Term
| 1. What are area of the brain is affected with a diffuse axonal injury? |
|
Definition
|
|
Term
| 1. what are the long-term effects of DAI? |
|
Definition
| neurodegeneration later in life |
|
|
Term
| 1. severity of a DAI depends on what? |
|
Definition
| amount of shearing force applied to the brain |
|
|
Term
1.
what is the most common DAI?
what happens in this case? |
|
Definition
Moderate DAI
-involves actual tearing of axons in both hemispheres
-posttraumatic coma lasts longer than 24 hours
-widespread physiologic impairment exists throughout the cerebral cortex and diencephalon |
|
|
Term
2.
Describe the ischemic cascade in relation to free radicals post-CVA. |
|
Definition
ischemic cells use anaerobic metabolism, producing lactic acid
ATP reliant ion transport pumps fail, causing deoplarization, allowing Ca++ to enter cell, and releasing glutamate and creating free radicals which are toxic to neurons
reperfusion injury causes inflammation and release of albumins, causing edema due to osmosis |
|
|
Term
3.
what are the most common causes of bacterial meningitis? |
|
Definition
| meningococcus and pneumococcus |
|
|
Term
3.
what are manifestations of bacterial meningitis? |
|
Definition
1. inflammation, headache, photophobia, nuch rigidity, and positive Kernig and Brudzinski signs
2. Local tissue dysfunction- cranial nerve palsies, focal neurologic deficits, and seizures
3. mass effect- decreased level of consciousness, nausea, vomiting, and increased ICP
3. Vascular compromise (thickening of CSF fluid)
4. Vascular compromise |
|
|
Term
4.
what immunoglobulin is positive at the onset of Lyme disease?
what immunoglobulin is drawn about four weeks after disease onset |
|
Definition
IgM is elevated at onset
IgG is elevated later in disease progression, and likely both IgG and IgM antibodies are elevated |
|
|
Term
5.
what is the cause of Myasthenia Gravis? What is the major pathology happening with Myastenia Gravis? |
|
Definition
Type II hypersensitivity
IgG attacks acetylcholine receptors at post-synaptic membrane, blocking or destroying the receptors |
|
|
Term
6.
what is the cause of Multiple sclerosis?
what is the major pathology happening with MS? |
|
Definition
Type IV hypersensitivity
Demyelinating disorder of the Central nervous system
clinically isolated syndrome is precursor
decreased vitamin D may cause MS |
|
|
Term
6.
how long do paroxysmal attacks last in MS?
What are a couple common precursors to these attacks? |
|
Definition
sensory or motor symptoms of abrupt onset and short duration
short-lived attacks or temporary exacerbations can be caused by elevated temperature and serum Ca++ |
|
|
Term
7.
Ascending Paralysis is a hallmark of what syndrome? |
|
Definition
Guillain Barre
-rapid development of muscle paralysis, absence of reflexes, absence of likely cause. |
|
|
Term
7.
what is the pathology of Guillain-Barre syndome? |
|
Definition
acquired autoimmune disorder causing demyelination of peripheral nerves
Usually there is viral or bacterial prodrome
transient (or permanent damage, if unable to heal) |
|
|
Term
8.
What neurotransmitters are involved in Parkinson's?
which are increased, which are decreased? |
|
Definition
Dopamine levels are low,
Acetylcholine levels are likely low (imbalanced levels) |
|
|
Term
8.
what are 4 cardinal signs of parkinsons disease? |
|
Definition
cogwheel rigidity
bradykinesia
resting tremor
postural abnormalities |
|
|
Term
8.
what part of the brain is affected in parkinsons? |
|
Definition
| decreased dopamine in nigrostriatal pathway |
|
|
Term
9.
neuritic plaques are present in DAT. What effect do these have? |
|
Definition
neuritic plaques (concentrated in cerebral cortex and hippocampus) are made up of amyloid and other material which impacts glutamate
glutamate decreases cerebral perfusion affecting memory and attention |
|
|
Term
9.
which ventricle is most likely to be enlarged with DAT? |
|
Definition
|
|
Term
|
Definition
1. widespread coagulation activation-small clots in small vessels
2. fibrinolytic activation
3. coagulation inhibitor consumption
4. end-organ damage |
|
|
Term
10.
can severe trauma or trauma to the brain cause DIC? |
|
Definition
|
|
Term
|
Definition
| 1. eliminate pathology 2. control ongoing thrombosis 3. maintain organ function |
|
|
Term
10.
is there increased tissue factor in DIC? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
11.
zosteriform skin lesion |
|
|
Term
12.
what is the most common type of Herpes simplex virus? |
|
Definition
| Type II herpes simplex is most common |
|
|
Term
12.
where does herpes simplex virus appear and how? |
|
Definition
appears as a rash or clusters of inflamed painful vesicles around the mouth, tongue, lips, or nose
increased paresthesias, burning, and sensitivity to lesion areas
vesicles rupture and form a crust |
|
|
Term
12.
what is herpes zoster? |
|
Definition
shingles
S/S: pain, paresthesias
scattered vesicles that do not cross the midline
localized to dermatome (cutaneous area innervated by a single spinal verve |
|
|
Term
12.
what is herpes varicells? |
|
Definition
chickenpox
happens within the keratinocytes |
|
|
Term
12.
what skin lesions are caused by HPV? |
|
Definition
warts
-can be round, flat, or fusiform. |
|
|
Term
12.
where do condylomata acuminate appear?
what is the cause? |
|
Definition
|
|
Term
13./14.
what mediates urticaria?
what is another name for urticaria? |
|
Definition
IgE mediated
Type I hypersensitivity reactions to allergies
-histamine release causes endothelial cells of the skin to contract, fluid leaks from the vessels |
|
|
Term
15.
what is actinic keratosis?
