NR-507 Study Guide I I
Chapters I1-5, I11-14, I16-20, I21-25, I27-3-33, I34-39, I40-47
1. GI Isymptoms Iresulting Iin Iheart Iburn( Ich I41, Ipg I1429- I1466)
➢The Iclinical Imanifestations Iof I(GERD) Ireflux Iesophagitis Iare Iheartburn Ifrom Iacid Iregurgitation, Ichronic Icough, Iasthma
Iattacks Iand Ilaryngitis.
➢ Heartburn Ialso Imay Ibe Iexperienced Ias Ichest Ipain, Iwhich Irequires Iruling Iout Icardiac Iischemia.
➢ Hiatal Ihernias Iare Ioften Iasymptomatic. IGenerally, Ia Iwide Ivariety Iof Isymptoms Idevelop Ilater Iin Ilife Iand Iare Iassociated
Iwith Iother Igastrointestinal Idisorders, Iincluding IGERD. IManifestations Iof Ithe Ivarious Itypes Iof Ihiatal Ihernia Iare Idifficult
Ito Idistinguish. ISymptoms Iinclude I heartburn, Iregurgitation, Idysphagia, Iand Iepigastric Ipain
➢ Early Istages Iof Iesophageal Icarcinoma Iare Iasymptomatic. IThe Itwo Imain Imanifestations Iof Iesophageal Icarcinoma Iare
chest Ipain Iand Idysphagia. IThe Imost Icommon Itype Iof Ipain Iis Iheartburn I(pyrosis). IIt Iis Iinitiated Iby Ieating Ispicy Ior Ihighly
Iseasoned Ifoods Iand Iby Ilying Idown.
2. Complications Iof Igastric Iresection Isurgery I(c I41, Ipg I1439)
➢ Weight Iloss Ioften Ifollows Igastric Iresection Ibut Istabilizes Iwithin I3 Imonths. IInadequate Ifood Iintake Iis Ia Icommon Icause
Ibecause Imany Iindividuals Icannot Itolerate Ithe Iosmotic Ieffect Iof Icarbohydrates Ior Ia Inormal-size Imeal. IFoods Imay
Ibe Ipoorly Iabsorbed Ibecause Ithe Istomach Iis Iless Iable Ito Imix, Ichurn, Iand Ibreak Idown Ifood Iparticles. IAbdominal
Ipain, Ivomiting, Idiarrhea, Iand Imalabsorption Iof Ifats Ialso Icontribute Ito Iweight Iloss. IIn Ithe Icase Iof Ibariatric Isurgery
Ifor Iextreme Iobesity, Iweight Iloss Iis Ithe Iintended Ioutcome.
3. Chicken Ipox I( Ic I46,pg I1659)
➢ an Iinfectious Iviral Idisease Ithat Iis Ispread Iby Idirect Icontact Ior Ithrough Ithe Iair Iby Icoughing Ior Isneezing; Iit Icauses Ia
Iblister-like Irash Ithat Ifirst Iaffects Ithe Iface Iand Itrunk Iand Ithen Ican Ispread Iover Ithe Irest Iof Ithe Ibody; Isymptoms
Iinclude Isevere Iitching, Ifatigue, Iand Ifever.
4. Skin Icancer I( Ich I46 Ipg, I1641)
➢
Basal Icell Icarcinoma Iand Isquamous Icell Icarcinoma Iare Ithe Imost Iprevalent Iforms Iof Icancer. IMalignant Imelanoma Iis
Ithe Imost Iserious Iand Ithe Imost Icommon Icause Iof Ideath Ifrom I skin Icancer
➢ Chronic Iultraviolet I(UV) Iradiation Icauses Imost Iskin Icancers. IProtection Ifrom IUV Iradiation Ifrom Ithe Isun Iand Iartificial
sources I(e.g., Itanning Ibeds), Iparticularly Iduring Ithe Ichildhood Iyears, Isignificantly Ireduces Ithe Irisk Iof Iskin Icancer Iin
Ilater Iyears. IAreas Icommonly Iexposed Ito Ithe Isun’s Irays—face, Ineck, Iand Ihands—are Ihighly Ivulnerable Ifor Isuch Ilesions.
