Block 9 Flashcards
(187 cards)
1
Q
Epidemiology is
A
Where and when a disease takes place. Looks at the number of people affected
2
Q
Etiology is
A
The underlying cause
3
Q
Pathogenesis is
A
The disease process
4
Q
Pathology is
A
The study of disease, especially changes in tissues/cells
5
Q
Idiopathic
A
Unknown cause
6
Q
Iatrogenic
A
Caused by medical professional or medical procedure
7
Q
Nosocomial
A
Infection acquired from hospital
8
Q
Diagnosis
A
Describe the patients disease based on signs and symptoms and tests
9
Q
Signs
A
Objective evidence, you see it in the office i.e BP, vomiting
10
Q
Symptoms
A
Subjective evidence, the patient reports them
11
Q
What are some extrinsic factors
A
Biological
Chemical
Physical
Nutritional
12
Q
What are som intrinsic factors
A
Genetic
Congenital
Immunological
Psychological
13
Q
Acute
A
Rapid onset, short duration, not severe
14
Q
Chronic
A
Lasts longer than 3 months
15
Q
Subacute
A
Period between acute and chronic
16
Q
What are the top 5 preventable killer diseases in the US
A
- Heart disease
- Cancer
- Stroke
- T2DM
- Obesity
17
Q
Normal values are from this percent of the population
A
95%
18
Q
Pathophysiology
A
Functional changes that accompany a particular disease or syndrome
19
Q
We are able to cure/prevent _/10 preventable disease
A
7/10
20
Q
Index case
A
First identified case in a group of related cases
21
Q
Mortality
A
Death
22
Q
Morbidity
A
Rate of having a disease
23
Q
Epidemic
A
Abrupt and unexpected increase in the incidence of disease over endemic rates
24
Q
Endemic
A
Disease that has relatively stable and expected incidence and prevalence within a certain geographical area
25
Pandemic
Spread of a disease beyond continental boundaries
26
Incidence
Number of new cases
27
Prevalence
Total number of cases
28
Horizontal transmission
Direct/indirect contact
| This is the normal transmission of a disease
29
Vertical transmission
Form of direct transmission
| From mother to fetus
30
Cross sectional study looks at
Data from population to assess frequency of diseases at particular time
Prevalence
31
Case control study looks at
Effect then cause
Compare sick and healthy people
Looks for prior exposure risks
Starts with the disease
32
Cohort study looks at
Cause then effect
Compares a group with a given exposure risk to a group without exposure
Starts with exposure
33
Positive predictive value equation
TP/ (TP+FP)
34
Negative predictive value equation
TN/ (TN+ FN)
35
Sensitivity
Likelihood that a stick person tests positive
36
Specificity
Likelihood that a healthy person test negative
37
Sensitivity equation
TP/ (TP+ FN)
38
Specificity equation
TN/ (TN+FP)
39
+- 1 SD represents this % of the population
68%
40
+-2 SD represents this % of population
95%
41
What are 3 factors that determine a normal range
Age
Gender
Location
42
What is normal FBG and HgA1c
<100 mg/dL
| <5.7%
43
Pre-diabetes FBG and HgA1c
100-125 mg/dL
| 5.7-6.4%
44
Diabetes FBG DNA HgA1c
>126 mg/dL
| >6.5%
45
What 2 things diagnose diabetes
FBG >126
| A random BG level of 200
46
ALT/AST look at
Liver damage
47
Bilirubin indicates
Liver failure
48
What is the best enzyme to monitor the liver
ALT
49
Where are ALT and AST found
Hepatocytes
50
Where is ALP found
Liver ducts
51
What system does a Comprehensive Metabolic Panel look at a Basic Metabolic Panel does not?
Liver
52
What are the cardiac biomarkers
Myoglobin
CPK
Troponin
53
What molecule is most indicative of heart attack or heart damage
Troponin
54
Total cholesterol norm
<200 mg/dL
55
HDL is _____ cholesterol
Good
56
HDL does this
Transports cholesterol to the liver
57
HDL norm
>40
58
LDL is ___ cholesterol
Bad
59
LDL does this
Deposits cholesterol in vascular walls
60
LDL norm
<100
61
What is a test that is used to look at inflammation
Erythrocyte sedimentation rate
62
What is the normal SED rate value
0-20 mm/hr
63
What clotting factors are Vit K dependent
2, 7, 9, 10
64
Warfarin inhibits what clotting factor
7
65
Heparin inhibits what clotting factor
2 and 10A
66
What test is used to monitor warfarin treatment
TP
67
What test is used to monitor Heparin treatment
PTT
68
Neutrophils indicate
Bacterial infection
69
Lymphocytes indicate
Viral infection
70
Eosinophils indicate
Allergies, parasitic infection
71
Anemia is
Low HGB and HCT
72
What is the normal hemoglobin for women
<12
73
What is the normal hemoglobin for males
<13.5
74
A HGB level of 7 or 10 indicates what treatment is needed
Transfusion and hospital
75
Microcytic anemia has a MCV value of
<80
76
What is the most common form of anemia (microcytic)
Iron deficiency
77
What is the MCV value for macrocytic anemia
>110
78
What is a form of macrocytic anemia
B12 deficiency
79
What is the most common test to screen for syphillis
RPR
80
What test is used to confirm syphillis
FTA/ABS
81
What substances in the urine indicate a UTI
Leukocyte esterase
Blood
Nitrate
Proteins
82
Glucose in the urine indicates
Diabetes
83
Specific gravity of urine indicates
Hydration
84
Bilirubin in urine indicates
Hepatic function
85
T/F CT penetrate soft tissue
True
86
Is CT or X-ray more sensitive
CT
87
MRI uses this to make an image
Magnetic fields and radio waves
88
T/F MRI can penetrate soft tissues
True
89
Ultrasound uses this to make an image
Sound waves
90
Nuclear imaging uses this to make an image
Radioactive material
91
When are you concerned about fatigue?