how does it appear? |
|
Definition
permalignant lesion composed of aberrant proliferations of epidermal keratinocytes caused by prolonged exposure to UV radiation
reddish or brown papules more felt than seen
may cause telangiectasia (dilated blood vessels near area) |
|
|
Term
15.
is actinic keratosis cancer? |
|
Definition
yes,
early in situ squamous cell carcinoma |
|
|
Term
16.
what is the most common skin disease? |
|
Definition
|
|
Term
16.
in acne, what is the site? |
|
Definition
secaceous follicles
-small hair and dilated follicular canal |
|
|
Term
16.
what is the cause of acne? |
|
Definition
follicular hyperkeratinization
excessive sebum production
colonization of propionibacterium acnes
inflammation |
|
|
Term
16.
what role do androgens play in acne? |
|
Definition
| androgens boost size and productivity of sebaceous glands |
|
|
Term
15.
is actinic keratosis cancer? |
|
Definition
| early in situ squamous cell carcinoma |
|
|
Term
16.
what is the most common skin disease? |
|
Definition
|
|
Term
16.
what are the sites in acne? |
|
Definition
| sebaceous follicles- small hair and dilated follicular canal |
|
|
Term
|
Definition
follicular hyperkeratinization
excessive sebum production
colonization of propionibacterium acnes
inflammation |
|
|
Term
16.
what role do androgens play in the pathology of acne? |
|
Definition
| androgens boost size and producivity of sebaceous glands |
|
|
Term
17.
what is another term for atopic dermatitis? |
|
Definition
|
|
Term
17.
what mediates the inflammation in AD? |
|
Definition
IgE
inflammation is due to cytokine release and activation of mast cells, eosinophils, and macrophages |
|
|
Term
17.
what is the hallmark symptom of atopic dermatitis? |
|
Definition
|
|
Term
17.
atopic dermatitis is related to what other disease? |
|
Definition
| asthma, allergic rhinitis, food allergy |
|
|
Term
18.
is aplastic anemia macrocytic or microcytic? |
|
Definition
|
|
Term
18.
what is the primary defect in aplastic anemia leading to low RBCs? |
|
Definition
Autoimmune disorder from defects in DNA repair where stem cells cannot make blood cells.
bone marrow is replaced by fat. |
|
|
Term
18.
what are the effects of aplastic anemia related to levels of WBC, RBC, and PLATELETS? |
|
Definition
|
|
Term
19.
What is the most common anemia worldwide, affecting 1/5 of the world population? |
|
Definition
|
|
Term
19.
what are causes of iron deficiency anemia? |
|
Definition
pregnancy
parasites
lead poisoning
inadequate dietary intake
excessive blood loss (esophagitis, ulcers, cancer, meds)
bariatric surgery
pica (eating non-food items)
decreased erythrocyte production |
|
|
Term
19.
what are s/s of iron deficiency anemia? |
|
Definition
| SOB, pale earlobes, pale palms, pale conjunctivae |
|
|
Term
19.
what is the most serious effect with children? |
|
Definition
|
|
Term
19.
what is the term for spooning of the nails related to hypochromic anemia? |
|
Definition
|
|
Term
19.
how does iron deficiency anemia contrast with pernicious anemia regarding signs?
what is the term for this? |
|
Definition
cracking of the mouth only in pernicious anemia
cheilitis is the term for cracking of the mouth |
|
|
Term
20.
what does MCV regard?
What is the purpose of MCV? |
|
Definition
mean corpuscular volume, related to cell size of RBCs
It helps determine the type of anemia involved |
|
|
Term
20.
what is normocytic cell size regarding RBC indices? |
|
Definition
|
|
Term
21.
does Folic Acid deficiency lead to macrocytic or microcytic anemia? |
|
Definition
Macrocytic (megaloblastic) anemia
-unusually large stem cells in the marrow mature into erythrocytes that are unusually large in size (macrocytes), thickness, and volume |
|
|
Term
21.
what effect does folic acid deficiency have on life span of RBCs?
what is the term? |
|
Definition
| Eryptosis- premature death of damaged erythrocytes |
|
|
Term
21.
how does folic acid deficiency lead to eryptosis? |
|
Definition
defective DNA synthesis leads to RBC growth and small nucleus.
this leads to heme breakdown |
|
|
Term
21.
what are complications associated with folate deficiency? |
|
Definition
risk for neural tube defects in the feturs
increased risk for atherosclerosis
deficiency is common with ETOH abuse, interfering with liver metabolism |
|
|
Term
21.
are humans dependent on dietary intake for folate? |
|
Definition
|
|
Term
22.
what is infectious mononucleosis?
what is the most common etiologic agent? |
|
Definition
an acute, self-limiting neoplastic lymphoproliferative clinical syndrome characterized by acute viral infection of B lymphocytes (B cells)
caused by EBV
(also can be caused by CMV) |
|
|
Term
22.
what is the classic triad for infectious mononucleosis? |
|
Definition
| pharyngitis, lymphadenopathy, and fever |
|
|
Term
22.
what type of tumor can be caused by EBV? |
|
Definition
burkitt lymphoma
-fastest growing human tumor |
|
|
Term
23.
what is the difference between nehprotic and nephritic syndrome? |
|
Definition
nephrotic syndrome is related to excessive protein excretion as a result of glomerular injury (glomerulonephritis)
nephritic syndrome is excessive RBC and protein excretion |
|
|
Term
24.
what is the most common cause of UTI? |
|
Definition
|
|
Term
24.
what is the most common cause of prostatitis? |
|
Definition
|
|
Term
24.
why should we place a foley cather in a patient with prostatitis? |
|
Definition
Trick question-
never place a foley in a patient with prostatitis |
|
|
Term
24.
what is the most common site of UTI? |
|
Definition
cystitis- bladder
more common in women than men |
|
|
Term
25.
what is the gold standard for diagnosis of renal disease? |
|
Definition
Creatinine clearance
(and GFR) |
|
|
Term
25.
with renal disease, what labs are affected and how? |
|
Definition
increased CRT
Increased BUN
Decreased GFR ( <60 ) |
|
|
Term
23.
