Skin Disorders
Dermis
What is a thick layer of connective tissue?
· contains elastic collagen fibers
· flexibility strength of skin supports BV + nerves
· contains BV nerves sensory receptors for pressure, touch, pain , heat + cold
- usually differentiated cells that reproduce at a higher rate than normal
- unable to spread to other organs (metastasize
- encapsulated, usually moveable + soft
- tissue damage is a result of compression of
adjacent structures (can be life-threatening in the brain)
What is Benign Tumors?
Radiation
- causes mutations/alterations in target DNA
- most effective in rapidly dividing cells
T3, T4, calcitonin
What is Thyroid?
ANP
Hormone from the heart
· reduces Na + fluid reabsorption in Kidneys
Psoriasis
- chronic inflammatory skin disorder, genetic
- onset usually occurs in teen years
-results from abnormal T-cell activation
· increase in cytokines in affected tissues · excessive proliferation of Keratinocytes
· cellular proliferation is greatly increased, leading to thickening of dermis epidermis
-lesions are found on face, scalp, elbows + knees
- Itching o r burning sensation
- begin a s small red papules + base rem ains red
- If plaque is removed bleeding occurs underneath ,
- treated with glucocorticoids, tar preparations , + antimetabolites (methotrexate chemodrug
Diagnostic Tests
- routine screenings are essential for early detection ex : mammogram, ultrasounds
- self-exams help with early detection if done consistently
· breast testicular skin exams are important
- blood tests measure blood cell levels during treatment · may detect tumor markers (ex: PSA test
- biopsy is the only way to tell if tumor is benign o r malignant
- genetic testing fo r BRACA 1 + 2 , oncogenes
- radiologic, ultrasound, MRI, CT scans can help visualize changes in tissues o r organs
- cytologic tests require biopsy o r cell sample
· determines degree o f differentiation tumor type
may be tested for growth promotor sensitivities,·
ex: estrogen-dependent tumors
· most dependable confirmation of malignancy
- insulin shock
- more common with Insulin replacement therapy (T1D)
- can occur due to excess oral hypoglycemics
- excess insulin in circulation
- glucose deficit in blood
- can occur following strenuous exercise, dosage error, vomiting, Or skipping a meal after taking insulin
- can be life-threatening if untreated
What is Hypoglycemia?
Diabetes Insipidus
deficit of ADH
· adenoma
· may originate in the neurohypophysis
-> head injury o r surgery
-> possible genetic problem
-> replacement treatment required
· effects include polyuria excess thirst
Inability to empty bladder
· may be accompanied by overflow incontinence
· spinal cord injury at sacral level blocks micturition reflex /failure to void)
· can follow anesthesia (general or spinal)
What is Retention?
Athlete's foot
What is tinea pedis?
UV, X-rays, gamma rays, radioactive Isotopes (risk Inc. with higher cumulative dosage)
What are Risk Factors of Radiation?
Stages of Chronic Renal Failure
Stage 1- dec. renal reserve
· dec. In GFR
· higher than normal serum creatinine levels · n o apparent clinical symptoms
Stage 2- renal insufficiency (v75 % of nephrons lost) · dec. GFR to about 20% of normal
Stage 3- end-stage renal failure
· negligible GFR all body systems affected
· fluid electrolytes, + wastes retained In body
· azotemia, anemia, +acidosis (3 As)
· marked oliguria or anuria
· regular dialysis or kidney transplant to maintain life
Stage 4- complete failure
- caused by excessive levels of glucocorticoids
· possible result of adrenal or pituitary adenoma, ectopic carcinoma, iatrogenic conditions, or substance abuse
What is Cushing Syndrome?
Cystitis
bladder wall + urethra are inflamed
· hyperactive bladder reduced capacity
- pain is common in pelvic area
- dysuria, frequency, urgency , nocturia
- systemic signs like fever can be present
- Urine is often cloudy with unusual odor - urinalysis indicates bacteriuria, pyuria, + microscopic hematuria
benign lesions usually associated with aging or skin damage
What is Keratoses?
Biologic Response Modifiers (BRMs)
augment the natural immune response
- occurs in AIDS + other immune deficiencies
- may affect viscera as well as skin
-malignant cells arise from endothelium in small blood vessels
- purplish macules, nonpruritic, nonpainful
· often on face scalp, oral mucosa
- In immunocompromised pts lesions develop rapidly over upper body
- treated with a combo of radiation, surgery, + biologic therapy
What is Kaposi's Sarcoma?
Diabetic Ketoacidosis
- occurs in insulin-dependent pts
- more common in type one diabetics - result of insufficient Insulin in the blood
- high blood glucose levels
- mobilization use of lipids to meet cellular
needs result in production of Ketoacids
- may be initiated by infection or stress
- can result from dosage error, diet change, alcohol intake, or exercise
- due to acute bilateral Kidney diseases severe prolonged circulatory shock or HF nephrotoxins ,(drugs, chemicals, toxins), or mechanical Obstruction (calculi blood clots tumors
- sudden onset
- elevated serum urea , nitrogen, + creatinine - metabolic acidosis hyperkalemia
- treated by removing or treating primary problem, + with dialysis to normalize body fluids
- S/SX include oliguric phase, diuretic phase, + recovery phase (when GFR Inc .)
What is Acute Renal Failure?
- result of type I hypersensitivity reaction
· Ingestion of substances like shellfish drugs fruit
- lesions are often highly pruritic
· check for swelling around mouth - check airway
· administer EpiPen or other first and as required
What are Urticaria (Hives)?
- pts with advanced cancer are often malnourished - contributing factors :
· change in taste sensation (metallic taste common)
· anorexia
· vomiting/diarrhea from treatments · sore mouth or loss of teeth
· pain + fatigue
· malabsorption due to inflamed digestive tract
What is Nutrition?
Hyperglycemic Hyperosmolar Non-ketotic
- acute complication of type 2 diabetes
- slow onset, diagnosis may be missed
- often occurs in older pts often assumed to be cognitive impairment
- results in severe dehydration + electrolyte imbalances
- treated with fluids insulin
enlargement of thyroid gland
What is Goiter (Thyroid Disorder)?
Bloodflow Through Kidneys
renal artery -> Interlobar artery - arcuate
artery ->Interlobular artery-> afferent
arteriole -> glomerular capillaries-> efferent
arteriole -> peritubular capillaries -> interlobular
vein -> arcuate vein -> interlobar vein -> renal vein