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ADV. Human Phys > Test 4 Clinical Applications > Flashcards

Test 4 Clinical Applications Flashcards

1
Q

Cerebrovascular Accident:

  • Also called:
  • Define:
  • Two categories:
  • Ranks where in causes of death?
A 
- Also called:
Stroke
- Define:
Blood loss to brain
- Two categories:
Ischemic stroke (caused by blockage)
Hemorrhagic Stroke (caused by hemorrhage)
- Ranks where in causes of death?
3rd in the US
2nd in the world
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2
Q

Major risk factor for a cerebrovascular accident?

Other risk factors:

A 
Hypertension
Other risk factors:
Diabetes
atrial fibrillation
High blood cholesterol
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3
Q

Treatment for ischemic stroke:

A

Delivery of anticoagulants and antithrombolytic drugs

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4
Q

Excitotoxicity:

  • Is what?
  • How does it complicate stroke treatment?
A
  • Is what?
    Ischemia induced impairment of the removal of glutamate from synaptic cleft.
    Results in a build of Ca2+ through NMDA receptors causing neuronal death
  • How does it complicate stroke treatment?
    It increases in magnitude with the duration of ischemia, so antithrombolytics/anticoagulants must be delivered rapidly.
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5
Q

Atrial fibrillation:

- On a ECG:

A
  • On a ECG:

Missing P wave

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6
Q

Artificial Pacemaker:

  • Where is it inserted:
  • How does it work?
A
  • Where is it inserted:
    Implanted in the skin under the clavicle
  • How does it work?
    Electrodes from device are threaded into heart through a vein.
    Most sense if the heartbeat is delayed and stimulate the heart on demand.
    Some can even sense if you are exercising and increase cardiac rate accordingly.
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7
Q
  • Define:
    Swelling of arm or leg caused be excessive fluids and protein build up due to a blocked/damaged lymph drainage/vessel.
  • Complications:
    Protein rich interstitial fluid can lead to inflammation, damaging peripheral tissue
  • Causes:
    Damage from surgery or radiation therapy
    Infection of nematode worm causing elephantiasis (tropics)
A

Lymphedema:

  • Define:
  • Complications:
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8
Q

Injection of what is given to treat endometriosis?

A

GnRH analog, which given at a constant level instead of a pulsatile fashion will desensitize the anterior pituitary.

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9
Q

What do birth control pills contain?

How do they prevent contraception?

A

Synthetic progesterone and estrogen.
High levels of progesterone and estrogen simulate the luteal phase. A week spent of the pills mimics menstruation and allows shedding of buildup of stratum functionale which is seen in the luteal phase.
The patient will then be returned to pseudo-luteal phase by more synthetic progesterone and estrogen.

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10
Q

Low blood plasma conc.
- Relation to edema development?
This lowers oncotic pressue, as the plasma colloid osmotic pressure is less. This will result in less water returning into the capillaries, and more leaving

A

Hypoproteinemia:

- Relation to edema development?

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11
Q

Filariasis:

A

an infection by a nematode worm

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12
Q

Elephantiasis:

A

A complication of filariasis, where the nematode larvae occupy and block lymphatic vessels
This causes build up of interstitial fluid and EDEMA from inability to drain

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13
Q

Is Elephantiasis treatable?

Filariasis?

A

No.

Yes.

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14
Q

At what rate is water lost per hour through sweat?

A

900 ml (I doubt this matters)

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15
Q
  • Causes of failure during exercise related to dehydration:
  • Why is drinking water alone insufficient to restore rehydration?
  • What is better?
A
  • Causes of failure during exercise related to dehydration:
    Decreased cardiac output
    Inability to cool oneself
    Difficulty in oxygen flow
  • Why is drinking water alone insufficient to restore rehydration?
    Salts are also lost during sweating, water does not restore these
  • What is better?
    Electrolyte drink, such as a sports drink
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16
Q

Sal is Roman for what?

Gandhi encouraged people to make their own ____.