IDark-skinned Ipersons Iand Ithose Iavoiding Isunlight Iare Isignificantly Iless Ilikely Ito Idevelop Ithese Imalignant Itumors. IIn
Idark-skinned Ipersons, Ibasal Icells Icontain Ithe Ipigment Imelanin, Ia Iprotective Ifactor Iagainst Isun Iexposure
➢ Basal Icell Icarcinoma I( Imost Icommon) Iis Ia Isurface Iepithelial Itumor Iof Ithe Iskin Ioriginating Ifrom Iundifferentiated
IbasalIor Igerminative Icells. IThe Itumors Igrow Iupward Iand Ilaterally Ior Idownward Ito Ithe Idermal-epidermal Ijunction.
IThey Iusually Ihave Idepressed Icenters Iand Irolled Iborders. IEarly Itumors Iare Iso Ismall Ithat Ithey Iare Inot Iclinically
Iapparent.
➢ Squamous Icell Icarcinoma I(SCC) Iis Ia Itumor Iof Ithe Iepidermis Iand Ithe Isecond Imost Icommon
human Icancer. Icharacterized: Iin Isitu I(Bowen Idisease I[BD]) Iand Iinvasive. IAreas Iaffected Iare Ithe Ihead Iand Ineck I(75%)
Iand Ithe Ihands I(15%), Iwith I10% Iof Isquamous Icell Icarcinomas Ioccurring Ielsewhere Ion Ithe Ibody.
5. Parts Iof Ithe Iheart Iin Iterms Iof Ifunction, Isuch Ias Ipericardium I( Ich I31, Ip I1085)
➢ The Iheart Iwall Ihas Ithree Ilayers—the Iepicardium, Imyocardium, Iand Iendocardium—and Iis Ienclosed Iin Ia Idouble-walled
Imembranous Isac, Ithe Ipericardium
➢ The Ipericardial Isac Ihas Iseveral Ifunctions. IIt I(1) Iprevents Idisplacement Iof Ithe Iheart Iduring Igravitational Iacceleration Ior
deceleration, I(2) Iacts Ias Ia Iphysical Ibarrier Ithat Iprotects Ithe Iheart Iagainst Iinfection Iand Iinflammation Ifrom Ithe Ilungs
Iand Ipleural Ispace, Iand I(3) Icontains Ipain Ireceptors Iand Imechanoreceptors Ithat Ican Ielicit Ireflex Ichanges Iin Iblood
Ipressure Iand Iheart Irate.
➢ the Iouter Ilayer Iof Ithe Ipericardium, Ithe Iparietal Ipericardium, Iis Icomposed Iof Ia Isurface Ilayer Iof Imesothelium Iover
Ia Ithin Ilayer Iof Iconnective Itissue. IThe Ivisceral Ipericardium, Ior Iepicardium, Iis Ithe Iinner Ilayer Iof Ithe Ipericardium
➢ At Ione Ipoint Ithe Ivisceral Ipericardium Ifolds Iback Iand Ibecomes Icontinuous Iwith Ithe Iparietal Ipericardium, Iallowing Ithe
large Ivessels Ito Ienter Iand Ileave Ithe Iheart Iwithout Ibreaching Ithe Ipericardial Ilayer
➢ The Iouter Ilayer Iof Ithe Iheart, Ithe Iepicardium, Iprovides Ia Ismooth Isurface Ithat Iallows Ithe Iheart Ito Icontract Iand
Irelax Iwithin Ithe I pericardium I with Ia Iminimal Iamount Iof Ifriction.
