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Flashcards in Exam 2 Deck (157)
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1
Q
Hormones secreted by the anterior pituitary
A
ACTH, thyroid stimulating hormone (TSH), LH, FSH, prolactin, growth hormone, and melanocyte stimulating hormone (MSH)
2
Q
Hormones secreted by the posterior pituitary
A
Vasopressin (ADH), oxytocin
3
Q
Disorder of too much ADH
A
SIADH
-Hyponatremic
-hyperosmolarity
-hypervolemia/ wt gain
4
Q
Disorder of too little ADH
A
DI
-Polyuria, polydipsia
-UOP 8-12 L/day (norm 1-2)
-low urine specific gravity
-low urine osmolarity
-hypernatremia
5
Q
Too much GH
A
Gigantism- kids and adolescents
Acromegaly- adulthood
6
Q
Hypofunction of pituitary gland
A
*Panhypotituitarism (all hormones affected)
-ACTH deficiency- cortisol deficiency
-TSH deficiency-altered metabolism
-FSH and LH deficiency- lack of secondary sex characteristics
-GH deficiency- lack of growth in children
7
Q
DM type 1
A
Polyuria, polydipsia, polyphagia
Weight loss, fatigue
-Pancreatic atrophy and loss of beta cell function, no longer producing insulin
8
Q
DM type 2
A
Cells become insulin resistant
-fatigue, recurrent infections, visual changes, s/s of neuropathy
9
Q
Signs of hypoglycemia
A
tachycardia, palpitations, diaphoresis, tremors, pallor, arousal anxiety
10
Q
DKA
A
Polyuria, dehydration, kussmal respirations, sweet/fruity breath, glucose over 250, acidotic, urine ketones
-usually associated with type 1
11
Q
HHS
A
*emergency
-precipitated by infections, noncompliance of meds, usually type 2 DM
-glycosuria, polyuria, dehydration, coma
-glucose over 600
12
Q
Somogyi effect
A
hypoglycemia with rebound hyperglycemia
-usually type 1 and kids
-eat a high protein snack at night to prevent hypoglycemia
13
Q
Dawn phenomenon
A
early morning glucose elevation without nocturnal hypoglycemia
-increase nighttime insulin dose to peak during the morning
14
Q
Microvascular complications of DM
A
retinopathy, neuropathy, and nephropathy
15
Q
Macrovascular complications of DM
A
CAD, CVA, PAD, infection
16
Q
Hyperparathyroid
A
*increase in pth levels
-hypercalcemia, hyperphosphatemia, pathologic fractures
17
Q
Hypoparathyroid
A
*decrease in pth levels
-hypocalcemia, hypophosphatemia, muscle spasms, chvostek's sign (cheek), and trousseau sign (BP cuff)
18
Q
Addison's disease
A
adrenal insufficiency; low cortisol levels, elevated ACTH
-weakness, hyperpigmentation, vitiligo
19
Q
Cushing's
A
too much ACTH leads to excessive cortisol levels
-truncal (central) obesity, moon face, buffalo hump, na/h20 retention, glucose intolerance, purple striae, brown hyperpigmentation of skin
20
Q
Thyrotoxicosis
A
hyperthyroidism
-low TSH and high T3 and T4
21
Q
Grave's disease
A
hyperthyroidism
-increased metabolic rate, tachycardia, heat intolerance, weight loss, insomnia, palpitations, diarrhea, goiter, exopthalmus
22
Q
Thyrotoxic storm
A
rare and life threatening
-results from excessive stress, increased T3 and T4
-hyperthermia, tachycardia- esp atrial tachydysrhythmias, high output heart failure, delirium, nvd
23
Q
Hypothyroidism
A
-primary is iodine deficiency (most common worldwide)
-autoimmune thyroiditis (most common in US)
-congenital
-thyroid carcinoma
-secondary hypothyroidism
24
Q
Hypothyroidism (cont.)
