Block 1 Flashcards by Emily Raynor

Disease occurrence and spread

Where and when

Epidemiology

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The underlying cause

- infectious, idiopathic, iatrogenic

Etiology

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Formal name to describe a pt’s disease

Diagnosis

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Made based on signs, symptoms and results of diagnostic tests

Diagnosis

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Unknown cause or source

Idiopathic

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Source of disease is medical professional or procedure

Iatrogenic

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Infectious disease that is acquired from a hospital-type setting

Nosocomial

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Referring to the disease process

Pathogenesis

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The study of disease, especially changes in cells/tissues/organs that cause or are caused by disease

Pathology

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Something that you measure

Sign

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Something the patient tells you

Symptom

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Bridges basic sciences and medicine

Pathology

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Etiological factors from the outside

Extrinsic

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Examples of extrinsic etiological factors

Biological
Chemical
Physical
Nutritional

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Etiological factors that come from within

Intrinsic factors

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Examples of intrinsic etiological factors

Genetic
Congenital
Immunological
Psychological

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Rapid onset and short duration

- no necessarily severe

Acute

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Disease that is lasting for >/= 3 months

Chronic

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Ill defined time between acute and chronic

Subacute

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How many diseases can be cured?

7 out of 10

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List in order the leading causes of death in Americans

Heart disease
Cancer
Stroke
Type 2 DM
Obesity

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What are the 4 phases of disease

Latency
Prodrome
Clinical symptoms
Recovery

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What is the latency period

Quiet phase

- no/few signs/symptoms

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What is prodrome

Symptoms start

- usually ‘flu-like’ are most common

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What are different outcomes of disease

Death Recovery - complete or incomplete recovery

Deaths per 100,00

Mortality

Illnesses per 100,000

Morbidity

And abrupt and unexpected increase in the incidence of disease over endemic rates

Epidemic

Has a relatively stable and expected incidence and prevalence within a geographic area

Endemic disease

Spread of disease beyond continental boundaries

Pandemic

Looks at new or newly diagnosed cases

Incidence

Looks at all current cases alive

Prevalence

Transmission to surrounding people/strangers

Horizontal

Transmission to fetus or to baby through breast milk

Vertical

What happens to incidence and prevalence if: | -new effective treatment ins initiated

Prevalence dec | Incidence constant

What happens to incidence and prevalence if: | - new effective vaccine gains widespread used

Both incidence and prevalence dec

What happens to incidence and prevalence if: | - number of deaths from the condition decline

Prevalence inc | Incidence constant

What happens to incidence and prevalence if: | - recovery is more rapid than it was 1 year ago

Prevalence dec | Incidence constant

Collects data from a population to assess frequency of disease at a particular point in time

Cross sectional study

Study referring to "what's happening"

Cross-sectional study

Study that measures disease prevalence

Cross-sectional study

Compares a group of people with disease to a group without disease - looks for prior exposure or risk factor

Case-control study

Refers to "what happened" | - from effect to cause

Case-control study

Study that measures odds ratio | - starts with disease

Case-control study

Compares a group with a given exposure or risk factor to a group without such exposure - looks to see if exposure affects the likelihood of disease

Cohort study

Refers to "who gets it" | - from cause to effect

Cohort study

Study that measures relative risk | - starts with exposure

Cohort study

Common measurements about the disease

Sensitivity or specificity

Common measurements about the test

Positive predictive value and negative predictive value

True positive rate

Sensitivity

True negative rate

Specificity

Likelihood that a positive test is found only in sick people | - true and false POSITIVES

Positive predictive value (PPV)

Likelihood that a negative test is found only in non-sick people - true and false NEGATIVE

Negative predictive value (NPV)

Formula for sensitivity

TP/(TP+FN)

Formula for specificity

TN/(TN+FP)

Formula for positive predictive value

TP/(TP+FP)

Formula for negative predictive value

TN/(TN+FN)