➢ the Iinternal Ilining Iof Ithe Imyocardium Iis Icomposed Iof Iconnective Itissue Iand Ia Ilayer Iof Isquamous Icells Icalled
the Iendocardium
➢ The Iendocardial Ilining Iof Ithe Iheart Iis Icontinuous Iwith Ithe Iendothelium Ithat Ilines Iall Ithe Iarteries, Iveins, Iand
Icapillaries Iof Ithe Ibody, Icreating Ia Icontinuous, Iclosed Icirculatory Isystem
6. Congenital Iheart Idefects I(ch I33pg I1200)
, ➢ Congenital Iheart Idisease Iis Ithe Ileading Icause Iof Ideath, Iexcluding Iprematurity, Iduring Ithe Ifirst Iyear Iof Ilife.5It Iis
Iestimated Ithat Ias Imany Ias I35% Iof Ideaths Icaused Iby Icongenital Iheart Idefects Ioccur Iin Ithe Ifirst Iyear Iof Ilife Iand Ithat
Ione Ithird Iof Ichildren Iborn Iwith I congenital Iheart Idisease Iwill Idie Ias Ia Iresult Iof Itheir Icardiac Idisease
➢ The Ietiology Iof Imost Icongenital Iheart Idisease Iis Iunknown.
➢ As Imany Ias I50% Iof Iinfants Iwith Itrisomy I21 Ihave Ia Icongenital Iheart Idefect, Ieither Ian IAV Icanal Idefect Ior Ia IVSD.
IExtra Icardiac Idefects Iare Inoted Iin Ias Imany Ias I35% Iof Iinfants Iwith Icardiac Ilesions. IProspective Istudies Iusing
Ichromosomal Ianalysis Ihave Isuggested Ithat Icongenital Icardiac Imalformations Imay Ibe Ithe Iresult Iof Ia Isingle Igene
Idefect
7. Urinary Itract Iobstruction I(ch I37, Ipg I1340)
➢ Urinary Itract Iobstruction Iis Ian Iinterference Iwith Ithe Iflow Iof Iurine Iat Iany Isite Ialong Ithe Iurinary Itract.
An Iobstruction Imay Ibe Ianatomic Ior Ifunctional. IIt Iimpedes Iflow Iproximal Ito Ithe Iobstruction, Idilates Istructures Idistal Ito
Ithe Iobstruction, Iincreases Irisk Ifor Iinfection, Iand Icompromises Irenal Ifunction. IAnatomic Ichanges Iin Ithe Iurinary Isystem
Icaused Iby Iobstruction Iare Ireferred Ito Ias Iobstructive Iuropathy. IThe Iseverity Iof Ian Iobstructive Iuropathy Iis Idetermined
Iby: I(1) Ithe Ilocation Iof Ithe Iobstructive Ilesion, I(2) Ithe Iinvolvement Iof Ione Ior Iboth Iupper I urinary Itracts I(ureters Iand Irenal
Ipelvis), I(3) Ithe Icompleteness Iof Ithe Iobstruction, I(4) Ithe Iduration Iof Ithe Iobstruction, Iand I(5) Ithe Inature Iof Ithe
Iobstructive Ilesion. IObstructions Imay Ibe Irelieved Ior Ipartially Ialleviated Iby Icorrection Iof Ithe Iobstruction, Ialthough
Ipermanent Iimpairments Ioccur Iif Ia Icomplete Ior Ipartial Iobstruction Ipersists Iover Iweeks Ito Imonths Ior Ilonger.
8. GI Isymptoms Iof Iconditions Isuch Ias Ipyloric Istenosis, Ihiatal Ihernia, Iulcerative Icolitis- I(ch I41 Ipg I 148,1429,1440)
➢ Hiatal Ihernia Iis Ithe Iprotrusion Iof Ithe Iupper Ipart Iof Ithe Istomach Ithrough Ithe Ihiatus I(esophageal Iopening Iin
ItheIdiaphragm) Iat Ithe Igastroesophageal Ijunction. IHiatal Ihernia Ican Ibe Isliding, Iparaesophageal, Ior Imixed.
