the result is an imbalance in production of globin chains and [...]
» Eczematous Diseases
Basic Information on Eczematous Diseases basic pathologic change common to most eczemas = Spongiosis Ø inter-cellular edema between keratinocytes exocytosis – inflammatory cells migrate into the epidermis Acanthosis – thickened Malphigian (spinous) layer in the epidermis Hyperkeratosis – thickened stratum corneum Lichenified – chronically thickened skin Lichen Simplex Chronicus – when the skin gets very [...]
» Basic Skin Path
I. Basic Histo: v “Barry Sanders Goes Long Constantly” v Skin = Mostly Keratinocytes II. Path Findings Not Unique to the Skin A. H & E: Tumors = Blue (basophilic nuclear staining), W More malig = more blue W Pink = usually benign B. Granulomas W Enlarged Macs -> Epithelioid Cells -> Fuse -> Multinucl [...]
» Dermatopathology
INTRODUCTION Normal Skin Histology Epidermis Keratinocytes make up most of each layer of the epidermis 1) Cornified Layer – stratum corneum Ø anucleated 2) Granular Layer – stratum granulosum Ø flattened cells with tiny basophilic keratohyaline granules Ø 1-2 cell layers thick 3) Spinous Layer – stratum spinosum Ø usu the largest region 4) Basal [...]
» Bone Tumors
Introduction Sites of 1o tumors that most commonly metastasize to bone Ø Breast, Lung, Prostate, Thyroid, Kidney Some common bone tumors and tumor-like lesions seen in general practice Ø osteochondroma, enchondroma, osteoid osteoma, osteomyelitis, metaphyseal fibrous cortical defect, fibrous dysplasia, metastases At this time, all Orthopaedic organizations recommend that bone tumors be managed only by [...]
» Bone Pathology
Review of Normal Structure: Mature/Secondary/Lamellar Bone slowly produced & highly organized Remember – anything other than lamellar bone in the adult skeleton is abnormal HISTO Ø few osteocytes, parallel arrangement of type I collagen fibers, uniform osteocytes Immature/Primary/Woven Bone rapidly produced & ill-arranged low tensile strength HISTO Ø irregular arrangement of type I collagen fibers, [...]
» Anemia
Anemia – Pathophysiologic Consequences and Clinical Investigation Definition of Anemia any condition resulting from a significant decrease in the total body erythrocyte mass working definition – hemoglobin < 12 g/dL or hematocrit < 37 cL/L usually results from the body’s compensation to maintain blood volume in the response to rbc loss. Physiologic Compensation for the [...]
» Thyroid
Normal Anatomy two lobes, one isthmus follicular cells – produce thyroid hormones C cells – produce calcitonin (parafollicular) Colloid – stores thyroid hormone extracellularly Abnormalities of Development agenesis Maldescent Ø can result in a pyramidal lobe Ø ectopic thyroid tissue Ø pathway of descent – foramen cecum to thyroid and cricoid cartilage Ø can be [...]
» Teratogenesis
Definitions teratology – “the study of monsters”, the science of congenital malformations Teratogenesis – 1) the path. Process resulting in a malformation 2) cell injury, mitotic arrest, or impeded gene-enzyme activation resulting in structural or functional malformation Congenital Malformation – a structural defect present at birth with or without a genetic defect Congenital anomaly – [...]
» Stomach Pathology
Acute Gastritis Pathology congested, edematous gastric mucosa coagulation or hemorrhage of gastric mucosa can have many acute erosions into the gastric mucosa Clinical Presentation Epigastric pain Tender, nausea, vomiting Bleeding Ranges from occult (hidden) to major hemorrhage Most common causes Aspirin, NSAIDS, EtOH Usually self-limited Chronic Gastritis General Remember H.pylori and NSAIDS are the most [...]
» Small Bowel and Appendix
Even though the Small Intestine is the longest part of the GI tract, it has less than 5% of all the neoplasms of the GI tract!! Benign tumors of the Small Intestine Brunner’s Gland Adenoma can be both focal or diffuse usually found on the posterior wall of the duodenum at the junction between the [...]
» Sexually Transmitted Diseases
Herpesvirus Infections – HSV1 & HSV2 History replicate in the skin, mucous membranes, oropharynx, and genital tract the lesions are vesicular can reactivate repeatedly Diseases adults – fever blisters, genital lesions neonates – stomatitis, conjunctivitis, encephalitis immunosuppressed – disseminated disease Pathology Intranuclear inclusions (Cowdry A bodies – acidophilic, homogenous with clear halo surrounding) Ø Replicate [...]
» Pituitary
Introduction Two functional components 1) anterior lobe – adenohypophysis Ø derived from Rathke’s pouch Ø Secretory portion of the pituitary Ø Three morphological cell types (acidophils, basophils, chromophobes); Chromophobes make up the majority of the anterior lobe cells Ø Five functional cell types produce 6 hormones (PATFGL) – (Point after try, FGL = field goal) [...]
» Renal and Urinary Tract Disorders in Children
Development Malformation in the Lower Urinary Tract Duplication of the renal pelvis and ureter common 80% are unilateral May be asymptomatic May result in (if there is obstruction to the lumen of the duplication) 1) hydroureter 2) hydronephrosis 3) susceptibility to infection (pyelonephritis) Ureteral Valves unknown developmental basis could represent defective innervation with local inability [...]
» Pediatric Tumors
Incidence Cancer is 2nd most common cause of death in children aged 1-14 – 10%. (Accidents #1 – 42%) Leukemia accounted for ~33% of all cancers in children in the US in 1985. CNS tumors was second with ~20%. They are followed by: lymphomas, neuroblastoma, Wilms tumor, Bone cancer, rhabdomyosarcoma Overall survival from all malignancies [...]