What is the most common form of idiopathic acute glomerulonephritis in developed countries, especially asia? |
|
Definition
| IgA nephropathy (Berger disease) |
|
|
Term
23.
what is the effect on sodium regarding nephrotic syndrome? |
|
Definition
| sodium retention is associated with nephrotic syndrome, contributing to the development of edema and ascites |
|
|
Term
26.
What is the pathophysiology for glomerulonephritis? |
|
Definition
immune complexes deposit in glomerulus, activating complement and recruiting immune cells
inflammation causes decreased glomerular perfusion, scarring, and thickening of basement membrane (but increasing permeability to proteins and RBCs) |
|
|
Term
26.
what are the 5 types of glomerulonephritis described in the book? |
|
Definition
IgA nephropathy (Berger)
Membranous nephropathy
crescentic glomerulonephritis
mesangial proliferative glomerulonephritis
membranoproliferative glomerulonephritis |
|
|
Term
26.
what are the clinical manifestations of glomerulonephritis? |
|
Definition
hematuria with red blood cell casts
(brown)
proteinuria exceeding 3 to 5 g/day with albumin
low serum albumin
-edema
severe: oliguria ( <30ml/hr ) |
|
|
Term
26.
what are some secondary cauases of glomerulonephritis? |
|
Definition
diabetic nephropathy-progressive thickening and fibrosis of basement membrane
lupus nephritis
-inflammation
-formation of autoantibodies against double-stranded DNA |
|
|
Term
26.
what are the effects on Vit D and Thyroxine in relation to glomerulonephritis?
how? |
|
Definition
Loss of protein via urine causes loss of transport proteins.
this leads to lower levels of Vitamin D and Thyroxine |
|
|
Term
27.
what is the common name for tinea corporis? |
|
Definition
|
|
Term
27.
what is the cause of tinea corporis? |
|
Definition
fungal infection
often transmitted by pets directly |
|
|
Term
27.
what test is used to determine a fungal infection? |
|
Definition
|
|
Term
27.
what population is most likely to get a tinea corporis infection? |
|
Definition
|
|
Term
28.
What is tinea unguium or onychomycosis?
what does it look like? |
|
Definition
nail fungus
-superficial or deep inflammation of the nail that develops yellow-brown accumulations of brittle keratin over all portions of the nail |
|
|
Term
|
Definition
thickened, white patches form on your gums, the insides of your cheeks, the bottom of your mouth and, sometimes, your tongue. These patches can't be scraped off.
-no known cause, but orally is associated with tobacco use and EBV
-may be a sign of cancer |
|
|
Term
30.
what are the plasma proteins? |
|
Definition
albumin and globulins,
fibrinogen and prothrombin |
|
|
Term
30.
what are 4 roles of plasma proteins? |
|
Definition
oncotic pressure
transport binding proteins
defense/ immune reaction
coagulation |
|
|
Term
30.
where are plasma proteins synthesized? |
|
Definition
hepatocytes
(except Ig; this is made in lymph nodes) |
|
|
Term
31.
How are decubitus ulcers best prevented? |
|
Definition
|
|
Term
32.
define reduction of fracture |
|
Definition
| realigning the bone fragments to normal anatomic position |
|
|
Term
32.
define closed manipulation |
|
Definition
| bone moved into place without opening the skin |
|
|
Term
|
Definition
| exposing fracture site surgically to visualize realignment |
|
|
Term
|
Definition
| failure of bone ends to grow together |
|
|
Term
|
Definition
| union that does not occur until approximately 8 to 9 months after a fracture |
|
|
Term
|
Definition
| healing of a bone in a nonanatomic position |
|
|
Term
|
Definition
|
|
Term
32.
what are the 4/5 steps to adult fracture healing? |
|
Definition
1. hematoma formation-damaged vessels cause hemorrhage.
2. procallus formation- fibroblasts, osteoblasts move into the wound to produce granulation tissue
3. callus formation- osteoblasts in the procallus form membranous or woven bone
-phosphate and calcium join to form a mineral deposit, hardening the callus
4. callus replacement- by osteoblasts
5. Remodeling- back to size/shape prior to injury |
|
|
Term
32.
what is the term for the shaft of long bone? |
|
Definition
|
|
Term
32.
what is the term for the area of the bone with the growth plate? |
|
Definition
|
|
Term
33.
Osgood schlatters and Legg Calve' Perthes disease are associated with what condition? |
|
Definition
|
|
Term
33.
what is avascular necrosis?
what are associations with this condition? |
|
Definition
death of bone tissue due to lack of blood supply
-high dose steroids
-sickle cell anemia
-radiation
-pancreatitis
-HIV
-SLE |
|
|
Term
34.
What is the pathophysiology regarding steroids and bone density? |
|
Definition
| RANKL is increased with steroids, inhibiting action by osteoblasts, leading to lower bone density |
|
|
Term
34.
what level of bone density is required to diagnose osteoporosis? |
|
Definition
| less than 2.5 standard deviations from normal |
|
|
Term
35.
What is the most common cause of Osteomyelitis? |
|
Definition
|
|
Term
35.
why is osteomyelitis more serious with children? |
|
Definition
children have an open metaphyseal plate
infection can lift the periosteum off bone, disrupting blood vessels and depriving of blood supply |
|
|
Term
36.
