Schematic Diagram Pathophysiology of Colon Cancer, Anemia Secondary to Blood loss (chronic) Secondary to Colon Cancer, CAP high

Risk Lung metastisis To Consider PTB and Bronchietaeisis

Dx: Predisposing: Gender: Female 50 years and older: Precipitating: Diet: fatty foods and frequently eats red meat smoker Stool occult blood test Endoscopy

High levels of fat in the diet

Increase synthesis of bile acids in the liver

Mngt: High fiber diet, increases stool bulk thereby dilute and remove potential carcinogens Aspirin and NSAIDS inhibits COX-1 and COX-2 thus inhibits prostaglandin synthesis thus decrease proliferation and tumor growth.

Bacterial flora in the colon activated and reacts to increase bile acids Proliferation enhanced by high dietary levels of refined sugar. Bacterial organisms then convert bile acids to possible carcinogens

Formation of neoplasms

Excess proliferation in the colon

Adenomatous polyps formation

Tubular

Tubulovillou s

Villous

Grows slowly 5 to 10years or longer

Schematic Diagram Pathophysiology of Colon Cancer, Anemia Secondary to Blood loss (chronic) Secondary to Colon Cancer, CAP high Risk Lung metastisis To Consider PTB and Bronchietaeisis

Become a malignant tumor

Mngt: Chemotherapeutic drugs

Invasive carcinoma develops

Surgical interventions

Invasion directly to the bowel walls Polyps increase in number S/sx Constipation Ulceration of lesions Intestine becomes bulk Bleeding Congestion bleeding Decrease blood flow Abdominal pain

Decrease O2 distribution to the colon Mngt: Necrosis of the tissue due to decrease O2 Leading to cell and tissue death in the area Dysfunction of the colon Stool softener Blood transfusion

Schematic Diagram Pathophysiology of Colon Cancer, Anemia Secondary to Blood loss (chronic) Secondary to Colon Cancer, CAP high Risk Lung metastisis To Consider PTB and Bronchietaeisis

Stage 1

Stage 2

Stage 3

Stage 4

Limited invasion 5 years survival 80-100%

Invades the entire wall of the colon without lymph node 5 years survival 50-70%

Invasion of serosal layer and regional lymph node 5 years survival 30-50%

Far-advance metastasis poor prognosis

Mngt: Blood transfusion, cross matched Aticuagulants Fluid volume replacement IVF Acute blood loss

f c

Mngt: Iron suppliments Blood transfusion

Chronic blood loss

Hypovolemia/ shock Decrease RBC count Stimulates bone marrow to produce RBCs hemodilution Microcytic hypochromic anemia Decrease haemoglobin, decrease synthesis

Iron stores are depleted

Iron-deficiency anemia

Hypoxia of the cell Sufficient iron stores

Decrease RBCs

Schematic Diagram Pathophysiology of Colon Cancer, Anemia Secondary to Blood loss (chronic) Secondary to Colon Cancer, CAP high Risk Lung metastisis To Consider PTB and Bronchietaeisis
Bleeding controlled Bleeding uncontrolled

Small RBCs unable to carry O2

d e
Decrease blood components

Immune compromised Bacterial droplets inhaled through the lungs Aspirated bacteria through tracheobronchial tree Mngt: O2 administration Braod spectrum antibiotic administration Bronchodilators Dx: Chest x-ray Sputum exam

S/Sx: Increased RR Chest discomfort Generalized malaise Watery sputum Coughing Fever Chills

Invasion of bacteria to the LRT Inflammation of the alveoli and the bronchioles

Community acquired pneumonia

Increased BP Cold/If treated clammy skin Cyanosis Restlessness Good prognosis

If untreated

Respiratory failure

Schematic Diagram Pathophysiology of Colon Cancer, Anemia Secondary to Blood loss (chronic) Secondary to Colon Cancer, CAP high Risk Lung metastisis To Consider PTB and Bronchietaeisis

f
Mngt: antituberculosis drugs Dx: skin test, sputum culture

e
Droplets evaporated and circulate to air current Inhalation of tubercle bacillus

Mngt: antituberculosis drugs Dx: skin test, sputum culture

Primary tuberculosis

Secondary tuberculosis

Cell-mediated hypersensitivity response

Development of cell mediated immunity

Reinfection

Granulomatous inflammatory response Ghons focus Combination of primary lung lesion and lymph node granulomas Ghons complex Healed dormant leasion

Progressive or disseminated tuberculosis

Positive skin test Reactivation occurs

If untreated

Respiratory failure

f
Death