When it is persistent
92
When are you concenerned about weight loss?
When it is non-intentional
93
What is chronic fatigue syndrome associated with
Epstein Barr Virus
94
What is a high grade fever
Higher than 103 degrees F
95
What is a moderate fever
102 F
96
What is a low grade fever? How do you treat it?
Less than 101, you let it run the course
97
What are pro inflammatory cytokines
IL1, and NFa
98
What are anti-inflammatory cytokines
IL 4
99
What are the criteria for FUO
- Illness of 3 weeks
- temp over 101 F
- failure to diagnose after 3 outpatient visits
100
What are the 3 most common causes of FUO
Infection
Neoplasms
Autoimmune
101
What are criteria that ALWAYS indicate a serious headache etiology
Visual loss
Disequilibrium
Confusion/lethargy
New onset seizures
102
Who do migraines affect
Young women (20-30 yo)
103
What is the presentation of a migraine headache
Throbbing, pulsatile, unilateral, 4-72 hours
104
Who do tension headaches affect
All ages and genders
105
What is the presentation of a tension headache
Late in the day
Work week
Worse with stress (can precede a migraine)
Band like distribution
106
Who do cluster headaches affect
Middle aged men (30-50 yo)
107
What is the presentation of cluster headaches
Unilateral
Smokers/drinkers
1-2 attaches per day
Presents with red eyes and nasal stuffiness
May cause transient ipsilateral Horner's syndrome
108
Who do giant cell arteritis affect
Patients over 60
109
What is giant cell arteritis
Inflammation of the medium and large arteries
May cause blindess
110
Why should you give steroids for GCA?
To bring down the inflammation
111
What does FAST mean for Stroke
Face: paralyzed?
Arms: can hold arms out parallel to ground
Speech: slurred?
Time: get them to the hospital
112
What are some mechanisms of cell injury?
Free radical formation
Hypoxia and ATP depletion
Disruption of intracellular Ca homeostasis
Membrane damage
113
How do free radicals damage our bodies?
Damage cell membranes
| Damage nucleic acids
114
Free radicals are key to multiple complications in this disease
Diabetes
115
Fat soluble vitamins
D A K E
116
What are the most toxic fat soluble vitamins?
A and D
117
What is ATP depletion
<5-10% normal levels
118
What affect does hypoxia and ATP depletion have on the cell
Na/K pump
Cell metabolism
Protein synthesis
119
Any stress in the body produces what substance?
Lactic acid
120
If you decrease Ca what are activated
ATPases
Phosphatases
Proteases
Endonucleases
121
What are some things that cause membrane damage
```
Increase cytosolic Ca
Loss of membrane phospholipids
Cytoskeleton damage
Reactive oxygen species
Lipid breakdown
```
122
What are some reversible cell damages
```
Atrophy
Hypertrophic
Hyperplasia
Metaplasia
Dysphasia
```
123
What does -trophy mean?
Nourish
124
What are irreversible cell damage responses
Cell death
125
What is neoplasia?
| Can it be reversed?
Cancer, it cannot be reversed?
126
What is hyperplasia
Change in cell number
127
What is metaplasia
Change in cell types
128
What is dysphasia?
Abnormal cells
129
What are atrophy and hypertrophy a change in
Change in cell size
130
In Metaplasia you replace what?
A normal Mature cell type with a different mature cell type
131
What cells are more likely to become cancer cells
Dysphasia
132
What is atrophy
Shrinking in cell size
133
What causes atrophy
```
Lack of use/innervation
Low Blood supply
Bad nutrition
Loss of endocrine stimulation
Again
Pressure
```
134
What is a natural atrophy that happens in the body?