➢ Ulcerative Icolitis Iis Ian Iinflammatory Ibowel Idisease Ithat Icauses Iulceration, Iabscess Iformation, Iand Inecrosis Iof Ithe
colonic Iand Irectal Imucosa. ICramping Ipain, Ibleeding, Ifrequent Idiarrhea, Idehydration, Iand Iweight Iloss Iaccompany
Isevere Iforms Iof Ithe Idisease. IA Icourse Iof Ifrequent Iremissions Iand Iexacerbations Iis Icommon
➢ Pyloric Istenosis Iis Ian Iobstruction Iof Ithe Ipyloric Isphincter Icaused Iby Ihypertrophy Iof Ithe Isphincter Imuscle. IIt Iis
Ione Iof Ithe Imost Icommon Idisorders Iof Iearly Iinfancy Iand Iaffects Iinfants Ibetween Ithe Iages Iof Ieither I1 Iand I2
Iweeks Ior I3 Iand I4 Imonths
9. Skin Icancer Ilesions I( Ich I46, Ipg I1641)
➢ Basal Icell Icarcinoma Iand Isquamous Icell Icarcinoma Iare Ithe Imost Iprevalent Iforms Iof Icancer. IMalignant Imelanoma
Iis Ithe Imost Iserious Iand Ithe Imost Icommon Icause Iof Ideath Ifrom Iskin Icancer
➢ Basal Icell Icarcinoma Iis Ia Isurface Iepithelial Itumor Iof Ithe Iskin Ioriginating Ifrom Iundifferentiated Ibasal Ior
germinative Icells. IThe Itumors Igrow Iupward Iand Ilaterally Ior Idownward Ito Ithe Idermal-epidermal Ijunction. IThey
Iusually Ihave Idepressed Icenters Iand Irolled Iborders. IEarly Itumors Iare Iso Ismall Ithat Ithey Iare Inot Iclinically Iapparent.
➢ Basal Icell Icarcinoma Iis Ithe Imost Icommon Itype Iof Iskin Icancer Iin Iwhites Iand Iis Ithought Ito Ibe Icaused Iby
IUVIradiation Iexposure
➢ Squamous Icell Icarcinoma I(SCC) Iis Ia Itumor Iof Ithe Iepidermis Iand Ithe Isecond Imost Icommon Ihuman Icancer.
➢ Two Itypes Iare Icharacterized: Iin Isitu I(Bowen Idisease I[BD]) Iand Iinvasive. IAreas Iaffected Iare Ithe Ihead Iand
Ineck I(75%) Iand Ithe Ihands I(15%), Iwith I10% Iof Isquamous Icell Icarcinomas Ioccurring Ielsewhere Ion Ithe Ibody.
IThese Itumors Iare Imore Ipredominant Iin Icountries Iwhere Iarsenic Iis Ifound Iin Ihigher Irates Iin Idrinking Iwater.
➢ Cutaneous Imelanoma Iis Ia Imalignant Itumor Iof Ithe Iskin Ioriginating Ifrom Imelanocytes, Ior Icells Ithat Isynthesize Ithe
pigment Imelanin. IThe Iincidence Iof Imelanoma Iis Iincreasing, Iand Iyoung Ito Imiddle-age Iadults Iare Iat Ihighest Irisk.
CHARACTERISTIC DESCRIPTION
Lentigo IMalignant IMelanoma
Frequency 4% Ito I15% Iof Icutaneous Imelanomas
Age Iat Idiagnosis 50 Ito I80 Iyears Iold, Imean Iage I65 Iyears
Primary Ilocation Head, Ineck, Idorsum Iof Ihands I(sun-exposed Iareas)
Pigmentation Iaccording Ito Ithickness
<1.5 Imm I(levels II Iand III) Tan Iand Ibrown
>1.5 Imm I(level IIII) Tan, Ibrown, Iand Iblue-black
>1.5 Imm I(levels IIV Iand IV) Nodule Iformation
Superficial ISpreading IMelanomas
Frequency 57% Ito I70% Iof Icutaneous Imelanomas
Age Iat Idiagnosis 20 Ito I60 Iyears Iold
Primary Ilocation Legs Iof Ifemales; Iupper Iback Iof Iboth Igenders
Pigmentation Iaccording Ito Ithickness
<1.5 Imm I(levels II Iand III) Tan Iand Ibrown
>1.5 Imm I(level IIII) Tan, Ibrown, Iand Iblue-black
>1.5 Imm I(levels IIV Iand IV) Nodule Iformation
Primary INodular IMelanoma
Chapters I1-5, I11-14, I16-20, I21-25, I27-3-33, I34-39, I40-47
1. GI Isymptoms Iresulting Iin Iheart Iburn( Ich I41, Ipg I1429- I1466)
➢The Iclinical Imanifestations Iof I(GERD) Ireflux Iesophagitis Iare Iheartburn Ifrom Iacid Iregurgitation, Ichronic Icough, Iasthma
Iattacks Iand Ilaryngitis.