High prevalence does what to positive predictive value

Improves

Low prevalence does what to positive predictive value

Harms

Likelihood a sick person will test positive

Sensitivity

Likelihood a positive test identifies a sick person

Positive predictive value

What is the percentage of a normal population that is included in 1SD

68%

What is the percentage of a normal population that is included in 2SD

95%

3 things that affect normal reference ranges

Age Geographical location Gender

What happens at a higher altitude

Lower oxygen | Higher RBC

What must be low to be anemic

Hemoglobin AND hematocrit

Normal fasting blood glucose (FBG) levels

60-100 mg/dL

FBGL threshold

126 mg/dL

HbA1c level indicating diabetes

>/= 6.5%

Normal HbA1c value

<5.7%

Gold standard for diagnosing diabetes

HbA1c of >/= 6.5%

Reflects 2-3 month glucose average

HbA1c

Found only 2 hours after meal

Fasting blood glucose level

Liver tests dealing with INJURY/DAMAGE

ALT and AST

Liver test dealing with FUNCTION

Bilirubin

What levels are affected if there is a loss of liver function

HIGH bilirubin

What comes first, liver damage or loss of liver function

Liver damage

What levels help estimate GFR

BUN and creatinine

Dialysis or transplant when at this level

GFR <15

See nephrologist is GFR is at what level

<30

Most specific biomarker for heart

Troponin

Which cholesterol is the good one

HDL-C

Which cholesterol is the bad one

LDL-C

Goal for total cholesterol

<200

Goal of HDL-C

>40

Goal for LDL-C

<100

Goal for triglycerides

<150

Transports cholesterol to liver

HDL-C

Deposits cholesterol into vascular walls

LDL-C

Which metabolic panel looks at liver function, CMP or BMP

CMP

Which metabolic panel measures cardiac function, BMP or CMP

Neither

3 most common lab tests

CMP CDC Urinalysis

Levels of HGB and HCT in anemia

BOTH will be low

What level is checked to determine the type of anemia

MCV (size of RBC)

the primary indicators of inflammation

ESR and CRP

High ESR suggests

Inflammation

Vitamin K dependent factors

2, 7, 9 and 10

Which is ULTRA vit K dependent

Vitamin K antagonist

Coumadin

Coumadin hits what factor mainly

Coumadin is monitored with

PT/INR

PT/INR measures which pathway

Tissue factor pathway | Extrinsic path

Antithrombin activator

Heparin

Targets 10 mainly and also 2

Heparin

Heparin is monitored with

aPTT

aPTT measures which path

Contact factor pathway | Intrinsic path

Most common serious bleeding disorder

Hemophilia A

Absence of factor 8

Hemophilia A

Hemophilia A is monitored by

aPTT

Neutrophilia may suggest

Bacterial source

Lymphocytosis may suggest

Viral source

Eosinophilia suggests

Allergies or worms

How are the values of hematocrit and hemoglobin related

HGB x 3 = hematocrit

Is RBC low in anemia? HGM and HCT?

Not always HGM and HCT are always low

HGB levels in women

<12 g/dL

HGB levels in men

<13.5 g/dL

If 7 g/dL or less, what needs to be done

Transfusion

When transfusing, how do you determine how many units of blood to give

Enough to reach 10 g/dL

MCV value in microcytic anemia

<80

MCV value in normocytic anemia

80-100

MCV value in macrocytic anemia

>110

Iron deficiency anemia

Microcytic anemia

Recent blood loss or renal failure are related to which anemia

Normocytic anemia

Vit B12 deficiency or Folic acid deficiency are related to which anemia

Macrocytic anemia

Which anemia will have low RBC

Normocytic and macrocytic anemia

Which anemia will have normal to high RBC

Microcytic anemia

Most common cause of anemia

Iron deficiency

Most common screening test for syphilis

RPR

Is RPR specific and sensitive for syphilis

Sensitive but not specific

What tests confirm syphilis

FTA-ABS or MHA-TP

Can syphilis be seen on a gram stain

How is lupus confirmed

Anti-dsDNA and anti-Sm

How are autoimmune conditions screened

ANA

Best indicator for UTI

Leukocyte esterase

What will also likely be seen in UTI

Blood, protein and nitrite

Least valuable test for imaging soft tissue

X-ray

Penetrate soft tissue but not dense tissue

X-ray

Multiple angle X-ray | - can image soft tissue

CT scan

Uses magnetic fields/radio waves | - image areas where soft and tissues meet

MRI

Uses sound waves to image various tissues

Ultrasound

Uses radioactive material to produce image

Nuclear scan

Indicates current or recent infection (acute)

IgM

Indicated past infection (convalescent)

IgG

Indicates allergy

IgE

Antibody found in tears, sweat and breast milk

IgA

2 test used to SCREEN for syphilis

RPR and VDRL

When do providers become concerned with fatigue

When it becomes persistent

When do providers tend to become concerned with weight loss

When the loss is unexplained/unintentional

Top 2 proinflammatory cytokines

IL-1 and TNF-alpha

Threshold for a high temperature in the morning

99 degree

Threshold for a high temperature in the evening

100 degrees

Low grade fever in kids and adults

= 101 degrees

Moderate fever in kids and adults

102

High grade fever in kids and adults

>/= 103 degrees

High grade fever in newborns

99 degrees

3 criteria for defining fever of unknown origin

- illness of at least 3 weeks - temperature > 101 on several occasions - failure to diagnosis after 3 visits