What is multiple myeloma? |
|
Definition
a clonal plasma cell cancer characteried by the slow proliferation of malignant cells as tumor cell masses in the bone marrow
- usually results in destruction of the bone |
|
|
Term
36.
what population has the highest incidence of multiple myeloma? |
|
Definition
| blacks are twice as likely as whites |
|
|
Term
36.
what chromosome is affected with multiple myeloma? |
|
Definition
|
|
Term
36.
what do MM cells secrete and what is the effect?
what lab tests are elevated? |
|
Definition
MM cells secrete hepatocyte growth factor and parathyroid hormone, and cause stromal cells to release cytokines
cytokines stimulate osteoclasts to resorb bone, resulting in high serum calcium (as well as renal failure and anemia |
|
|
Term
37.
what happens with a fourth degree sprain? |
|
Definition
| ligament broken as well as a broken bone |
|
|
Term
38.
what is epicondylitis?
what is the cause? |
|
Definition
inflammation of a tendon where it attaches to a bone
-tissue degredation |
|
|
Term
38.
where are common sites for epicondylitis? |
|
Definition
lateral epicondyle (tennis elbow)
medial epicondyle (golfer's elbow) |
|
|
Term
39.
what is the cause of achilles tendonitis? |
|
Definition
rapid plantar hyperflexion (running, new increase in activity)
-tendon gets overstretched! |
|
|
Term
40.
what is the pathology for bursitis? |
|
Definition
| repeated trauma causes damage to bursae (sacs lined with synovial membrane containing synovial fluid) |
|
|
Term
40.
give examples of bursitis |
|
Definition
 Bartender’s elbow (olecranon bursa) from elbow leaning like a bartender does
 Postman’s heel (plantar bursa) repeated pressure on the heel
 Housemaid’s knee (prepatellar bursa) excessive kneeling and a bunion is due to friction at bursar of metatarsophalangeal joint |
|
|
Term
41.
what is the anatomic reason for an infant's inability to concentrate urine? |
|
Definition
infants have short loops of Henle in the medullary nephrons, resulting in more dilute urine
infants also have a high anabolic state with lower urea excretion, and blood flow to the kidney in a newborn is primarily to the medullary nephrons |
|
|
Term
42.
what happens with the vesicoureteral reflux? |
|
Definition
| urine backflows into the kidney from ureters |
|
|
Term
42.
what would be one cause of vesicoureteral reflux?
how is it diagnosed? |
|
Definition
congenital abnormality or ectopic insertion of the ureter into the bladder
voiding cytourethrogram and IV pyelogram |
|
|
Term
43.
what are the 3 categories of acute renal disease? |
|
Definition
prerenal
intrarenal
postrenal |
|
|
Term
43.
what is the cause of prerenal disease? |
|
Definition
|
|
Term
43.
what is the cause of intrarenal disease? |
|
Definition
disorders that involve renal parenchyma or interstitial tissue.
most common cause- acute tubular necrosis caused by ischemia |
|
|
Term
43.
what is the cause of postrenal disease?
-how common is it? |
|
Definition
acute urinary tract obstruction
-rare |
|
|
Term
44.
what lab tests are used to diagnose rheumatoid arthritis? |
|
Definition
rheumatoid factor
CCP antibody (CYCLIC CITULLINATED PEPTIDE ANTIBODY) |
|
|
Term
44.
what is usually the trigger for rheumatoid arthritis? |
|
Definition
|
|
Term
44.
what are other alterations leading to RA?
(antibodies, repair) |
|
Definition
Defects in telomere repair (faster aging) with loss of immune function
antibodies become autoantibodies, termed rheumatoid factors IgG and IgM
Associated with HLA-DR4 (Death Receptor 4) |
|
|
Term
44.
In RA, is there a genetic susceptibility or is it an antigen problem? |
|
Definition
| both antigens and genetic susceptibility are implicated |
|
|
Term
44.
what do t-cells do to mediate the symptoms of RA? |
|
Definition
-release RANKL, activating osteoclasts, and causing bony erosion
-activating cytokines that break down cartilage and bone
-activating cytokines that convert synovium into a pannus
-activate B-lymphocytes that form Rheumatoid Factor, depositing autoimmune complexes that degrade synovial tissue and articular cartilage |
|
|
Term
45.
what disease is associated with Bouchard and Heberden nodes? |
|
Definition
| Osteoarthritis-degredation of cartilage |
|
|
Term
45.
what is the cause of Bouchard and Heberden nodes? |
|
Definition
| Formation of calcific spurs of the aurticular cartilage in response to repeated trauma at the joint |
|
|
Term
45.
where are bouchard nodes located?
where are heberden nodes located? |
|
Definition
bouchard: proximal interphalangeal joint (PIPs)
heberden: distal interphalangeal joint (DIPs) |
|
|
Term
46.
what factors predispose to gout? |
|
Definition
Metabolic Syndrome
middle-older age
genetic predisposition
ETOH
obesity
thiazide diuretics
lead toxicity |
|
|
Term
46.
what enzyme leads to uric acid |
|
Definition
|
|
Term
46.
at high concentrations, uric acid crystallizes into monosodium urate. Where does this deposit, triggering a macrophage inflammatory response? |
|
Definition
|
|
Term
46.
What is the cause in primary gout? |
|
Definition
|
|
Term
46.
is there a known pathology in secondary gout? |
|
Definition
|
|
Term
46.
what are the stages of manifestation in gout? |
|
Definition
1. asymptomatic hyperuricemia- elevated levels of serum urate without S/S
2. acute gouty arthritis- flare ups
3.
tophaceous gout- chronic stage where tophi appear in cartilage, synovial membranes, tendons, and soft tissue |
|
|
Term
46.
what are the causes of manifestation in gout? |
|
Definition
1.Hyperuricemia
2.Single joint recurrent attacks
3.MU deposits (tophi) in and around joints
4.Renal disease that involves glomerular, tubular, and interstitial tissues and blood vessels
5.Renal stones |
|
|
Term
47.
what is the cause of increased ammonia levels?
what is the result? |
|
Definition
ammonia is a byproduct of protein digestion, converted to urea by liver, and excreted by kidney
-can cause hepatic encephalopathy-blood is not detoxified by liver but is shunted directly to the brain |
|
|
Term
48.
what happens when biliary channels are obstructed due to fibrosis and scarring? |
|
Definition
| results in portan HTN, blood shunted away from liver, and hypoxic necrosis |
|
|
Term
48.
vomiting of blood is a sign of what? |
|
Definition
| esophageal varices and portal hypertension |
|
|
Term
48./51.
how are RBCs related to jaundice? |
|
Definition
| destruction of RBCs causes increased bilirubin. if bilirubin levels are higher than conjugation ability of the liver, jaundice will result |
|
|
Term
49.
