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Chapter 1: Introduction to Pathophysiology

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Pathophysiology

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Study of functional (physiological) changes in the body resulting from disease

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Disease

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Deviation from normal structure or function of the body or a state of wellness

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Homeostasis

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The body’s ability to maintain stable internal conditions

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Primary Prevention

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Don't develop the disease! Education on disease risk factors and prevent acquiring disease.

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Secondary Prevention

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After disease or serious risk factors for disease development. Goal to halt or slow progression of disease in early stages (if possible.)

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Tertiary Prevention

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Management of chronic health problems. Prevent further deterioration and improve quality of life.

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What is the purpose of Patient Medical History?

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Obtains info on patient's health status and assess implications of health status for planning and implementing health care interventions.

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Diagnosis

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Identification of a specific disease using signs, symptoms, and diagnostic tests

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Etiology

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Cause or causative factors of a disease

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Idiopathic

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Disease with no known cause

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Iatrogenic

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Disease caused by medical treatment, procedure, or error

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Predisposing factor

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A condition that increases the risk factor and likelihood of developing a disease

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Prophylaxis

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Measures taken to prevent disease or its spread

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Prevention

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Actions aimed at reducing the risk or progression of disease

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Pathogenesis

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The sequence of events in the development of a disease

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Onset of disease

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The time when disease manifestations begin (acute/sudden or insidious/gradual)

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Acute

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Short-term disease with rapid onset

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Chronic

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Long-term or persistent disease

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Subclinical

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Disease state with pathological changes but few or no symptoms

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Latent period

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Interval between exposure and onset of symptoms

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Prodromal period

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Early stage of disease with vague, nonspecific symptoms

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Manifestations

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Signs and symptoms of disease; local at site of problem or systemic

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Signs

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Objective indicators of disease observed by others

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Symptoms

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Subjective experiences reported by the patient

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Lesion

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Specific local change in tissue caused by disease

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Syndrome

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Group of signs and symptoms that occur together

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Course of disease

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The progression of disease over time

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Remission

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Period when disease manifestations decrease or disappear

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Exacerbation

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Worsening or flare-up of disease manifestations

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Precipitating factor

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A condition that triggers the onset of an acute episode

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Complication

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Secondary problem that arises after the initial disease

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Therapy / Therapeutic intervention

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Treatment measures used to promote recovery or slow disease progression

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Sequelae

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Long-term or permanent consequences of a disease

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Convalescence / Rehabilitation

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Period of recovery and return toward normal health

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Prognosis

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Predicted outcome or likelihood of recovery

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Morbidity

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Disease rates in a group; functional impairment that certain conditions cause in a population

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Mortality

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Relative number of deaths from a disease

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Autopsy

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Postmortem examination to determine cause of death

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Epidemiology

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Study of disease patterns in populations

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Incidence

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Number of new cases in a population during a specific time period

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Prevalence

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Total number of existing cases in a population at a given time

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Epidemic

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Occurrence of disease above expected levels in a population

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Pandemic

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Worldwide epidemic

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Communicable disease

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Disease that can be transmitted from person to person

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Notifiable / Reportable disease

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Disease that must be reported to public health authorities

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Endoscopic Examination

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Visualize lesions or structures directly through a tube inserted in the body through opening or body wall

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Radiograph/X-ray film

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Ionizing radiation, image on film of bones and soft tissue that vary in density. Plain, contrast, mammography, and DXA.

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Computed Tomography (CT Scan)

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360o x-rays in series of shots that uses ionizing radiation.

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Ultrasound

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High frequency sound waves that bounce off body structures.

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Doppler Ultrasound

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Assesses blood flow

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Echocardiography

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Measures efficiency of heart valves, function, and blood flow.

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Magnetic Resonance Imaging (MRI)

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Uses magnetic field surrounding body and hydrogen (water) content of body; radio waves energy source; nonionizing. Can project past bone.

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Nuclear Scanning

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Track distribution of a radioactive tracer substance injected in the body that interacts with various structures in a way to highlight areas of interest.

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Positron Emission Tomography (PET)

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Radioisotopes w/scanner and computer to produce a cross-sectional functional image of tissue. Biochemical changes in the tissue.

