Question

1. Patient A complains about feet swelling recently which gets worse and worse. Please list the potential pathological conditions associated with foot swelling and explain the pathogenesis of the edema under that condition.

2. Please list at least 5 conditions that cause secondary hypertension and explain the pathogenesis of each condition.

3. Please list at least 5 pathological conditions that clinically present with Jaundice, and explain the pathogenesis of each condition.

4. Patient B complains about fatigue. Please explain the potential causes of fatigue, and list the examples for each cause. (the more examples the better). (Hint: what can decrease the cellular ATP production?)

5. What are the potential conditions associated with hepatomagely and/or splenomegaly? Explain the pathogenesis of hepatomegaly for each condition.

6. Please explain the differences between pulmonary hypertension and pulmonary edema, and the relationship (cause/outcome) between them.

7. List the pathological conditions that patient needs to control the sodium, water, or protein, and explain why for each condition.

8. For the following conditions what type of exercise would you recommend to the patient and why.
Chronic stress
Primary hypertension
Chronic heart failure (left, right or both)
COPD
Chronic kidney disease
Diabetes millitus

Answer 1

1. Pathological conditions associated with foot swelling are :-

- Increase in capillary pressure

- Decrease in osmotic pressure

- Obstruction in lymphatic system

- Increase in capillary permeability

Specific Pathological Conditions Which Cause Edema

Cancer: lymph nodes are removed so lymphadema presents itself.

1. Trauma or surgery

2. Pregnancy

Can cause edema in the lower extremities due to pressure on the inguinal lymph nodes.

Is caused by the expanding uterus.

3. Congestive heart failure (CHF)

- Is caused when left side of heart does not adequately pump blood; blood builds up in lungs and pulmonary edema may result. Prognosis is poor.

4. Burns

5. Muscular inactivity

2. Conditions that cause secondary hypertension are :-

renal disease

endocrine causes

congenital CVS causes

drugs

#. types of renal disease that cause secondary hypertension

renal artery stenosis

polycystic kidney disease

chronic pyelonephritis

glomerulonephritis

diabetic nephropathy

3. Conditions associated with jaundice :-

Congenital abnormalities of red cell structure or content (e.g. hereditary spherocytosis, sickle cell disease).

Autoimmune haemolytic anaemia,

Transfusion reactions.

Drug toxicity

Infection

Intramural abnormalities

4. Causes of fatigue :-

- inadequate energy delivery and metabolism

- accumulation of metabolic by product

- failure of muscle contractile mechanism

- altered neural control of muscle contraction