➢ Heartburn Ialso Imay Ibe Iexperienced Ias Ichest Ipain, Iwhich Irequires Iruling Iout Icardiac Iischemia.
➢ Hiatal Ihernias Iare Ioften Iasymptomatic. IGenerally, Ia Iwide Ivariety Iof Isymptoms Idevelop Ilater Iin Ilife Iand Iare Iassociated
Iwith Iother Igastrointestinal Idisorders, Iincluding IGERD. IManifestations Iof Ithe Ivarious Itypes Iof Ihiatal Ihernia Iare Idifficult
Ito Idistinguish. ISymptoms Iinclude I heartburn, Iregurgitation, Idysphagia, Iand Iepigastric Ipain
➢ Early Istages Iof Iesophageal Icarcinoma Iare Iasymptomatic. IThe Itwo Imain Imanifestations Iof Iesophageal Icarcinoma Iare
chest Ipain Iand Idysphagia. IThe Imost Icommon Itype Iof Ipain Iis Iheartburn I(pyrosis). IIt Iis Iinitiated Iby Ieating Ispicy Ior Ihighly
Iseasoned Ifoods Iand Iby Ilying Idown.
2. Complications Iof Igastric Iresection Isurgery I(c I41, Ipg I1439)
➢ Weight Iloss Ioften Ifollows Igastric Iresection Ibut Istabilizes Iwithin I3 Imonths. IInadequate Ifood Iintake Iis Ia Icommon Icause
Ibecause Imany Iindividuals Icannot Itolerate Ithe Iosmotic Ieffect Iof Icarbohydrates Ior Ia Inormal-size Imeal. IFoods Imay
Ibe Ipoorly Iabsorbed Ibecause Ithe Istomach Iis Iless Iable Ito Imix, Ichurn, Iand Ibreak Idown Ifood Iparticles. IAbdominal
Ipain, Ivomiting, Idiarrhea, Iand Imalabsorption Iof Ifats Ialso Icontribute Ito Iweight Iloss. IIn Ithe Icase Iof Ibariatric Isurgery
Ifor Iextreme Iobesity, Iweight Iloss Iis Ithe Iintended Ioutcome.
3. Chicken Ipox I( Ic I46,pg I1659)
➢ an Iinfectious Iviral Idisease Ithat Iis Ispread Iby Idirect Icontact Ior Ithrough Ithe Iair Iby Icoughing Ior Isneezing; Iit Icauses Ia
Iblister-like Irash Ithat Ifirst Iaffects Ithe Iface Iand Itrunk Iand Ithen Ican Ispread Iover Ithe Irest Iof Ithe Ibody; Isymptoms
Iinclude Isevere Iitching, Ifatigue, Iand Ifever.
4. Skin Icancer I( Ich I46 Ipg, I1641)
➢
Basal Icell Icarcinoma Iand Isquamous Icell Icarcinoma Iare Ithe Imost Iprevalent Iforms Iof Icancer. IMalignant Imelanoma Iis
Ithe Imost Iserious Iand Ithe Imost Icommon Icause Iof Ideath Ifrom I skin Icancer
➢ Chronic Iultraviolet I(UV) Iradiation Icauses Imost Iskin Icancers. IProtection Ifrom IUV Iradiation Ifrom Ithe Isun Iand Iartificial
sources I(e.g., Itanning Ibeds), Iparticularly Iduring Ithe Ichildhood Iyears, Isignificantly Ireduces Ithe Irisk Iof Iskin Icancer Iin
Ilater Iyears. IAreas Icommonly Iexposed Ito Ithe Isun’s Irays—face, Ineck, Iand Ihands—are Ihighly Ivulnerable Ifor Isuch Ilesions.
