Exam 2: Gero Lecture 6 PATHO

Question 1

GERD etiology

Answer 1

older age
meds
nicotine
obesity
hiatalehemia

Question 2

GERD CM

Answer 2

dysphagia
heartburn
epigastric pain
dry cough
water brash: increase spit
laryngitis
asthma attacks

Question 3

GERD patho

Answer 3

weakened LES/ increase intra- abd pressure
stomach contents reflex up to esophagus
acidic juices irritate epithelium and erosion
repeat injury causes metaplasia of epithelial cells
barrets esophagus: esophagus cancer

Question 4

OP etiology

Answer 4

primary: postmenopausal (lose estrogen)
secondary: other condition

Question 5

OP CM

Answer 5

decrease heigh
compression spinal FX
kyphosis
decrease bone mass measurements
pathologic FX

Question 6

OP patho

Answer 6

decrease estrogen
increase RANKL
bone reabsorption is greater than bone deposition
alter in bone microarchitecture
loss of bone mineralization
diminished bone mass and porous bone

Question 7

what is OP?

Answer 7

a metabolic bone disease resulting in a reduction in density in a reduction in density or mass of bone
bone becomes lacy and weak; decrease density

Question 8

what is OA?

Answer 8

a progressive destruction of cartilage in both synovial joints and vertebrae (bone rubbing bone)

Question 9

OA etiology

Answer 9

risk factors
secondary:
age
obesity
injury
repetitive trauma
primary: idiopathic

Question 10

OA CM

Answer 10

asymmetric joint pain
increase w activity
relieved by rest
heberdens nodes (DIP)
bouchards nodes (PIP)

Question 11

OA patho

Answer 11

loss of articular cartilage
inflam response
new bone form of joint margins (bone spurs)
subchondral bone changes
synovitis and thickening of joint capsule

Question 12

What is RA?

Answer 12

a chronic progressive systemic auto immune disease with inflam of joints and deformity

Question 13

RA etiology

Answer 13

unclear
higher in women
autoimmune
most common to: OA

Question 14

RA CM

Answer 14

symmetrical pain in small joints
swelling
warmth
erythema
anorexia/fatigue
ulnar drift
swan neck deform. (finger looks like swan neck)
boutonniere deform

Question 15

RA patho

Answer 15

B lymph activation
RA factors is form and binds w IgG
inflam response
enzyme destroy collagen
forms pannus (thick abnorm. layer of grandiose tissue)
destruction of cartilage and bone
RANKL increase
T lymph activation

Question 16

Hyperthyroidism (thyrotoxicosis) etiology

Answer 16

graves disease
autoimmune
disorder/type II hypersensitivity toxic multi-nodular goiter (not common)
toxic adenoma (lump on thyroid)

Question 17

Hyperthyroidism CM

Answer 17

weigh loss
nervousness
hyperactive reflexes
diaphoresis
tachycardia
increase SBP
expothalmus

Question 18

Hyperthyroidism patho

Answer 18

body produces TSI or gland enlarges
increase T3 and T4
neg feedback inhibition of pituitary TSH
low TSH more hormone secreted
high basal metabolic rate

Question 19

hypothyroidism etiology

Answer 19

congenital thyroid defects
autoimmune: Hashimoto disease (common)
surgical removal
thyroiditis

Question 20

hypothyroidism CM

Answer 20

fatigue
weight gain
constipation
delayed reflex
feels cold
sluggishness

Question 21

hypothyroidism patho

Answer 21

loss of thyroid function
decrease production of thyroid hormone (TH)
increase production of TSH
slow basal metabolism rate

Question 22

DMT2 etiology

Answer 22

exact etiology Unknown

risk factors: obesity and genetics

Question 23

DMT2 CM

Answer 23

polyuria
polydipsia
polyphagia
fatigue
pruritus
recurrent infection

Question 24

DMT2 patho

Answer 24

genetic:
decrease activity of amylin (co-secreted with insulin)
decrease beta cell mass function
hypoinsulinemia
increase glucagon

obesity:
decrease activity of ghrelin
insulin resistance
increase demand for insulin synthesis leads to hyperinsulinemia

HIGH BS

Question 25

Prostate CA etiology

Answer 25

dietary factors
hormones: androgen
chronic inflam
genetic factors: BRCA2

Question 26

prostate CA patho

Answer 26

> 95% are adenocarcinomas
norm/ semen secreting cells mutate to PSG/CIS to adenocarcinomas

Question 27

prostate CA CM

Answer 27

mainly asymptomatic –> screening with DRE and PSA is key
bladder outlet obstruction –> slow urine stream, hesitancy, incomplete bladder empty, frequency, nocturia, dysuria
back pain –> bone metastasis

Question 28

HTN silent killer etiology

Answer 28

primary: idiopathic
secondary: underlying disorder

Question 29

HTN CM

Answer 29

HA
fatigue
impaired vision
decrease urine output
dizzy
epistaxis
flushed face

Question 30

HTN patho

Answer 30

dysfunction of SNS, RAA, and natriuretic hormones (ANA and BNP)
renal Na+ and H2O retention –> inflam
increase blood vol
sustained HTN

dysfunction of SNS, RAA, and natriuretic hormones (ANA and BNP)
vasoconstriction –> obesity
increase peripheral resistance
sustained HTN

Question 31

LHF (CHF) etiology

Answer 31

increase RAAS = increase aldosterone pt at risk for hypokalemia

LUNGS

CAD: myocardial ischemia
MI
cardiomyopathy
HTN; pulmonary HTN
valve disease
CKD
anemia
hyperthyroidism: thyroid controls vasometabolism; severe tachycardia

Question 32

LHF (CHF) CM

Answer 32

dyspnea
orthopnea
frothy sputum
fatigue
decrease urine output
edema
abnormal heart sounds (s3 gallops)
pulmonary congestion

Question 33

LHF patho

Answer 33

decrease contracting cause SV to fall and LVEDV increase – dialation
kidney sense decrease in blood flow
activation of RAA
increase PVR
increase preload and after load

increase hydrostatic pressure into pulmonary system back up fluid
pulmonary edema

aortic pressure fall and systemic arterial pressure decreases
baroreceptors sense a decrease
activates SNS and hypothalamus releases ADH

Question 34

RHF etiology

Answer 34

rest of body

LHF
increase pulmonary vascular resistance
ARDS
COPD

Question 35

RHF cm

Answer 35

peripheral edema
ascites
JVD
hepatomegaly
nocturia
weight gain

Question 36

RHF patho

Answer 36

lung disease
increase pulmonary vascular resistance
increase force of RV contraction
increase RV o2 demand
decrease o2 supply
RV hypoxia
decrease force of RV contraction
increase RV preload
increase RA preload
edema