Patho

• Rule of Nines/Lund and Browder Chart


  A commonly used assessment tool with estimates of the percentages (in multiples of 9) of the total body surface area burned
• Types of Shock


  • Cardiogenic: heart failure
  • Hypovolemic: insufficient intravascular fluid system
  • Neurogenic: neutral altercations of vascular smooth muscle tone
  • Anaphylactic: immunologic processes
  • Septic: infection
• Fibromyalgia


  • Chronic widespread joint and muscle diffuse pain and fatigue
  • Scientific studies are unclear
• Causes of Fibromyalgia


  • Flu-like viral illness
  • Chronic symptoms
  • HIV Infection
  • Lyme disease
  • Medications
  • Physical, emotional trauma
• Osteoporosis


  Porous (spongey), poorly mineralized bone
• Bone Density


  • Normal: 833 mg/cm2
  • Osteopenic: 833-648 mg/cm2
  • Osteoporosis: <648 mg/cm2
• Causes of Osteoporosis


  • Decreased levels of estrogen and testosterone
  • Decreased activity level
  • Inadequate levels of Vit D and C, and Mg++
• Rheumatoid Arthritis


  • Autoimmune
  • Systemic damage to connective tissue, primarily joints (synovial membrane)
  • Joint fluid analysis reveals inflammatory exudate
• Signs and Symptoms of Rheumatoid Arthritis

  • Pain
  • Stiffness of joints
  • Limited mobility
  • Presence of Rheumatoid Factors (RA/RF test)
• Rheumatoid Factors (RA/RF test)


  Antibodies (IgG and IgM) against antibodies
• Criteria for Diagnosis of Rheumatoid Arthritis

  • Morning joint stiffness lasting at least 1 hour
  • Arthritis of three or more joint areas and hand joints
  • Symmetric arthritis
  • Rheumatoid nodules
  • Abnormal amounts of serum rheumatoid factor
  • Radiographic changes
• Gout


  Metabolic disorder that disrupts body's control of uric acid production or excretion
• High uric acid in Gout


  Leads to sharp, needle-like crystallization
• Signs and Symptoms of Gout

  • Pain
  • Inflammation and swelling
  • Usually found in the feet, can't walk
• Treatment of Gout


  • Lifestyle Modifications - diet changes
  • Medications to lower uric acid
• Pancreatitis


  Inflammation of pancreas caused by obstruction to outflow of pancreatic digestive enzymes
• Causes of Acute Pancreatitis

  • Direct cellular injury from alcohol, drugs, viral infection
• Signs and Symptoms of Acute Pancreatitis

  • Epigastric pain
  • Mid abdominal constant pain
• Chronic Pancreatitis


  Process of progressive fibrotic destruction of pancreas caused by chronic alcohol abuse
• Signs and Symptoms of Chronic Pancreatitis

  • Continuous/intermittent abdominal pain
  • Weight loss
• Appendicitis


  Inflammation of vermiform appendix
• Causes of Appendicitis


  • Obstruction, foreign bodies, infection
• Signs and Symptoms of Appendicitis

  • Rebound tenderness to RLQ
  • Epigastric or periumbilical pain
• Complications of Appendicitis


  • Perforation, peritonitis, abscess formation
• Treatment of Appendicitis


  • Antibiotics
  • Appendectomy
• Cirrhosis


  Irreversible inflammatory, fibrotic liver disease where biliary channels become obstructed, causing portal hypertension
• Inflammatory Bowel Diseases


  Chronic, relapsing inflammatory bowel disorders caused by genetics, environmental factors, alterations of epithelial barrier functions, altered immune reactions to intestinal flora
• Types of Inflammatory Bowel Diseases

  • Ulcerative Colitis
  • Crohn Disease
• Ulcerative Colitis


  Inflammation of large intestine and rectum lining
• Signs and Symptoms of Ulcerative Colitis

  • Diarrhea (10-20x/day)
  • Urgency
  • Bloody stools
  • Cramping
• Crohn Disease


  Idiopathic inflammatory disorder that can involve any part of the GI tract with skip lesions
• Signs and Symptoms of Crohn Disease

  • Anemia
  • Similar to Ulcerative Colitis
• Irritable Bowel Syndrome


  Disorder of brain-gut interaction, more common in females
• Signs and Symptoms of Irritable Bowel Syndrome

  • Recurrent abdominal pain with altered bowel habits
  • Bloating
  • Diarrhea, constipation, or both
• Pressure Ulcers


  Prolonged pressure on skin causing tissue damage, especially bony prominences, which impedes blood flow to tissues causing tissue ischemia and tissue death
• Stages of Pressure Ulcers

  • Stage 1: Nonblanchable erythema of intact skin
  • Stage 2: Partial-thickness skin loss involving epidermis or dermis
  • Stage 3: Full-thickness skin loss involving damage or loss of subcutaneous tissue
  • Stage 4: Full-thickness skin loss with damage to muscle, bone, or supporting structures
• Peptic Ulcer Disease


  Break or ulceration in protective mucosal lining (stomach, proximal duodenum, esophagus), can be acute or chronic, superficial or deep
• Zollinger-Ellison Syndrome


  Rare digestive disorder that results in too much gastric acid, burning the lining
• Indications for Surgical Treatment of Peptic Ulcers


  • Recurrent or uncontrolled bleeding
  • Perforation of stomach or duodenum
• Nonsurgical Treatment of Severe Peptic Ulcers

  • Antacids
  • Vitamin K
  • Blood transfusion if severe bleeding occurs