Patho exam

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musculoskeletal and integument

fatigue

type of stress fracture that occurs when abnormal stress or torque is applied to a bone (joggers/runners)

insufficiency

type of stress fracture that occurs in bones that lack the normal ability to form and recover

procallus formation

inflammatory response, part of the bone healing process triggered by bone destruction

strain

tear in a tendon

sprain

tear in a ligament

epicondylitis

inflammation of a tendon where in attaches to the bone, caused by degeneration of tissue rather than inflammation

lateral epicondylitis

degeneration of the extensor carpi radialis brevis tendon

paget disease

state of increased metabolic activity in bone d/t abnormal and excessive bone remodeling, leads to disorganized, thickened, enlarged, soft bones.

paget CMs

impaired motor function, abnormal bone curvatures, vision and hearing problems

osteomyelitis

bone infection commonly dt s. aureas. can be exogenous (outside the body) or endogenous (from the blood)

ischemic necrosis of bones

caused by local vessel damage, usually d/t bacteria (osteomyelitis) because bone microcirculation is extremely vulnerable to damage and destruction by bacterial toxins.

sequestrum

area of devitalized bone d/t blood vessel damage, complication of bone abscess in children, which can lift the periosteum from the bone

osteosarcoma

malignant, aggressive osteogenic tumor most often found in bone marrow, and located in the metaphyses of long bones

osteosarcoma TX

preoperative chemo increases number of limb salvage procedures, which are preferred to amputation

inflammatory joint disease

inflammatory destruction of synovial membrane and articular cartilage. systemic signs of inflammation (fever, malaise, anorexia, leukocytosis) are also present

osteoporosis

disease in which bone tissue is normally mineralized but the mass (bone density) is decreased & the structural integrity of trabecular bone is impaired.

regional osteoporosis

osteoporosis confined to a region or segment of the appendicular skeleton. Associated w/disuse or immobilization of a limb bc of fractures, motor paralysis, bone or joint inflammation. Negative calcium balance develops early & continues throughout period of immobilization.

osteoarthritis

Degeneration of articular cartilage around joints, damages bone ends. Related to aging and use. No systemic inflammation is present.

ankylosing spondylitis

chronic inflammatory joint disease characterized by stiffening and fusion (ankylosis) of spine and sacroilliac joints (no lumbar curve). Is autoimmune in nature and ass'd with histocompatibility antigen HLA-B27

gout

inflammatory syndrome caused by uric acid crystals in the blood and synovial fluid which are deposited in the joints, (and kidneys) causing acute painful inflammation (and renal failure).

tophi

small white nodules that are visible thru the skin in individuals with chronic gout. Caused by continous deposition of uric acid crystals in cutaneous tissues.

fibromyalgia

Chronic musculoskeletal syndrome. Diagnosed by presence of widespread joint and muscle pain, fatigue, and tender points (9 pairs)

physeal growth plate

layer of cartilage between the metaphysis and epiphysis of long bones. Retains the ability to form new cartilage and bone and growth of bone length until the skeleton matures, the plate closes and growth stops.

creatinine

Formed in the muscle from creatine at a rate of 2%/day. Used to estimate the total mass of muscle in the body by measuring levels in a urine or serum/blood test.

syndactyly

Webbing of the fingers, most common congenital defect of upper extremities. Can be simple, involving only soft tissues, or complex, involving fusion of nails, bones and tissue.

rickets

Disorder in which bones fail to mineralize, leaving soft bones and skeletal deformity.

juvenile rheumatoid arthritis

systemic inflammatory disease which mostly affects large joints (hips, shoulders, knees). More rapid and acute than adult form

osteochondrosis

avascular disease of bones caused by insufficient blood flow during periods of rapid bone growth. Bones are not able to grow as they should.

causes of osteochondrosis

vascular impairment and trauma, underlying developmental or genetic predisposition

Legg-calve perthes

type of osteochondrosis that affects the hips. Caused by recurrent interruption of blood supply to the femoral head. The ossification center becomes necrotic, collapses, and is remodeled by live bone.

Osgood-Schlatter

Osteochondrosis of the tibial tubercle and anterior patellar tendonitis caused by stress and overuse, commonly seen in boys who play sports.