A

Salt

Salt

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17
Q

Angiotensin Converting Enzyme Inhibitors:

  • Do what?
  • Examples:
  • Treats:
A
  • Do what?
    Inhibit the conversion of Angiotensin 1 to angiotensin 2
    Lowers blood pressure by alleviating vasoconstriction
    Lower secretion of aldosterone by adrenal cortex
  • Examples:
    Captopril, enapril, and lisinopril
  • Treats:
    Hypertension, heart failure, stroke, and potential kidney failure
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18
Q

Angiotensin receptor blockers (ARBs):

  • Do what?
  • Examples:
  • Treats:
A
  • Do what?
    Inhibits binding of angiotensin 2 to its target sites
    Lowers blood pressure by alleviating vasoconstriction
    Lower secretion of aldosterone by adrenal cortex
  • Examples:
    Telmisartan, losartan, and valsartan
  • Treats:
    Hypertension, heart failure, stroke, and potential kidney failure
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19
Q

Essential hypertension:

A

Primary hypertension (hypertension without a known secondary cause)

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20
Q

In Vitro Fertilization is done by what method in this application:

A

Ovarian Hyperstimulation -> collect eggs -> intracyoplasmic sperm injection (ICSI) -> grow from 3 - 5 days (8 cell or blastocyst) -> transfer 3 or more embryos into uterus with a small tube

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21
Q

Ovarian Hyperstimulation:

A

Give FSH at high levels (or another gonadotropin, but this one is the most common)
->
Produces high number of eggs which can be collected

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22
Q

Intracytoplasmic sperm injection (ICSI)

A

insertion of a single capacitated sperm through zona pellucida and into the cytoplasm of an egg.

23
Q

Angiogram:

  • Define:
  • Meant to identify:
A 
- Define:
catheter is guided to spot of interest.
Iodine contrast material is injected is injected into blood
X-ray taken, with venous contrast increased
- Meant to identify:
Plaque
Atherosclerosis
Spasm
24
Q

Coronary angiogram is the primary method to assess what?

A

Coronary artery disease

25
Q

Coronary Angioplasty:

  • Used:
  • Common complication:
A
  • Used:
    tube with a balloon is inserted into artery and inflated to open it
  • Common complication:
    Restenosis (recurrence of narrowing)
26
Q

How is restenosis normally prevented in a coronary angioplasty?

A

Insertion of a stent (metallic mesh tube)

27
Q

Most common open heart surgery.

A vessel taken from the patient is grafted back onto the patient to bypass a block or troublesome area

A

Coronary bypass grafting (CABG):

28
Q

Orthostatic (postural) hypotension:

A

Hypotension which occurs upon standing

29
Q

Postprandial hypotension:

A

hypotension after eating a meal, most common in elderly individuals

30
Q

Orthostatic Hypotension is prevented by the baroreceptor reflexes, unless there is an underlying condition like:

A

Anything which causes low blood pressure.
Dehydration
Medications (beta adrenergic receptor blockers)
post-prandial hypotension

31
Q

Valsalva Maneuver:

A

Bearing down, as if having a bowel movement, while trying to exhale, while preventing exhaling (plugging nose)

32
Q

What does the Valsalva Maneuver do?

A

1: Intrathoracic pressure raises:
- Fall in atrial pressure
- Reduces pressure on baroreceptors
2: baroreceptor reflex
- Heart rate slows
3: Venous return
- There is a fall in venous return due to rise in intrathoracic pressure
4: baroreceptor reflex
- Increases heart rate (due to low venous return dropping pressure)
5: person again breathes
- Intrathoracic pressure falls
- Less pressure in the aorta briefly
6: baroreceptor reflex
- Increases heart rate (due to low venous return dropping pressure)
7: improved venous return
- Causes rise in aortic pressure
8: baroreceptor reflex
- Decreases heart rate

33
Q

When is Valsalva maneuver accidentally performed:

A

Weightlifters when they hold their breaths

Those straining at stools

34
Q

When is the Valsalva maneuver dangerous?