What tests need to be positive to diagnose with acute Hepatitis A infection? |
|
Definition
HAV
IgM
positive surface antigen |
|
|
Term
49.
what tests need to be positive to have Hep A immunity? |
|
Definition
|
|
Term
|
Definition
50.
Turner's sign
-bruising to flanks
poor prognosis associated with acute pancreatitis |
|
|
Term
50.
what is the likely cause of acute pancreatitis? |
|
Definition
obstruction of the outflow of enzymes in bile duct or pancreatic duct (gallstones
-chronic alcohol can also cause spasm of sphincter of Oddi, forming protein plugs |
|
|
Term
50.
what happens with chronic pancreatitis? |
|
Definition
repeated exacerbations of acute pancreatitis.
pancreatic parenchyma are destroyed and replaced by fibrous tissues, strictures, calcification, ductal obstruction, and pancreatic cysts
-can lead to pancreatic cancer
can lead to shock, MODS, SIRS |
|
|
Term
51.
with sickle cell anemia, how is hyperbilirubinemia result? |
|
Definition
hemolytic jaundice causes excessive lysis of RBCs
hepatocytes cannot conjugate and excrete bilirubin as rapidly as it is formed so bilirubin enters the bloodstream |
|
|
Term
52.
what is zollinger-ellison syndrome?
where is the source? |
|
Definition
gastrinomas secrete large amounts of the hormone gastrin, which causes your stomach to produce too much acid. The excess acid then leads to peptic ulcers, as well as to diarrhea and other symptoms.
-gastrinomas are in the duodenum or pancreas |
|
|
Term
53.
what are the clinical manifestations of GERD? |
|
Definition
heartburn from acid regurgitation, chronic cough, larygitis
upper abdominal pain within 1 hour of eating |
|
|
Term
53.
how is GERD diagnosed?
what can happen as a long-term effect from GERD? |
|
Definition
biopsy: indicates dysplastic changed
-Barret esophagus |
|
|
Term
54.
What is a serious implication with hematemesis? |
|
Definition
|
|
Term
54.
What is likely the cause of esophageal varices? |
|
Definition
|
|
Term
55.
What is one of the GI complications implicated in cystic fibrosis?
How? |
|
Definition
Pancreatic duct obstruction
-impaired Cl- ion channels
-resulting inspissation (DEHYDRATION) and precipitation of pancreatic secretions, causing obstruction of pancreatic ducts |
|
|
Term
56./58.
What is the bag of worms?
What can be a long-term effect? |
|
Definition
Varicocele- abnormal dilation of a vein within the spermatic cord
-left sided most common due to vein being at a right angle
-interferes with spermatogenesis, decreasing blood flow through the testis |
|
|
Term
57.
What is the term for a congenital bladder defect when the urethra opens on the dorsal surface of the penis? |
|
Definition
|
|
Term
57.
What is the term for a congenital bladder defect in females where there is a cleft along the ventral urethra extending to the bladder neck? |
|
Definition
Exstrophy of the bladder
-same congenital defect as epispadias, but expressed to a different degree |
|
|
Term
58.
Can androgen insensitivity cause male infertility? |
|
Definition
| Yes, results in dramatic phenotypic manifestations with genitalia |
|
|
Term
58.
What is the most common defect regarding male genitalia? |
|
Definition
|
|
Term
58.
What is cryptorchidism?
What is a correlated complication? |
|
Definition
Undescended testes.
-most individuals with bilateral testicular maldescent have poor fertility (treated OR untreated)
-correlated with male infertility |
|
|
Term
58
what is the long-term effect of testicular torsion? |
|
Definition
Permanent testicular malfunction can occur.
-surgery must be performed within 6 hours
-related to male infertility |
|
|
Term
58.
What is inflammation of the testis?
What are long-term effects? |
|
Definition
| Orchitis-atrophy with irreversible damage to spermatogenesis may result in 30% of affected cases. |
|
|
Term
58.
What is the term for inflammation of the epididymis?
What are long-term effects?
What are the causes? |
|
Definition
Epididymitis- can cause infertility
-caused by bacteria (chlamydia, gonorrhea)
-caused by urine backflow/inflammation |
|
|
Term
58.
What is the required sperm count for fertility? |
|
Definition
| A sperm count of 20 million sperm per milliliter of semen is minimum for fertility. |
|
|
Term
58.
What can antisperm antibodies result in? |
|
Definition
| Antisperm antibodies may be cytotoxic or sperm immobilizing. |
|
|
Term
59.
What is the most common cause of scrotal swelling? |
|
Definition
| Hydrocele- collection of fluid within the tunica vaginalis |
|
|
Term
59.
what is a secondary hydrocele? |
|
Definition
| Trauma or infection from a testicular tumor, where fluid accumulation is sudden |
|
|
Term
|
Definition
-relief of testicular pain with support
-be sure to get an ultrasound to confirm it is epididymitis rather than testicular torsion |
|
|
Term
60.
What is the most common site of HPV and cervical cancer?
What type of cells are here? |
|
Definition
The transformation zone of cervix
-site of columnar cells and squamous cells |
|
|
Term
60.
