sᴘᴏᴛ ᴅɪᴀɢɴᴏsɪs

2022-02-28 18:17:17
#Notes:
Bengin neoplasm (wither epithelial or mesynchymal in origin, we add the suffix - oma.
#Example:
1)Epithelial: adenoma, papiloma.
2)Mesynchymal (I.e connective tissue): lipoma, rhabdomyoma, leiomyoma, Myxoma, hemangioma, chondroma and fibroma.

Adeno: glandular epithelium.
Adenoma: benign neoplasm of the glandular epithelium.
Papiloma (#Image) : benign neoplasm of squamous epithelium e.g. Squamous cell papiloma and warts.
Some malignant Tumors have the suffix -oma, be aware of them e.g. Seminoma, Lymphoma, multiple Myeloma, Melanoma and hepatoma.

Malignant neoplasm of epithelial origin, add the suffix -Carcinoma: adenocarcinoma or the term cancer e.g. Papilary cancer.
Malignant neoplam of epithelial origin add the suffix -sarcoma: liposarcoma...etc.

#Histological_difference:
Malignant neoplasm:
Grading: Poorly deffrentiated (no resemblance to the normal tissue.
High mitotic activity.
Invade locally and metastasize distally.

#Reference:
1)Goljan pathology review.
2)Pathoma. Open / Comment

2022-02-27 20:20:38 #Ischemic_Colitis:

Ischemia: Decrease in blood supply to a tissue either occlusive or non occlusive.

#Occlusive: atherosclerosis (Mesentric angina), thromboembolism (atrial fibrillation).

#Non_Occlusive: shock, Hypotension and extreme excersie. In non-occlusive Ischemia the most susceptible areas are damaged first those areas known as "Watershed Areas".

#Manifestation:
1-Abdominal pain: postprandial left lower quadrent or left upper quadrent pain.
2-Diarrhea: bloody.
3-Risk factors: Hx of shock, peripheral vascular disease and diabetes.

#Notes:
Watershed zones : territories b/w two blood supplies :
1- Area of the bowel supplied by dual artery:
Splenic_flexure : b/w Suprior mesentric arterial territory and inferior mesentric artery (IMA).
Rectosegmoid zone: area supplied by both IMA and branches of internal iliac artery.

2-Area of the brain supplied by both anterior cerebral artery and middle cerebral artery.

Watershed zones suffer the most during Ischemia.

#Reference:
Netter images. Open / Comment

2022-02-27 12:22:22 #Abbreviations:

1)HHV8: human herpevirus 8: cause kaposi sarcoma.
2)HPV: human papiloma virus, cause cervical cancer and warts (Papilomas).
3)HCV: hepatitis C virus cause hepatoma ( Hepatocellular carcinoma or HCC).
4)HBV: hepatitis B virus, cause HCC.
5)HTLV: Human T Lymphtropic ( T cell) virus, causes T cell leukemia.
6-EBV Episten barr virus, cause burkitt lymphoma.

Any carcinogenic viruses you know share it with us . Open / Comment

2022-02-27 12:11:54 #Pathology_Flasback:

Neoplasia:
Uncontrolled cell division & growth, usually arising from a single cell (Monoclonal) in contrast to hyperplasia. Neoplasia either benign or malignant.

#Why_Neoplasia_develop?
1-DNA damage (Mutations).
2- Immunodeficiency: predispose to cancer.

#Where_Mutations_Occur?
Genes.

#Which_genes?
1-Tumor suppressor genes: Retinoblastoma(Rb), VHL and Protien 53.
2 - Regulators of apoptōsis: BCL2 (over expression lengthen cell life span).
3 - Proto-Oncogenes: normally those genes promote cell growth and differentiation. Mutation of these genes (Oncogenesis) predisposes to neoplasm.

#What_Causes_Mutations?
Carcinogens.

#Common_Carcinoges:
1- Chemical & Toxins: Aflatoxin, CCL4, Benzene... etc.
2- Viral: HBV, HCV, HHV8, EBV, HTLV & HPV.
3- Radiation: Ionizing and non ionizing.

#To_be_continued.


#Reference:
1)Goljan rabid pathology review.
2)Dr hussein abdisattar manuscript "Pathoma".
3)UWORLD Surgery (#Von_hippel_Lindau_Syndrome). Open / Comment

2022-02-27 01:23:27 Open / Comment

2022-02-27 01:16:16 #Von_Hippel_Lindau_Syndrome:

Autosomal dominant inheritance.
I.e. 50% of offspring will express the disease.
Pathophysiology: Hippel-Lindau gene(VHL) mutation.
VHL gene supress tumor growth (Tumor suppressor gene).
VHL gene is on chromosome 3.
Patients with mutation in VHL gene are susceptible to neoplasms (bengin or malignant).
Bengin : retinal and cerebellar hemiangioblastoma, Pheochromcytoma.
Malignant: Renal cell carcinoma.

#Reference:
1)UWORLD Surgery. Open / Comment

2022-02-27 00:59:30 #Physical_Examination:

1-Cullen's sign:
Periumblical eccymosis.

2-Grey Turner's sign:
Flank eccymosis.

#Value:
Rise the suspicion of intra-abdominal and retropretonieal hemorrhage.

#Notes:
Not specifc.
Seen in fair skinned patients.

#Reference:
Mechanism of Clinical Signs by Mark Dennis. Open / Comment

2022-02-27 00:49:28 #Retropretonieal_Hematoma:

Bleeding within the retropretonieal space.

#Causes:
1)Trauma: pancreas, kidneys, major vessels and colon.
2) Procedures (Iatrogenic): Femoral catheterization in PCI.
3)Medications: Anticoagulants and antiplatlets.

#Clinical_manifestion:
Hx: trauma, medications and PCI.
Ex: obvious injury, signs of shock, Cullen's and Grey turner sign.

#Classification:
Anatomically
1) ZONE-I (#Central) :area injury usually involves the pancreas, duodenum and major vesseles.
2)ZONE-II (#Lateral): involved organs include genitourinary organs and the colon.
3)ZONE-III (Pelvic) : iliac and femoral vessels, femoral veins and pelvic fracture are the source of the hematoma in this zone.

#DDX:
1) Retoperitoneal tumor.
2)Retoperitoneal abscess.

#Dx: CT + clinical.

#Managment:
Supportive (IV hydration and blood transfusion) +
1) ZONE-I : always surgical.
2) ZONE-II : surgical penetrating or rabidly increasing in size.
3) III: if penetrating surgical.

#Reference:
1)Current surgical diagnosis and Tx Open / Comment

2022-02-27 00:27:54 #Anatomy_Flashback:

Retro: Behind.
Peritoneal cavity: serous Membrane that encircles most of the intra-abdominal viscera.
Retoperitoneal: behind the cavity.
Retoperitoneal space contain the kidneys, ureters, pancreas, most of the duodenum, colon(except transverse and sigmoid colon), iliopsoas muscles and major blood vessels.

Secondary retropretonieal organs(Ascending abd descending colon and duodenum) , means that during early developmental stage where intra peritoneal (I.e. Covered entirely with serous membrane).
Bowel layers is as follow: Mucosa, Submucosa, Muscularis Propria and #Serosa (if intraperitoneal) or #Adventitia if retropretonieal.

#Image:
Osmosis.org Open / Comment

2022-02-24 23:22:32 Open / Comment