IDark-skinned Ipersons Iand Ithose Iavoiding Isunlight Iare Isignificantly Iless Ilikely Ito Idevelop Ithese Imalignant Itumors. IIn
Idark-skinned Ipersons, Ibasal Icells Icontain Ithe Ipigment Imelanin, Ia Iprotective Ifactor Iagainst Isun Iexposure
➢ Basal Icell Icarcinoma I( Imost Icommon) Iis Ia Isurface Iepithelial Itumor Iof Ithe Iskin Ioriginating Ifrom Iundifferentiated
IbasalIor Igerminative Icells. IThe Itumors Igrow Iupward Iand Ilaterally Ior Idownward Ito Ithe Idermal-epidermal Ijunction.
IThey Iusually Ihave Idepressed Icenters Iand Irolled Iborders. IEarly Itumors Iare Iso Ismall Ithat Ithey Iare Inot Iclinically
Iapparent.
➢ Squamous Icell Icarcinoma I(SCC) Iis Ia Itumor Iof Ithe Iepidermis Iand Ithe Isecond Imost Icommon
human Icancer. Icharacterized: Iin Isitu I(Bowen Idisease I[BD]) Iand Iinvasive. IAreas Iaffected Iare Ithe Ihead Iand Ineck I(75%)
Iand Ithe Ihands I(15%), Iwith I10% Iof Isquamous Icell Icarcinomas Ioccurring Ielsewhere Ion Ithe Ibody.
5. Parts Iof Ithe Iheart Iin Iterms Iof Ifunction, Isuch Ias Ipericardium I( Ich I31, Ip I1085)
➢ The Iheart Iwall Ihas Ithree Ilayers—the Iepicardium, Imyocardium, Iand Iendocardium—and Iis Ienclosed Iin Ia Idouble-walled
Imembranous Isac, Ithe Ipericardium
➢ The Ipericardial Isac Ihas Iseveral Ifunctions. IIt I(1) Iprevents Idisplacement Iof Ithe Iheart Iduring Igravitational Iacceleration Ior
deceleration, I(2) Iacts Ias Ia Iphysical Ibarrier Ithat Iprotects Ithe Iheart Iagainst Iinfection Iand Iinflammation Ifrom Ithe Ilungs
Iand Ipleural Ispace, Iand I(3) Icontains Ipain Ireceptors Iand Imechanoreceptors Ithat Ican Ielicit Ireflex Ichanges Iin Iblood
Ipressure Iand Iheart Irate.
➢ the Iouter Ilayer Iof Ithe Ipericardium, Ithe Iparietal Ipericardium, Iis Icomposed Iof Ia Isurface Ilayer Iof Imesothelium Iover
Ia Ithin Ilayer Iof Iconnective Itissue. IThe Ivisceral Ipericardium, Ior Iepicardium, Iis Ithe Iinner Ilayer Iof Ithe Ipericardium
➢ At Ione Ipoint Ithe Ivisceral Ipericardium Ifolds Iback Iand Ibecomes Icontinuous Iwith Ithe Iparietal Ipericardium, Iallowing Ithe
large Ivessels Ito Ienter Iand Ileave Ithe Iheart Iwithout Ibreaching Ithe Ipericardial Ilayer
➢ The Iouter Ilayer Iof Ithe Iheart, Ithe Iepicardium, Iprovides Ia Ismooth Isurface Ithat Iallows Ithe Iheart Ito Icontract Iand
Irelax Iwithin Ithe I pericardium I with Ia Iminimal Iamount Iof Ifriction.