Cervical cytology is most accurate if cells are obtained from where? |
|
Definition
| BOTH the endocervix and ectocervix |
|
|
Term
61.
What are S/S of bacterial prostatitis? |
|
Definition
Narrow urinary stream (medical emergency!)
Sudden onset of malaise, back pain, perineal pain, dysuria, nocturia, retention
Fever (up to 104F), fatigue, arthralgia, and myalgia
Pelvic pain with standing |
|
|
Term
61.
Is foley cath contraindicated in bacterial prostatitis? |
|
Definition
|
|
Term
62.
What is the cause for dysmenorrhea?
How? |
|
Definition
Excessive endometrial prostaglandin production
-prostaglandins are potent vasoconstrictor causing hypercontractility, decreased blood flow to uterus, and increased nerve hypersensitivity |
|
|
Term
62
Is there pelvic disease associated with primary dysmenorrhea? |
|
Definition
|
|
Term
62.
Is there pelvic pathology associated with secondary dysmenorrhea:? |
|
Definition
Yes,
Ovarian cysts, endometriosis |
|
|
Term
62.
What is endometriosis? |
|
Definition
| Functioning endometrial tissue outside the uterus |
|
|
Term
62.
Does primary or secondary dysmenorrhea have up-regulated cyclo-oxygenase enzyme activity (COX)? |
|
Definition
| Both primary and secondary dysmenorrhea |
|
|
Term
63.
What effect does ovulation have on progesterone levels? |
|
Definition
Increases: Progesterone secreted by the corpus luteum stimulated thickened endometrium to become more complex in preparation for implantation of a blastocyst.
Implantation causes increased progesterone secretion |
|
|
Term
63.
Infertility patients should not take which drugs? |
|
Definition
| Drugs that inhibit prostaglandin synthesis: NSAIDS, ASA, steroids |
|
|
Term
63.
What are the roles of progesterone in pregnancy?
(6) |
|
Definition
Maintaining endometrium
Relaxing smooth muscle in myometrium
Thickening myometrium
Promoting growth of lobules and alveoli in breast
Preventing maturation of ove (suppress FSH and LH-stopping menses)
Modulate fetal antigens |
|
|
Term
64.
What is the leading cause of infertility in the US? |
|
Definition
| PCOS polycystic ovarian syndrome |
|
|
Term
64.
What is needed to diagnose PCOS? |
|
Definition
2 of the following:
-oligo-ovulation or anovulation
-elevated levels of androgens
-clinical signs of hyperandrogenism/ polycystic ovaries |
|
|
Term
64.
Are androgens or estrogens elevated in PCOS? |
|
Definition
|
|
Term
64.
What four body systems are implicated in PCOS? |
|
Definition
|
|
Term
66.
What does the Neuro system do in relation to autoregulation? |
|
Definition
| Cerebral autoregulation plays an important role in maintaining an appropriate blood flow. Brain perfusion is essential for life since the brain has a high metabolic demand. the body is able to deliver sufficient blood containing oxygen and nutrients to the brain tissue for this metabolic need, and remove CO2 and other waste products. |
|
|
Term
67.
What is asterixis and what is it associated with? |
|
Definition
Flapping tremor
-hepatic encephalopathy |
|
|
Term
67.
What are normal serum ammonia levels? |
|
Definition
|
|
Term
68.
What is required to diagnose hepatitis? |
|
Definition
Physical exam, labs, symptoms
Labs: AST, ALT
S/S: jaundice, abd pain, prodrome (anorexia, malaise, nausea, vomiting, headache, hyperalgia, cough, low-grade fever) |
|
|
Term
69.
What are liver transanimases? |
|
Definition
|
|
Term
70.
What hepatitis has a chronic, carrier state?
Hepatitis B, C, and D |
|
Definition
70.
What test helps determine a carrier state?
Hepatitis core antigen positive |
|
|
Term
71.
Hemolytic jaundice is due to what? |
|
Definition
Excessive destruction of RBCs,
Due to:
membrane defects
Hemolytic anemias
Immune reactions
Severe infection
Toxic substances in the circulation
Transfusion of incompatible blood |
|
|
Term
71.
What is the most common cause for pathologic jaundice?
How quickly does it appear? |
|
Definition
Hemolytic disease of the newborn is the most common cause
-within 24 hours after birth |
|
|
Term
71.
What is the deposition of toxins and unconjugated bilirubin in the brain? |
|
Definition
|
|
Term
72.
Which is more likely to cause severe cirrhosis, Hep A or Hep C? |
|
Definition
HAV often resolves on its own
HCV will lead to chronic and severe cirrhosis |
|
|
Term
72.
What is the association with alcoholic cirrhosis and HCV? |
|
Definition
Alcoholic cirrhosis is more severe when associated with HCV.
-caused by the toxic effects of alcohol metabolism on the liver, immunologic alterations, oxidative sress from lipid peroxidation, and malnutrition |
|
|
Term
72.
What is the most common cause of post-necrotic cirrhosis |
|
Definition
|
|
Term
73.
What is a common result of uncontrolled cholelithiasis? |
|
Definition
|
|
Term
73.
What are causes of cholesterol related gallstone formation? |
|
Definition
Enzyme defect: Increased cholesterol synthesis
Decreased secretion of bile acids to emulsify fats
Decreased resorption of bile salts from the ileum
Gallbladder smooth muscle hypomotility and stasis
Genetic predisposition
Combination of any or all of the above |
|
|
Term
73.
What are causes of pigmented gallstones? |
|
Definition
Black pigmented stones: Are formed in a sterile environment and are primarily composed of calcium bilirubinate polymer from hyperbilirubinbilia.
Brown stones: Are associated with bacterial infection of the bile ducts with formation of stone that is composed of calcium soaps, unconjugated bilirubin, cholesterol, fatty acids, and mucin |
|
|
Term
74.