A
-low basal metabolic rate, cold intolerance, lethargy, lower body temp, possible diastolic hypertension
-myexedema: non-pitting edema esp around eyes, hands, and feet, thickening of tongue
25
Q
Myxedema coma
A
*emergency
-diminished LOC, hypothermia without shivering, tachypnea, hypotension, hypolgycemia, lactic acidosis, coma
26
Q
Chromosomes
A
carries genetic information; 23 pairs of chromosomes
27
Q
Genes
A
tells body how to make proteins; responsible for inherited characteristics
28
Q
Allele
A
one of the possible forms of a gene (2 possible forms are dominant and recessive)
29
Q
Codon
A
a set of three adjacent nucleotides or a triplet that constitutes the genetic code for a particular amino acid that is to be added to a polypeptide chain in the synthesis of a protein
30
Q
Autosome
A
22 chromosome pairs in both males and females; not sex (X and Y)
31
Q
Genotype
A
the set of genes in our DNA that is responsible for a particular trait
32
Q
Phenotype
A
the physical characteristics of a trait
33
Q
Hemizygous
A
males, having only one X chromosome, are said to be hemizygous for genes on this chromosome.
-females are homozygous because they have 2 X chromosomes
34
Q
Transcription
A
the process of making an RNA copy of a DNA molecule
-gene splicing occurs (cleans it up to get ready for translation)
35
Q
Translation
A
RNA is decoded in a ribosome (site of protein synthesis) to produce a specific amino acid chain, or polypeptide.
36
Q
DNA
A
Cytosine (C), thymine (T), adenine (A), guanine (G)
A to T, C to G
37
Q
RNA
A
Cytosine (C), uracil (U), adenine (A), guanine (G)
A to U, C to G
38
Q
Mutation
A
any inherited alteration of genetic material
39
Q
Mutagens
A
are agents, such as radiation and chemicals, that increase the frequency of mutations
40
Q
Autosomal recessive inheritance
A
two copies of an abnormal gene must be present in order for the disease or trait to develop
41
Q
Turner syndrome
A
females only have one X chromosome
-absence of ovaries
-short stature
-webbing of the neck
-widely spaced nipples
42
Q
Klinefelter syndrome
A
Individuals with at least one Y and two X chromosomes
-male appearance, gynecomastia, small testes, sparse body hair
-treat with testosterone
-likelihood of disorder increases with mother's age
43
Q
Down syndrome
A
Trisomy 21
-mental challenges, low nasal bridge, epicathal folds, protruding tongue, flat/low set ears, poor muscle tone
-increased risk for congenital heart disease, respiratory infections, and leukemia
44
Q
Genetics of common diseases
A
CAD, htn, DM
45
Q
Alzheimer disease
A
produces amyloid plaques and neurofibrillary tangles
-risk doubles if you have a first-degree relative
46
Q
Alcoholism
A
risk is 3-5x higher in the individual with an alcoholic parent
-adoption studies- studies show it runs in genes rather than caregiver/environment
47
Q
Schizophrenia
A
recurrence risk among offspring of one affected parent is 10x higher than the gen population
48
Q
Bipolar affective disorder
A
also called manic depressive disorder
-risk rises 5-10% in an individual who has an affected first-degree relative as compared to normal, which is 0.5%
-genes that affect serotonin, dopamine, and noradrenaline systems have been implicated
49
Q
Dominance and recessiveness
A
If two alleles are found together, then the allele that is observable is dominant and the one whose effects are hidden is recessive
50
Q
Carrier
A
Has a disease allele but is phenotypically normal; can pass disease to offspring
51
Q
Autosomal aneuploidy
A
Aneuploidy is a somatic cell that does not contain a multiple of 23 chromosomes.