» Respiratory Disease in Infants and Children
Normal Development 4th week of gestation – lung bud appears 5th-20th week – lung buds continue to branch Pseudoglandular period (Weeks 6-16) – continuing bronchial branching; differentiation of certain cells Canalicular Period (Weeks 16-28) – period of acinar development, differentiation of type I & II pneumos Terminal Sac Period (Weeks 28 to term) – surfactant [...]
» Parathyroid
Normal Anatomy Embryology 1. Upper parathyroids derived from brachial pouch 4; found on posterior Superior aspect of the thyroid. 2. lower derived from B.P. 3; can be found from inferior pole of the thyroid to the thymus. May be intrathyroidal or intrathymic Gross Anatomy 1. in infancy – composed mainly of sheets of chief cells [...]
» Metabolic Disease
Carbohydrate Disorders Galactosemia Biochemical Pathway Galactose + ATP, 1 Galactose-1-P 2 UDP Galactose + Glucose 1-P 3 UDP Glucose + Galactose-1-P 4 Glucose-1-P Involved enzymes and their consequences if deficient or absent 1- galactokinase – some problems, not as fatal as 2 2- Galactose-1-P uridyl transferase – Fatal 3- UDP Galactose-4-epimerase – rare; no consequences [...]
» Mechanisms of Injury to Fetus and Newborn
Mechanism of Injury to Fetus and Newborn 1) anoxia, hypoperfusion, and ischemia 2) drugs and metabolites 3) Infection cause cell detah, malformation, Growth retardation, and inflammation Anoxia, Hypoperfusion and Ischemia Susceptibility early embryo (< 14 days) – resists most noxious stimuli later embryonic (14-56 days) – more susceptible; can lead to malformation or death The [...]
» Maternal Environment and the Placenta
Remember, that most maternal disease do not affect the fetus. Ways the maternal disease affects the fetus 1) transplacental disease – ex. Rubella 2) premature labor induction 3) altered fetal physiology – ex. Maternal Diabetes Mellitus 4) interference with fetal resp. or nutrition – Maternal HTN 5) Nutritional Status of the momma Infection Effects on [...]
» Pancreas
Acute Pancreatitis common disease both sexes; 5th and 6th decades Classification acute interstitial pancreatitis Acute hemorrhagic pancreatitis Pathogenesis Caused by pancreatic enzyme release that results in enzymatic autodigestion Theory Ø functional or structural duct obstruction coincides with active pancreatic secretion Ø small ducts dilate Ø disruption of small intralobular ducts Ø enzymatic auto digestion Necrosis [...]
» Male Reproductive Pathology
Penis Normal Anatomy of the Penis paired corpora cavernosa single corpus spongiosum Tyson’s glands produce smegma Glans – distal extension of corpus spongiosum – covered by prepuce Corpus spongiosum envelopes the penile urethra Normal anatomical position at erection Pathology of the Penis Congenital Abnormalities Ø Malformations of the urethral groove and canal ¨ Hypospadia – [...]
» Liver Pathology
Normal Anatomy falciform ligament divides into two lobes (right lobe is larger) dual afferent blood supply – hepatic artery and portal vein 60-70% of blood supply comes from portal vein single venous drainage system Histology and Metabolism Classic lobules – central vein surrounded by hepatocytes with portal tracts (hepatic artery, portal vein, and bile duct) [...]
» Liver Disease in Infancy & Childhood
Physiologic Jaundice of Infancy In term infants 1) rises <5mg/24 hr 2) peaks at 2-4 days 3) levels at 5-6 mg/dl Premies 1) variable level and rise 2) peaks at about 4-7 days Work up further if: 1) jaundice w/in the first 24 hours 2) serum bili rises >5mg/dl/24hrs 3) Serum bilirubin > 12 mg/dl [...]
» Hepatitis
3rd among reported diseases in incidence (STDs and chicken pox – #1 & #2) 1-2 million deaths worldwide 1.2 million Hep B carriers in the U.S. 300 million carriers worldwide Acute Hepatitis Asymptomatic Hepatitis inapparent disease unless the patient somehow gets liver function tests HAV is especially at risk for being asymptomatic Symptomatic Hepatitis Icteric [...]
» Hemochromatosis and Selected Hepatic Neoplasms
Hemochromatosis = a disorder of iron metabolism with excess deposition of iron in the tissues, bronze skin pigmentation, hepatic cirrhosis, and diabetes mellitus. IRON OVERLOAD SYNDROMES No physiological mech. for iron excretionÞ iron will accumulate in the body either from 1) increased intestinal absorption or from 2) parenteral administration Normal total body iron stores (3-4 [...]
» Hematologic Infections
Introduction infectious diseases are important to hematologists because: 1) they may simulate malignancies (lymphoma and leukemia) 2) may directly or indirectly cause anemia or abnormal peripheral blood counts 3) may involve direct infection of hematopoietic or lymphoid tissues Infections related to Lymphoid Tissues characteristics 1) lymph node enlargement (deuh!) 2) pain Ø if pain is [...]
» Normal Morphogenesis and Classification of Newborn Infants
Normal Morphogenesis Embryonic period = conception to 8 weeks gestation Ø 8 week division between the embryonic period and fetal period is one of the few definites as far as time goes on development Ø the embryo measures less that 3 cm (30 mm) in CR length. Fetal period = 8 weeks gestation to birth [...]