The thymus
| Huge in children and smaller in adults
135
What is hypertrophy
Increase in cell size, NOT number
136
What are some things that cause hypertrophy
Increased functional demand
Body builders (muscle fibers)
Breasts in pregnancy
Heart (hypertension, faulty valves)
137
What is hyperplasia
Increase in cell number
| Usually results in increased tissue volume
138
What are some examples of hyperplasia
Uterus and breast (pregnancy)
Connective tissue in wound healing
Benign prostatic hyperplasia
Skin warts
Gingival hyperplasia
139
T/F metaplasia may transform into malignancy
True
140
Is metaplasia reversible?
Yes
141
What is dysplasia
Abnormal cell growth. Changes in size, shape, and organization
142
Is dysplasia reversible?
It can be
143
What is dysplasia strongly implicated as a precursor to ?
Cancer
144
What are some endogenous products that accumulate intracellular lay
Normal body substances
| Abnormal products from inside the body
145
What are some exogenous products that can accumulate intracellularly
Environmental agents
| Pigments
146
What is bilirubin
An endogenous product
| Product of hemoglobin metabolism
147
What clears bilirubin
Liver
148
What is hepatitis
Liver inflammation
149
What are some symptoms of hepatitis?
- Increased bilirubin
- Jaundice/icterus in all body tissues
- Protein production ceases
- Can be Induced by acetaminophen
150
What is argyria?
Cause by exogenous product
Cosmetic condition that is caused by prolonged ingestion of silver salts
Blue discoloration in the skin
151
What is significant about calcifications
It is an abnormal deposition of calcium
| Deposits in dead or dying tissue, causes organ dysfunction
152
What is necrosis
Messy lysis of dead cells within living tissue
Huge inflammatory response
153
What is apoptosis
Programmed cell death without inflammatory response
| Cell shrinks, membrane blebs
154
What is the process of necrosis
1. Membrane damage
2. Lysosomal enzymes leak into cytoplasm
3. Cell and organelles swell
4. Cellular components leak out of the cell
5. Inflammatory response
155
What are exudates and how are they formed
Necrosis produces inflammation, the inflamed vessels leak fluid and cells, very cloudy
156
What is the protein content of exudates
High
| >1020
157
What are transudates and how are they formed
Fluid is pushed through capillary due to pressure.
| Clear
158
What is the protein content of transudate
Low
| <1012
159
What are the cells present in acute inflammation
Neutrophils
Mast cells
Platelets
Basophils
160
What are the cells present in a Chronic inflammation
B/T lymphocytes
Macrophages
Plasma cells
Antibodies
161
Look at slide 52
Apoptosis vs necrosis chart
162
What are factors that affect aging
Genetics
Diet
Diseases
Werners syndrome
163
What are the cellular mechanisms of aging
- cross linked DNA and proteins
- accumulation of toxic by-products
- aging genes
- Loss of repair mechanisms
- telomere shortens
164
What changes occur with again
- Gradual atrophy of tissues and organs
- dementia
- loss of skin elasticity
- CV damage
- loss of lens elasticity
165
What are som e factors that increase aging
```
Steve
Infections
Diseases
Malnutrition
Accidents
Toxins
```
166
What are some factors that decreases aging
Decreased stress
| Good health, nutrient, oral health, exercise
167
What does an accumulation of copper cause
Kayser-Fleischer rings
168
What are Kayser-Fleischer rings indicative of?
Is it treatable?
Wilson's disease
Yes
169
What enzyme is defective in Wilson's disease
What are some side effects
Ceruloplasm
Psychiatric issues
170
What layer of the cornea is affected by Wilson's Disease
Descemet's membrane
171
T/F argyria is permanent
True
172
What can calcium deposits cause?
Hard Knots in the body
| Neck and heart
173
What do sudden increases or decreases in atmospheric pressure cause?
Blast injuries
Decompression sickness
Caisson disease (bleeding eyes)
174
Caissons is caused by what pressure movement?
High to low
175
Necrosis is associated with what?
Inflammation
176
T/F necrosis is bad for healing
True
177
T/F apoptosis is bad for healin
False, it is a normal process
178
T/F the cell membrane stays in tact until it is phagocytized in apoptosis?
True
179
Apoptosis is beneficial
| Necrosis is detrimental
Know this
180
If you add dilute acetic acid solution to an unknown fluid and there is a lot of precipitate, what does this tell you?
What kind of fluid is this?
There is a lot of protein
It is an exudate
181
Calor and dolor are often often associated with
Acute
182
Granulomas are a sign of what kind of inflammation
Chronic
183
What is a granuloma? What is it composed of?
It is dead material and active macrophages(epithelioid cells) at its center and surrounded by lymphocytes
184
NEUTROPHILS: ________ inflammation
Acute
185
MACROPHAGES (EPITHELIODS) AND LYMPHOCYTES: ______ inflammation
Chronic
186
Apoptosis is very controlled
Yes
187
What are telomeres?
They are the end cap of a chromosome that shorten every time a cell duplicates