➢ the Iinternal Ilining Iof Ithe Imyocardium Iis Icomposed Iof Iconnective Itissue Iand Ia Ilayer Iof Isquamous Icells Icalled
the Iendocardium
➢ The Iendocardial Ilining Iof Ithe Iheart Iis Icontinuous Iwith Ithe Iendothelium Ithat Ilines Iall Ithe Iarteries, Iveins, Iand
Icapillaries Iof Ithe Ibody, Icreating Ia Icontinuous, Iclosed Icirculatory Isystem
6. Congenital Iheart Idefects I(ch I33pg I1200)
, ➢ Congenital Iheart Idisease Iis Ithe Ileading Icause Iof Ideath, Iexcluding Iprematurity, Iduring Ithe Ifirst Iyear Iof Ilife.5It Iis
Iestimated Ithat Ias Imany Ias I35% Iof Ideaths Icaused Iby Icongenital Iheart Idefects Ioccur Iin Ithe Ifirst Iyear Iof Ilife Iand Ithat
Ione Ithird Iof Ichildren Iborn Iwith I congenital Iheart Idisease Iwill Idie Ias Ia Iresult Iof Itheir Icardiac Idisease
➢ The Ietiology Iof Imost Icongenital Iheart Idisease Iis Iunknown.
➢ As Imany Ias I50% Iof Iinfants Iwith Itrisomy I21 Ihave Ia Icongenital Iheart Idefect, Ieither Ian IAV Icanal Idefect Ior Ia IVSD.
IExtra Icardiac Idefects Iare Inoted Iin Ias Imany Ias I35% Iof Iinfants Iwith Icardiac Ilesions. IProspective Istudies Iusing
Ichromosomal Ianalysis Ihave Isuggested Ithat Icongenital Icardiac Imalformations Imay Ibe Ithe Iresult Iof Ia Isingle Igene
Idefect
7. Urinary Itract Iobstruction I(ch I37, Ipg I1340)
➢ Urinary Itract Iobstruction Iis Ian Iinterference Iwith Ithe Iflow Iof Iurine Iat Iany Isite Ialong Ithe Iurinary Itract.
An Iobstruction Imay Ibe Ianatomic Ior Ifunctional. IIt Iimpedes Iflow Iproximal Ito Ithe Iobstruction, Idilates Istructures Idistal Ito
Ithe Iobstruction, Iincreases Irisk Ifor Iinfection, Iand Icompromises Irenal Ifunction. IAnatomic Ichanges Iin Ithe Iurinary Isystem
Icaused Iby Iobstruction Iare Ireferred Ito Ias Iobstructive Iuropathy. IThe Iseverity Iof Ian Iobstructive Iuropathy Iis Idetermined
Iby: I(1) Ithe Ilocation Iof Ithe Iobstructive Ilesion, I(2) Ithe Iinvolvement Iof Ione Ior Iboth Iupper I urinary Itracts I(ureters Iand Irenal
Ipelvis), I(3) Ithe Icompleteness Iof Ithe Iobstruction, I(4) Ithe Iduration Iof Ithe Iobstruction, Iand I(5) Ithe Inature Iof Ithe
Iobstructive Ilesion. IObstructions Imay Ibe Irelieved Ior Ipartially Ialleviated Iby Icorrection Iof Ithe Iobstruction, Ialthough
Ipermanent Iimpairments Ioccur Iif Ia Icomplete Ior Ipartial Iobstruction Ipersists Iover Iweeks Ito Imonths Ior Ilonger.
8. GI Isymptoms Iof Iconditions Isuch Ias Ipyloric Istenosis, Ihiatal Ihernia, Iulcerative Icolitis- I(ch I41 Ipg I 148,1429,1440)
➢ Hiatal Ihernia Iis Ithe Iprotrusion Iof Ithe Iupper Ipart Iof Ithe Istomach Ithrough Ithe Ihiatus I(esophageal Iopening Iin
ItheIdiaphragm) Iat Ithe Igastroesophageal Ijunction. IHiatal Ihernia Ican Ibe Isliding, Iparaesophageal, Ior Imixed.