A

When someone has coronary heart disease

35
Q

Preclampsia:

  • Definitive symptoms:
  • Possible additional symptoms:
A 
- Definitive symptoms:
Hypertension onset during pregnancy
Damage to liver and kidney
- Possible additional symptoms:
Thrombocytopenia
Proteinurea (protein in urine)
36
Q

Preclampsia protein in urine:

  • cause:
  • consequences:
A 
- cause:
Damage to glomeruli, allowing protein to leak through
- consequences:
Low plasma conc. of proteins
Lower oncotic pressure
Edema
37
Q

Treatment for preclampsia:

A

Delivery of baby

38
Q

What may be the cause of preclampsia:

A

Dysfunction in the placenta involving vasoconstriction and hypoxia within uterus/placenta

39
Q

Crohn’s disease:

A

Can involve loss of proteins into the intestines

40
Q

What type of cell does HIV infect?

Which region is hit hardest?

A

CD4 T cell (helper T cells)

The gastrointestinal tract, where up to 30% of helper t cells reside

41
Q

What does loss of CD4 T cells (helper T cells) result in?

A

Reduction in Cell mediated immunity, which targets intracellular issues.
Increased risk of: cancer, opportunistic infections (especially tuberculosis, and other intracellular parasites)

42
Q

ART stands for (HINT: HIV related):

- Inhibits what enzyme?

A

Anti-Retroviral Therapy

Reverse transcriptase

43
Q

ART has what antiviral targets?

- Efficiency?

A

Two different reverse transcriptase inhibitors
One protease inhibitor
- Efficiency?
Can delay HIV indefinitely, but does not cure it

44
Q

What hope is there for HIV treatment?

A

Early ART intervention reduces risk of spread by 96%
Vaginal antiretroviral gels reduce transmission of HIV to women
Circumcision reduces risk a man will be infected with HIV
Vaccines against HIV may be possible. Utilizing passive immunity antibody treatments and designer antigens

45
Q

Sepsis:

  • Define:
  • Symptoms:
A 
- Define:
Whole body inflammation, usually caused by a bacterial infection
- Symptoms:
Organ dysfunction
Hypotension (mass scale vasodilation caused by histamine/NO/Seratonin)
Hypoxemia
Oliguria (low urine output)
Acidosis (due to lactic acid)
46
Q

Treatment of sepsis:

A

Antibiotics, intravenous fluids, and more aggressive measures when required

47
Q

Septic Shock:

A

Where blood pressure falls so all organs are not perfused due to an inflammatory response

48
Q

Endotoxin:

  • Other name:
  • Complication:
  • Bacteria type:
A
  • Other name:
    Lipopolysaccharide
  • Complication:
    Small amounts activate toll-like receptors, helping.
    Large amounts in circulation is the most common cause of sepsis
  • Bacteria type:
    Gram negative bacteria
49
Q

Glucocorticoid drugs:

  • Examples:
  • Use:
A
  • Examples:
    Hydrocortisone, cortisone, prednisone, prednisolone, and dexamethasone
  • Use:
    Suppress immune system to treat inflammation, autoimmune diseases, and allergies.
50
Q

Glucocorticoids:

- Specificity iin T cells:

A
  • Specificity in T cells:

Broadly inhibitory but enchance Th2 cells over Th1 cells, this shifts from cell-mediated to humoral immunity

51
Q

Glucocorticoids:

  • How do they work:
  • Cytokines suppressed have whatever functionality:
A
  • How do they work:
    Suppress pro-inflammatory cytokines (Interleukins, including IL-1, gamma interferon, and TNFalpha)
  • Cytokines suppressed have whatever functionality:
    cytokines promote Corticotropin-releasing hormone -> ACTH -> Cortisol
    Reduction of cytokines results in less CRH, and therefore less cortisol, making a negative feedback system between the nervous endocrine and immune system
52
Q

Glucocorticoids:

  • Cytokines suppressed have whatever functionality:
  • What cells produce the cytokines which these cytokines:
A
  • Cytokines suppressed have whatever functionality:
    cytokines promote Corticotropin-releasing hormone (hypothalamus) -> ACTH (anterior pituitary) -> Cortisol
    Reduction of cytokines results in less CRH, and therefore less cortisol, making a negative feedback system between the nervous endocrine and immune system
  • What cells produce the cytokines which these cytokines:
    Microglia
53
Q

NMDA stands for:

- Related to what disease?

A

N-methyl D-aspartate

Excitatory toxcitity, overstimulated by glutamate causing Ca2+ build up (it’s a Ca2= ion channel)

ADV. Human Phys (51 decks)

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