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Electrocardiogram (ECG/EKG)

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Assesses conduction/electrical system of the heart. Abnormal patterns assist with diagnosis of myocardial infarctions, cardiac dysrhythmias, electrolyte imbalances, and digoxin toxicity.

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Stress test (exercise ECG)

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Test cardiac function under increased workload

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Electroencephalogram (EEG)

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Electrical activity in the brain. Abnormal patterns may indicate seizure disorders, tumors, or injuries.

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Spirometry

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Measures lung volumes and capacities. Deviations from normal can indicate restrictive or obstructive disorders.

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Complete blood count (CBC)

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Count and characteristics of formed elements.

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Hemoglobin (Hgb)

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Amount of hemoglobin (part that transports oxygen.)

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Glycosylated hemoglobin (HBA1c)

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Amount of glucose bound to hemoglobin; blood glucose levels over months.

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Hematocrit (HCT)

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Percentage of erythrocytes in a specific volume of blood

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White blood cell differential count

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Assess proportions of leukocytes, "differential count"

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Bone marrow aspiration

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Used to confirm abnormalities related to production of red blood cells in the marrow, megaloblastic anemia, leukemia

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Blood culture and sensitivity

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Bacteremia or unknown infection

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Blood clotting tests

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Evaluate clotting time or clotting factors

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Hemoglobin electrophoresis

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Detects abnormal hemoglobin by isolating the hemoglobin protein itself

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Serum-ferritin levels

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Amount of iron storage

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Arterial blood gas (ABG)

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Acid-base balance, oxygen levels, serum pH, PO2, PCO2, SO2, carbon dioxide and oxygen content, bicarbonate, base excess or deficit.

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Serum hormone levels

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Determines whether there are deficiencies in hormone secretion

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Lipid levels

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Cholesterol, triglycerides, low density lipoprotein (LDL), high density lipoprotein (HDL).

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Serum electrolytes

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Na+, K+, Magnesium levels, Ca+

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Serum enzymes or isoenzymes

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Might indicate damage to some part of the body

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Serum levels of bilirubin

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Showcases appropriate liver function

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Serum antigen antibody tests

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Determines if you had exposure to certain diseases in the past or currently have an ongoing infection

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Skin tests, scratch tests

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Immune responses, allergies

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Urinalysis

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Physical and chemical characteristics of freshly collected urine sample, specific gravity, microscopic examination, creatinine clearance

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Atrophy

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Decrease in cell size = decreased tissue mass

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Hypertrophy

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Increase in cell size= enlarged tissue mass

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Hyperplasia

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Increase in cell number= enlarged tissue mass

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Metaplasia

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One mature cell type replaced by another mature cell type

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Dysplasia

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Tissue in which differentiated cells vary in size and shape, large nuclei are frequently present, and rate of mitosis increased.

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Anaplasia

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Cells are undifferentiated with variable nuclear and cell structures and numerous mitotic figures

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Neoplasia

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"New growth," tumor; benign (non-spreading) or malignant (can spread/metastasize)

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Apoptosis

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Programmed cell death

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Necrosis

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Death of one or more cells (portion of tissue or organ) due to irreversible damage

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Ischemia

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Decreased oxygenated blood supply due to circulatory obstruction

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Hypoxia

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Decreased oxygen in cells or tissues

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Pyroptosis

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Lysis of cell, releasing contents causing inflammatory response and damage to nearby cells. Diagnostic tests can look for cellular enzymes in blood.

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Liquefaction necrosis

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Dead cells liquify due to cellular enzymes

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Coagulative necrosis

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cell proteins are denatured and cells retain some form for a time after death

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Fat necrosis

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Fatty tissue broken down into fatty acids, causing inflammation

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Caseous necrosis

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Form of coagulation necrosis in which a thick, yellowish, "cheesy" substance forms

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Infarction

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Area of dead cells resulting from lack of oxygen; loss of tissue function in the area

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Gangrene

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Area of necrotic tissue associated with a lack of blood supply followed by invasion of bacteria

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Wet Gangrene

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Liquefaction causing tissue to become cold, swollen, and black

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Dry Gangrene

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Coagulative necrosis, tissue dries, shrinks, and blackens

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Gas Gangrene

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Buildup of gases further reducing blood supply