-Trisomy: cell contains 3 copies of one chromosome
-Monosomy: presence of only 1 copy of any chromosome (is often fatal)
52
Q
Deletions
A
chromosome breakage or loss of DNA
-ex: cri du chat syndrome; "cry of the cat"-low birth weight, mentally challenged, and microcephaly
53
Q
Duplications
A
excess genetic material; usually have less serious complications
54
Q
Inversion
A
chromosomal rearrangement in which a chromosome segment is inverted
-ABCDEFG becomes ABEDCFG
55
Q
Translocation
A
the interchange of genetic material between nonhomologous chromosomes
56
Q
Fragile sites
A
chromosome develops breaks and gaps when the cells are cultured in a folate-deficient medium
57
Q
Congenital malformations
A
congenital diseases present at birth; having other disorders along with the congenital disease is common
58
Q
Concordant traits
A
both members of a twin pair share a trait;
more genetic
59
Q
Discordant traits
A
A twin pair does not share a trait;
more environmental
60
Q
Polygenic trait s
A
effects of multiple genes cause the variations in traits
-focus is on the genes- usually many (poly) genes
61
Q
Multifactoral traits
A
environmental factors cause the variations in traits
62
Q
Quantitative traits
A
are measured on a continuous numeric scale
follows a normal bell curve for distribution
63
Q
Incidence Rate
A
the number of new cases of a disease reported during a specific period (typically 1 year) divided by the number of individuals in the population
64
Q
Prevalence Rate
A
the proportion of the population affected by a disease at a specific point in time; varies from population to population
65
Q
Epigenetics
A
are chemical modifications of DNA sequences that alter the expression of genes, resulting in disease and phenotypic variations
66
Q
DNA methylation
A
makes part of the gene silent or inactive
67
Q
Genomic imprinting
A
the process of gene silencing, in which genes are predictably silenced, depending on which parent transmits them
68
Q
Prader-Willi
A
inherited from dad
-abnormal pairs of the long arm of chromosome 15
-short stature, hypotonia, small hands/feet, obesity, mild mental retardation, hypogonadism
69
Q
Angleman syndrome
A
Same deletion of pairs from long arm of chromosome 15 as prader willi, but angleman is inherited from mom*
-severe mental retardation, seizures, ataxic gait
70
Q
Beckwith-Weidemann syndrome
A
overgrowth condition accompanied by an increased predisposition to cancer
-large for gestational age, neonatal hypoglycemia, large tongue
-uniparent disomy, affecting chromosome 11
71
Q
Russel-silver syndrome
A
undergrowth condition
-growth retardation, proportionate short stature, leg length discrepancy, small/triangular shaped face
72
Q
Layers of epidermis (from outermost to innermost)
A
-stratum corneum
-stratum lucidum
-stratum granulosm
-stratum spinosum
-stratum basale
73
Q
Langerhans cell
A
-migrate from epidermis to bone marrow
-immune defense against environmental triggers
-present antigens to T cells
74
Q
Merkel cells
A
-touch receptors on epidermis
-identifies stress occurring on skin
75
Q
Keratinocytes
A
-produce keratin
-promotes hydration of skin
76
Q
what is the dermis composed of?
A
elastin
collagen
reticulum
gel-like ground substance connective tissue
77
Q
Layers of the dermis
A
Papillary- hair follicles, sebaceous and sweat glands, blood/lymph vessels, mast cells (release histamine), macrophages

Reticular- histocytes and fibroblasts that help with wound healing
78
Q
Eccrine sweat glands
A
-in dermis
-thermoregulators through evaporation
-palms, soles, forehead
79
Q
Apocrine sweat glands
A
-stink!
-scalp, axilla, genitalia, face, abd
80
Q
Hypodermis
A
-deep, fatty layer of skin
-adipocytes and connective tissue
-veins and arteries run through this layer
81
Q
Staging pressure ulcers
A
1. nonblanchable
2. partial; epidermis and/or dermis
3. full thickness: subcutaneous
4. full thickness; muscle, bone
82
Q
atopic dermatitis
A
*eczema
severe pruritus- hallmark sign
eczematoid appearance with redness, edema, and scaling
83
Q
where does atopic dermatitis appear in infants?
A
scaly red lesions appear on face, scalp, trunk, extensor surfaces of arms/legs
84
Q
where does atopic dermatitis appear in children and adults?