Top 3 causes of fever of unknown origin

Infection Neoplasms Autoimmune disorders

Most common cause of FUO

Infection

Headache warning signs indicating a serious etiology

- Visual loss - disequilibrium - confusion/lethargy - new onset seizure

Headache typically affecting young women

Migraine

Headache typically affecting all ages and both genders

Tension

Headache typically affecting middle aged men

Cluster

Headache typically affecting patients over 60

Temporal arteritis/giant cell arteritis

HA lasting 4-72 hours, throbbing, unilateral and aggravated by physical activity and light

Migraine

HA late in the day, may precede a migraine, and has a BAND LIKE DISTRIBUTION

Tension

HA that wakes people up, last less than an hour 1-2 times a day, in smoker/drinkers, orbital or temporal

Cluster

"Killer HA"

Cluster

HA presents with red eyes and or nasal stuffiness

Cluster

HA may cause transient or permanent ipsilateral horner's syndrome

Cluster

Horner's syndrome

Ptosis, miosis (small pupil), and anhydrosis

If GCA (giant cell arteritis) is suspected, therapy with what should be immediately initiated

Prednisone (steroid)

Acronym for stroke victims

FAST

For stroke: f stands for

Face paralyzed?

For stroke: A stands for

Arms - can they be held out

For stroke: S stands for

Speech slurred?

For stroke: T stands for

Time is critical - get to hospital quickly

4 mechanisms of cell injury

- free radical formation - hypoxia and ATP depletion (<5-10% normal ATP levels) - disruption of intracellular Ca homeostasis - membrane damage

How is free radical injury a key to multiple diabetes-related complications

Oxidative modification of proteins | - forming protein-protein cross linkages

How does free radical injury cause a BP disruption

Damage nuclei acid

5 mechanisms that can cause membrane damage

- inc cytosolic Ca - loss of membrane phospholipids - cytoskeleton damage - reactive oxygen species - lipid breakdown products

Indicator of significant body damage

Lactic acid

Fat soluble vitamins

D A K E

Most toxic fat soluble vitamin

A | - polar bear liver

Smaller cell size

Atrophy

Bigger cell size

Hypertrophy

Increase in number of cells

Hyperplasia

Change in cell TYPE | - One mature cell type is replaced by another mature cell type

Metaplasia

Abnormal cell growth that vary in size, shape and organization

Dysphasia

Atrophy is most often due to

Lack of use Aging Pressure Lack of blood

Physiological example of hypertrophy

- Bodybuilder | - breasts in prego ladies

Pathological example of hypertrophy

Hypertension or faulty valves in heart

Caused by increased functional demand or specific hormonal stimulation

Hypertrophy

Physiology example of hyperplasia

Uterine and breast growth during pregnancy

Pathologic example of hyperplasia

Benign prostatic hyperplasia

Metaplasia is common in who

Smokers

Precursor of cancer

Dypslasia

tests to test liver FUNCTION

Bilirubin, PT/INR, fibrinogen, and albumin

Liver inflammation

Hepatitis

Bilirubin levels in hepatitis

Increased

What is often seen in all body tissues due to hepatitis

Jaundice

Hepatitis can be induced by

Acetaminophen

Wilson's disease

Copper deposits in descemets mem

Key sign in Wilson's disease

Kayser-fleischer rings

How to treat Wilson's disease

Zinc

What happens to protein production in hepatitis

It STOPS

Prolonged infection of silver salts | - blue discoloration

Argyria

Intracellular accumulations of normal substances in abnormal amounts

Endogenous products

Is bilirubin accumulation endo or exogenous

Endogenous

Is silver accumulation endo or exogenous

Exogenous

Intracellular accumulations of environmental agents and pigments

Exogenous products

Messy lysis of dead cells

Necrosis

Programmed cell death

Apoptosis

Which has inflammation, necrosis or apoptosis

Necrosis

Is there membrane damage in necrosis

Yes

What happens to cell and organelles in necrosis

They swell

What happens to the cell in apoptosis

It shrinks

If there are high protein levels in fluid

Exudates

If there are low protein levels in fluid

Transudate

Cloudy/pus

Exudates

Clear fluid

Transudate

Cells in acute inflammation

Neutrophils

Cells in chronic inflammation

Lymphocytes and macrophages

Sign of chronic inflammation

Granulomas | - macrophages and dead material surrounded by a rim of lymphocytes

Produced when inflamed vessels leak fluid and cells

Exudates

Produced when fluid is pushed through capillary due to high pressure

Transudate

Biological clock is associated with what structure

Telomere shortening

Cellular mechanisms of aging

- cross-linked DNA and proteins - accumulation of toxic byproducts - aging genes - loss of repairing - telomere shortening

Process of deterioration with age | - los of cells power of division and growth

Senescence

Werner's syn

Pangeria

Premature aging after puberty with short stature | - Benjamin button

Pangeria

Block 1 Flashcards

(230 cards)