Duchenne MD

X-linked recessive disease, most common of MDs, affects boys. Caused by defect in the gene for dystrophin, causes poorly anchored muscle fibers which are destroyed under repeated stress. Calcium then enters the cells, causing death and necrosis of muscle fibers

facioscapulohumeral MD

mild form of autosomal dominant MD. Inherited from either parent, effects boys and girls equally. Characterized by weakness and atrophy of the facial and shoulder girdle muscles

osteosarcoma

most common malignant bone tumor of childhood, originates from mesenchymal cells. Tumors extend beyond bones into soft tissues, and most often met. to the lungs.

ewing sarcoma

2nd most common and most lethal malignant bone/soft tissue tumor of childhood. Arises from bone marrow to form soft tissue mass.

rhabdomyosarcoma

most common soft tissue sarcoma of childhood, develops anywhere there is striated (voluntary) muscle.

osteogenesis imperfecta

congenital genetic disorder of connective tissue. Caused by mutation of the gene that encodes for collagen.

subluxated hip

hip maintains contact with acetabulum but is not well-seated. Usuall the femur head is normal, with a shallow/dysplastic acetabulum

thermoregulation

mechanisms used by the body to balance thermal inputs and losses to maintain constant core temp. Major mediators are eccrine/sweat glands.

stage 1 pressure ulcer

unblanchable skin redness, usually over bony prominence

stage 2 pressure ulcer

breakdown of skin involving dermis and epidermis: shallow open ulcer or serum-filled blister

stage 3 pressure ulcer

breakdown in tissue involving subcutaneous tissue/deep fat

stage 4 pressure ulcer

breakdown in tissues with damage to muscle, bone, supporting structures.

keloid

overgrowth/hypertrophy of scar tissue d/t excessive collagen and fibroblast activity

allergic contact dermatitis

Caused by sensitization to an allergen that contacts the skin (poison oak/ivy). Lesions occur several hours after contact

stasis dermatitis

occurs in legs d/t venous stasis and edema.

atopic dermatitis

immune-mediated. related to asthma, food allergies, dry skin, eczema

dermatitis CMs

pruritis, erythema

carbuncle

collection of infected hair follicles, or boils. Commonly found on the thighs, upper back and back of neck

discoid lupus erythematosis

cutaneous response to environmental allergen or reaction to UV light d/t autoimmune susceptibility of persons with SLE. Commonly seen as a butterfly lesion of the face

herpes zoster

shingles, very painful outbreak of lesions along nerve tract in persons who have had chickenpox

varicella zoster

virus that causes chickenpox and later, shingles

tinea corporis

"ringworm"; fungal infection of the epidermis. Results from contact with cats, dogs, rodents. Results in round or oval lesion with scaling and a clear spot in the middle

scleroderma

sclerosis of the skin that may progress to internal organs. Cause is unknown but associated with autoantibody response, and genetics. Occurs most often in women.

basal cell carcinoma

Most common type of skin cancer in whites, begins on top layer of epidermis in basal cells. Commonly found on sun-exposed areas. Growth is slow and rarely metasizes. Damage to surrounding tissues is a concern.

squamous cell carcinoma

can be in situ or invasive. Affects sun-exposed areas. Mutation of the TP53 gene. Grows more rapidly than BSC, but rarely invades surrounding tissues or metasizes

malignant melanoma

malignant tumor of the skin, originates from melanocytes. usually arises from a benign melanocytic nevus (mole).

kaposi sarcoma

vascular malignancy associated with a type of herpesvirus, most often seen in immune-suppressed persons

frostbite

injury of the skin caused by vasoconstriction of microcirculation d/t extreme cold.

onychomycosis

fungal or dermatophyte infection affecting the nail plate. Affects 12-18% of the population

vesicular impetigo

contagious, acute form caused by group A Strep.pyogenes. Lesions begin as small vesicles w/ honey colored serum and form crusts as the vesicles rupture

molluscum contagiosum

highly contagious poxvirus of the skin primarily seen in children. Poxvirus blocks body's immune response, and body stops fighting virus, causing the rash to spread.

Thrush

fungal infection caused by c. albicans. characterized by formation of white plaques in the mouth

rubeola

acute viral infection, contagious w/ direct contact

rubella

usually mild, communicable disease of children and young adults. caused by an RNA virus that enters the bloodstream thru resp. route.

rubeola CMs

fever, enlarged lymph nodes, conjunctivitis, runny nose, barking cough, malaise, purple-brown rash begins on head, spreads to trunk and extremities

rubella CMs

faint pink to red maculopapular rash on face, trunk, extremities

pediculosis

highly contagious parasite that survives by sucking blood. Primary lesion is an itchy, red, pinpoint macule, papule or wheal with a hemorrhagic puncture site. Itchy.

scabies

contagious disease caused by itch mites. Primary lesions are itchy burrows, papules, vesicular lesions.

vascular anomaly

most common pediatric birthmarks. congenital abnormalities of blood vessels that tend to persist throughout life.

hemangiomas

benign tumors which usually regress or involute during childhood

port-wine stain

localized dilation of capillaries producing a stain-like discoloration of the skin.

strawberry hemangioma

superficial hemangioma. usually involutes by 5-6 yrs of age

cavernous hemangioma

deep hemangioma, larger and involving more mature vessels than strawberry hemangiomas. Usually involutes by age 9.

fungi that cause tinea corporis

M. canis or Trichophyton mentagrophytes.

pathologic

type of fracture that occurs with force that would not break normal bone, as seen with tumors, osteoporosis, infection.

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