➢ Ulcerative Icolitis Iis Ian Iinflammatory Ibowel Idisease Ithat Icauses Iulceration, Iabscess Iformation, Iand Inecrosis Iof Ithe
colonic Iand Irectal Imucosa. ICramping Ipain, Ibleeding, Ifrequent Idiarrhea, Idehydration, Iand Iweight Iloss Iaccompany
Isevere Iforms Iof Ithe Idisease. IA Icourse Iof Ifrequent Iremissions Iand Iexacerbations Iis Icommon
➢ Pyloric Istenosis Iis Ian Iobstruction Iof Ithe Ipyloric Isphincter Icaused Iby Ihypertrophy Iof Ithe Isphincter Imuscle. IIt Iis
Ione Iof Ithe Imost Icommon Idisorders Iof Iearly Iinfancy Iand Iaffects Iinfants Ibetween Ithe Iages Iof Ieither I1 Iand I2
Iweeks Ior I3 Iand I4 Imonths
9. Skin Icancer Ilesions I( Ich I46, Ipg I1641)
➢ Basal Icell Icarcinoma Iand Isquamous Icell Icarcinoma Iare Ithe Imost Iprevalent Iforms Iof Icancer. IMalignant Imelanoma
Iis Ithe Imost Iserious Iand Ithe Imost Icommon Icause Iof Ideath Ifrom Iskin Icancer
➢ Basal Icell Icarcinoma Iis Ia Isurface Iepithelial Itumor Iof Ithe Iskin Ioriginating Ifrom Iundifferentiated Ibasal Ior
germinative Icells. IThe Itumors Igrow Iupward Iand Ilaterally Ior Idownward Ito Ithe Idermal-epidermal Ijunction. IThey
Iusually Ihave Idepressed Icenters Iand Irolled Iborders. IEarly Itumors Iare Iso Ismall Ithat Ithey Iare Inot Iclinically Iapparent.
➢ Basal Icell Icarcinoma Iis Ithe Imost Icommon Itype Iof Iskin Icancer Iin Iwhites Iand Iis Ithought Ito Ibe Icaused Iby
IUVIradiation Iexposure
➢ Squamous Icell Icarcinoma I(SCC) Iis Ia Itumor Iof Ithe Iepidermis Iand Ithe Isecond Imost Icommon Ihuman Icancer.
➢ Two Itypes Iare Icharacterized: Iin Isitu I(Bowen Idisease I[BD]) Iand Iinvasive. IAreas Iaffected Iare Ithe Ihead Iand
Ineck I(75%) Iand Ithe Ihands I(15%), Iwith I10% Iof Isquamous Icell Icarcinomas Ioccurring Ielsewhere Ion Ithe Ibody.
IThese Itumors Iare Imore Ipredominant Iin Icountries Iwhere Iarsenic Iis Ifound Iin Ihigher Irates Iin Idrinking Iwater.
➢ Cutaneous Imelanoma Iis Ia Imalignant Itumor Iof Ithe Iskin Ioriginating Ifrom Imelanocytes, Ior Icells Ithat Isynthesize Ithe
pigment Imelanin. IThe Iincidence Iof Imelanoma Iis Iincreasing, Iand Iyoung Ito Imiddle-age Iadults Iare Iat Ihighest Irisk.
CHARACTERISTIC DESCRIPTION
Lentigo IMalignant IMelanoma
Frequency 4% Ito I15% Iof Icutaneous Imelanomas
Age Iat Idiagnosis 50 Ito I80 Iyears Iold, Imean Iage I65 Iyears
Primary Ilocation Head, Ineck, Idorsum Iof Ihands I(sun-exposed Iareas)
Pigmentation Iaccording Ito Ithickness
<1.5 Imm I(levels II Iand III) Tan Iand Ibrown
>1.5 Imm I(level IIII) Tan, Ibrown, Iand Iblue-black
>1.5 Imm I(levels IIV Iand IV) Nodule Iformation
Superficial ISpreading IMelanomas
Frequency 57% Ito I70% Iof Icutaneous Imelanomas
Age Iat Idiagnosis 20 Ito I60 Iyears Iold
Primary Ilocation Legs Iof Ifemales; Iupper Iback Iof Iboth Igenders
Pigmentation Iaccording Ito Ithickness
<1.5 Imm I(levels II Iand III) Tan Iand Ibrown
>1.5 Imm I(level IIII) Tan, Ibrown, Iand Iblue-black
>1.5 Imm I(levels IIV Iand IV) Nodule Iformation
Primary INodular IMelanoma
