Review Pathophysiology - V

[Intro: 90 BPM. The track opens with a wall of harsh feedback and heavy, rhythmic breathing. A sudden, massive distorted 808 kick drum drops in, establishing a menacing groove. The MC screams to hype the track before attacking the first verse.] [Block 1: Heavy industrial beat drops. The MC barks the lyrics with aggressive, staccato precision.] Noise-induced hearing loss. Damage to stereo ciliated cells in Corti. loss of high-frequency (Distorted Crash) NEXT Presbycusis. destruction of hair cells at the cochlear base, loss of high-frequency (Distorted Crash) NEXT Cholesteatoma. growth of keratinized squamous epithelium in middle ear. (Distorted Crash) NEXT Ménière disease. increase endolymph in inner ear so vertigo, sensorineural hearing loss, tinnitus, ear fullness (Distorted Crash) NEXT [Block 2: A screeching metallic synth loop joins the beat. The flow becomes frantic as the visual symptoms escalate.] Glaucoma. progressive vision loss from peripheral to central (Distorted Crash) NEXT Open-angle glaucoma. increase resistance in trabecular meshwork (Distorted Crash) NEXT Angle-closure glaucoma, associated anatomic abnormalities like anteriorly displaced lens (Distorted Crash) NEXT In diabetic retinopathy. increase permeability and occlusion of retinal vessels SO microaneurysms, hemorrhages (nonproliferative); retinal neovascularization (proliferative) (Distorted Crash) NEXT Hypertensive retinopathy. spasm, sclerosis, and fibrinoid necrosis of retinal vessels (Distorted Crash) NEXT [Block 3: Drums strip back to a heavy, distorted stomp-and-clap rhythm. The vocal delivery feels claustrophobic and intense.] Retinal detachment Neurosensory retina separates from retinal pigment epithelium; due to retinal tears, “rhegmatogenous” tractional or exudative (Distorted Crash) NEXT Retinitis pigmentosa. Progressive degeneration of photoreceptors and retinal pigment epithelium (Distorted Crash) NEXT Relative afferent pupillary defect “Marcus Gunn pupil” Unilateral or asymmetric lesions of afferent limb of pupillary reflex (eg, retina, optic nerve) (Distorted Crash) NEXT Horner syndrome. 1st neuron “pontine, lateral medullary syndrome, spinal cord lesion above T1”; 2nd neuron stellate ganglion compression by Pancoast tumor; 3rd neuron, carotid dissection (Distorted Crash) NEXT Cavernous sinus syndrome secondary to pituitary tumor, carotid-cavernous fistula, or cavernous sinus thrombosis related to infection (Distorted Crash) NEXT [Block 4: The full anarchic beat returns with double-kick flurries. The distorted backing vocals punch through violently.] Distal renal tubular acidosis “RTA type 1” alpha-intercalated cells cannot secrete hydrogen so metabolic acidosis (Distorted Crash) NEXT Proximal RTA “type 2” Defective PCT bicarbonate reabsorption (Distorted Crash) NEXT Hyperkalemic RTA “type 4” Hypoaldosteronism/aldosterone resistance so increase potassium so decrease NH₄⁺ excretion (Distorted Crash) NEXT Infection-related glomerulonephritis (Robotic Yell) MECHANISM Type III hypersensitivity reaction with consumptive hypocomplementemia (Distorted Crash) NEXT Alport syndrome. Type IV collagen mutation (X-linked dominant) so irregular GBM so nephritic syndrome (Distorted Crash) NEXT [Block 5: Maximum industrial chaos. Sirens wail through distortion. The MC pushes his voice to the limit, screaming over the heavy bass.] Preeclampsia (Robotic Yell) MECHANISM Abnormal placental spiral arteries so endothelial dysfunction, vasoconstriction, ischemia (Distorted Crash) NEXT Supine hypotensive syndrome. gravid uterus compresses abdominal aorta and IVC (Distorted Crash) NEXT Polycystic ovary syndrome. Hyperinsulinemia and/or insulin resistance so altered hypothalamic feedback response so increase LH/FSH, increase androgens, increase rate of follicular maturation so unruptured follicles (cysts), anovulation (Distorted Crash) NEXT Functional hypothalamic amenorrhea. altered pulsatile GnRH secretion (Distorted Crash) NEXT Methemoglobin. increase oxidized hemoglobin due to dapsone, local anesthetics, nitrites so tissue hypoxia (Distorted Crash) NEXT [Outro: The beat cuts off abruptly, leaving just a low, menacing synth drone. The MC delivers the final line breathless and exhausted.] Sarcoidosis. Macrophages increase 1α-hydroxylase so vitamin D D D D [Ending: A final burst of harsh, screeching static feedback cuts out instantly. Total silence.]