What is the most common site for diverticulitis? |
|
Definition
|
|
Term
74.
What is the recommended prevention for diverticulitis?
Why? |
|
Definition
High fiber, low-residue diet
-reduces fecal bulk, reducing the diameter of the colon |
|
|
Term
75.
What is the most common surgical emergency of the abdomen? |
|
Definition
|
|
Term
76.
What does it mean when urethral gonococci infection in men are uncomplicated? |
|
Definition
| Most untreated gonoccal urethritis resolves spontaneously after several weeks (but infectious for 6mo.) |
|
|
Term
77.
What is the cause of pelvic inflammatory disease? |
|
Definition
Infection
-most commonly chlamydia and gonorrhea |
|
|
Term
|
Definition
| Inflammation of the fallopian tubes |
|
|
Term
|
Definition
| Inflammation of the ovaries |
|
|
Term
78.
What stage of syphilis is most severe? |
|
Definition
|
|
Term
78.
What are the stages of syphilis and explain each one |
|
Definition
Primary syphilis-site of bacterial infection
Secondary syphilis-systemic with spontaneous resolution of skin lesions
Latent syphilis- NO clinical manifestations
Tertiary syphilis- severe hypersensitivity reaction affecting heart valves, CNS, CSF |
|
|
Term
79.
According to the CDC, what is the most common STI in the US? |
|
Definition
|
|
Term
79.
What are condylomata acuminata?
What is the cause? |
|
Definition
Soft, skin colored whitish pink to reddish brown discrete growths (warts)
HPV |
|
|
Term
80.
Where does a dormant herpes virus remain during the latent stage? |
|
Definition
| The virus is transported intra-axonally to the dorsal root where it remains in a latent stage until it becomes reactivated. |
|
|
Term
81.
What effect does cirrhosis have on hormones? |
|
Definition
Increased levels of androgens (decreased breakdown) result in increased estradiol levels in cirrhosis
Results in gynecomastia, loss of body hair, menstrual dysfunction, spider angiomas, palmar erythema |
|
|
Term
82.
What is dumping syndrome? |
|
Definition
Rapid emptying after surgically created residual stomach
Early:10-20min
Late: 1-3 hours |
|
|
Term
82.
How is dumping syndrome best managed? |
|
Definition
| Managed best with diet, lots of fluids between meals, high protein/low carbs |
|
|
Term
83.
How is hepatitis B transmitted? |
|
Definition
Contact with infected blood, body fluids, and contaminated needles
Maternal transmission I 3rd trimester |
|
|
Term
83.
Post exposure prophylaxis for hepatitis B is provided by what? |
|
Definition
| Hepatitis B immunoglobulin from Hepatitis B vaccine |
|
|
Term
84.
What is a stress ulcer? |
|
Definition
| Peptic ulcer accompanying severe burns, head trauma, extreme stress |
|
|
Term
84.
Do stress ulcers become chronic? |
|
Definition
|
|
Term
84.
What is a cushing ulcer? |
|
Definition
| Ulcer caused by severe head trauma, brain surgery |
|
|
Term
84.
What is an ischemic ulcer? |
|
Definition
| Ulcer that develops within hours of event |
|
|
Term
84.
What is a curling ischemic ulcer? |
|
Definition
| Ulcer after a burn injury |
|
|
Term
|
Definition
| Deprivation of all nutrients |
|
|
Term
85
What is kwashiorkor?
What are a few manifestations? |
|
Definition
Loss of muscle mass with sustained body fat
-due to protein deprivation in the presence of carbohydrate intake
Subcutaneous fat, hepatomegaly, and fatty liver |
|
|
Term
86.
What is the major problem with Wilson disease?
Explain the causes |
|
Definition
Impaired copper metabolism
Autosomal recessive defect of copper metabolism causing toxic levels of copper to accumulate in the liver brain, kidneys, and corneas |
|
|
Term
86.
What are the clinical manifestations of Wilson disease? |
|
Definition
| Neuromuscular abnormalities, intention tremors, dysarthria (indistinct speech), dystonia (disordered muscular tonicity) |
|
|
Term
86.
What is the cure for Wilson disease? |
|
Definition
| Only cure is liver transplantation |
|
|
Term
87.
What is the blocking or narrowing of the opening between the stomach and duodenum? |
|
Definition
| Pyloric (gastric outlet) obstruction |
|
|
Term
87.
What are some manifestations of pyloric stenosis? |
|
Definition
Epigastric pain and fullness, nausea, succession splash, vomiting
If prolonged: malnutrition and dehydration |
|
|
Term
88.
What is the cause of chronic fundal gastritis? |
|
Definition
| Autoimmunity mediated by t-cells |
|
|
Term
88.
What is Type B chronic antral gastritis associated with? |
|
Definition
|
|
Term
88.
Type A chronic fundal gastritis is associated with autoimmunity mediated by t-cells. What cells are affected? |
|
Definition
| Autoantibodies to parietal cells and intrinsic factor, resulting in gastric atrophy and pernicious anemia |
|
|
Term
88.
Lack of parietal cells lead to what? |
|
Definition
| Pernicious (B12) anemia and megaloblastic anemia (B12 and/or Folic acid) |
|
|
Term
89.
What are the most common of the peptic ulcers? |
|
Definition
|
|
Term
89.
What are developmental factors that lead to duodenal ulcers? |
|
Definition
Increased numbers of parietal (acid-secreting) cells
High gastrin AND pepsin levels
Rapid gastric emptying
Acid production caused by cigarette smoking |
|
|
Term
89.
What relieves pain with a duodenal ulcers? |
|
Definition
| Eating (but only until the stomach starts to empty) |
|
|
Term
90.
What is the most common cause of pathologic jaundice? |
|
Definition
| Hemolytic disease of the newborn |
|
|
Term
90.
Is physiological jaundice normal for premature infants?
Why? |
|
Definition
| Yes, due to a lack of glucoronosyl transferase |
|
|
Term
91.
What is intussusception? |
|
Definition
Telescoping or invagination of one part of the intestine to another
-most common the ileum invaginating into the cecum |
|
|
Term
91.
How does stool appear in intussusception? |
|
Definition
|
|
Term
92.
What is the triad for cystic fibrosis? |
|
Definition
-pancreatic enzyme deficiency
-overproduction of mucus in the respiratory tract and inability to clear secretions which cause progressive chronic obstructive pulmonary disease
-abnormally elevated sodium and chloride concentrations in sweat |
|
|
Term
93.
What population is most at risk for hepatitis A? |
|
Definition
|
|
Term
93.
How is HAV transmitted? |
|
Definition
Fecal-oral route
-replication happens in liver leading to injury |
|
|
Term
93.
How is liver injury manifested in Hep A? |
|
Definition
-Direct cellular injury that elevates serum liver enzyme levels
-Cholestasis that causes jaundice and hyperbilirubinemia
-Inadequate liver function that lowers serum albumin levels and prolongs the prothrombin time |
|
|
Term
94.
What is the medical term for red blood cells of unequal size? |
|
Definition
|
|
Term
94.
Prior to iron deficiency anemia, how do cells often appear? |
|
Definition
| Normal size (there is a 3 month lag prior to manifestation of microcytic-hypochromic anemia) |
|
|
Term
94.
What is poikilocytosis? |
|
Definition
| Poikilocytosis means that some of the RBCs are abnormally shaped. There are many different abnormal shapes (burr, sickle, tear drop, elliptical). Many of these are also associated with anemia. |
|
|
Term
95.
What is the most common macrocytic anemia? |
|
Definition
|
|
Term
95.
Are neuro S/S reversible in pernicious anemia? |
|
Definition
|
|
Term
|
Definition
Scales and fissures of the lips and corners of the mouth
-r/t macrocytic anemia |
|
|
Term
95.
Iron metabolism, heme synthesis, and globin synthesis all regard what type of anemia? |
|
Definition
|
|
Term
95.
What is the most common anemia worldwide? |
|
Definition
|
|
Term
95.
What is the concern with iron deficiency anemia in children? |
|
Definition
|
|
Term
95.
what lab test is used to diagnose iron deficiency? |
|
Definition
| Low serum ferritin (MOST IMPORTANT LAB TEST TO MEASURE Fe) |
|
|
Term
95.
What is sideroblastic anemia? |
|
Definition
Defect in mitochondrial heme synthesis
-ringed sideroblasts in the bone marrow |
|
|
Term
95.
What is myelodysplastic syndrome? |
|
Definition
Recombinant human erythropoietin
-pancytopenia due to bone marrow production failure |
|
|
Term
95.
What is hemochromatosis? |
|
Definition
| Iron overload where iron clogs organs |
|
|
Term
96.
What is the test for pernicious anemia? |
|
Definition
|
|
Term
97.
What is the term for purple-colored spots and patches that occur on the skin, and in mucus membranes, including the lining of the mouth? |
|
Definition
|
|
Term
97.
What are small purpura less than 3mm? |
|
Definition
|
|
Term
97.
What are purpura spots larger than 1 cm? |
|
Definition
|
|
Term
97.
What are causes of nonthrombocytopenic purpuras? |
|
Definition
Amyloidosis
Blood clotting disorders
Congenital cytomegalovirus
Congenital rubella syndrome
Drugs that affect platelet function
Fragile blood vessels seen in older people (senile purpura)
Hemangioma
Inflammation of the blood vessels (vasculitis), such as Henoch-Schonlein purpura, which causes a raised type of purpura
Pressure changes that occur during vaginal childbirth
Scurvy
Steroid use |
|
|
Term
97.
What are causes of thrombocytopenic purpura? |
|
Definition
Idiopathic thrombocytopenic purpura
Immune neonatal thrombocytopenia
Meningococcemia
Drugs (heparin) |
|
|
Term
98
When do we order a CBC withOUT diff? |
|
Definition
NEVER. ALWAYS ORDER
CBC WITH DIFF |
|
|
Term
98.
What is included in the cbc with diff? |
|
Definition
Red blood cell count
White blood cell count
Platelet count
Hemoglobin
Hematocrit
RDW
MCV
MCH
MCHC
Neutrophils
Neutrophils, Absolute
Lymphocytes
Monocytes
Eosinophils
Basophils
Lymphocytes Absolute
Monocytes Absolute
Eosinophils Absolute
Basophils Absolute |
|
|
Term
99
How does nephrotic syndrome manifest differently in adults compared to children? |
|
Definition
| Adults have fat in urine, children do not. |
|
|
Term
99.
How does nephrotic syndrome manifest in BOTH adults and children |
|
Definition
| Proteinuria, hypoalbuminemia, hyperlipidemia, and edema |
|
|
Term
99.
What is the first sign of nephrotic syndrome? |
|
Definition
|
|
Term
19.
is iron deficiency anemia macrocytic or microcytic? |
|
Definition
|
|
Term
19.
what can iron deficiency anemia eventually develop into? |
|
Definition
|
|
Term
22.
mononucleosis is usually associated with Epstein barr in the younger population. what disease is often associated with mono in older adults? |
|
Definition
|
|
Term
24.
what is a complicated UTI? |
|
Definition
|
|
Term
26.
what are the clinical manifestations of glomerulonephritis? |
|
Definition
proteinuria
hypercholesterolemia |
|
|
Term
33.
people can be predisposed to avascular necrosis by use of what? |
|
Definition
steroids
long-term ETOH abuse |
|
|
Term
82.
late dumping syndrome can have what effect on glucose levels? |
|
Definition
| hypoglycemia-weakness, diaphoresis |
|
|