A
neck, AC and popliteal fossa, hands, feet
85
Q
chronic eczema
A
-thick, leathery, hyperpigmented skin
-lichenification
86
Q
stasis dermatitis occurs as a result of?
A
venous stasis
edema
vascular trauma
87
Q
stasis dermatitis sequence of events
A
edema
erythema
pruritus
scaling
petechiae
hyperpigmentation
ulcerations
88
Q
seborrheic dermatitis involves what areas of the body?

is it constant or intermittent?
A
-chronic skin inflammation involving:
scalp
eyebrows
eyelids
nasolabial folds
axillae
chest
back

-periods of remission/exacerbation
89
Q
seborrheic dermatitis in infants
A
"cradle cap"
90
Q
psoriasis
A
-T cell autoimmune mediated skin disease
-cells do not have time to mature or keratinize
-systemic: arthritis and CV disease
91
Q
Lichen planus
A
-benign self limiting inflammatory disorder
-more prevalent during spring/fall
-may be linked to Hep C
92
Q
manifestations of Lichen Planus
A
-nonscaling flat papular violet-colored lesion
-pruritus on wrists, ankles, lower legs, and ginitals
-oral=white lacy rings
93
Q
acne vulgaris
A
-inflammatory disease of pilosebaceous follicles
-hypertrophy of sebaceous glands and telangiectasia
94
Q
acne rosacea
A
chronic immune mediated skin inflammation
easily exacerbated
95
Q
acne rosacea manifestations
A
-telangiectasia
-rhinophyma (bulbous nose)
96
Q
folliculitis
A
infection of hair follicles
S. aureus
pustules with erythema
97
Q
furuncle
A
*boil
inflammation from preceding folliculitis
follicular wall into surrounding dermis
S. aureus, MRSA
98
Q
carbuncle
A
collection of infected hair follicles
abscess can develop
erythematous, painful, drainage
99
Q
cellulitis definition, cause?
A
infection in dermis/subcutaneous
staphylococcus or GBS, MRSA
100
Q
erysipelas definition, cause?
A
superficial cellulitis
acute infection of upper dermis
streptococcus pyrogenes
face, ears, lower legs
101
Q
tinea cruris
A
jock itch
inner and upper surface of thighs
scaling vesicular patches, defined border
102
Q
tinea manus
A
hand
dry, scaly, erythematous OR moist vesicular lesions
clusters, intense itching
103
Q
HSV 1
A
infected saliva
cold sores/fever blisters
104
Q
HSV 2
A
genital infections
skin to skin contact during viral shedding
mother to neonate; high mortality
105
Q
varicella and herpes zoster
what kind of virus?
where does infection occur?
A
DNA virus
infection occurs within keratinocytes
contact, airborne precautions
106
Q
verrucae
cause?
transmission?
A
*warts
caused by HPV
transmitted by touch
107
Q
manifestations of verrucae
A
rough, grayish surface
108
Q
condylomate acuminata
A
venereal warts
sexually transmitted, highly contagious
oncogenic HPV primary cause of cervical cancer
109
Q
condylomate acuminata
A
veneral warts- very contagious
sexually transmitted
cauliflower like lesions
110
Q
kwashiorkor
A
protein deficient
1-4 years of age weaned from breast milk to high starch
can have leaky guy, inflammation, store fat in liver, pancreatic atrophy
111
Q
marasmus
A
deficient in all nutrients (protein, carbs)
younger than 1 year old
stunned growth, muscle/fat wasting, anemia, diarrhea, dermatosis, low Hgb
112
Q
gastrin
A
"stimulates secretion of gastric juice"
enhances relaxation of stomach
enhance peristalsis of stomach
113
Q
cholecystokinin
A
stimulates digestion of fat and protein
114
Q
D cells
A
somatostatin- inhibitory
decreases release of glucagon/insulin
slows gastric motility/perstalsis
115
Q
Kupffer cells
A
phagocytic cells
central to innate immunity
116
Q
stellate cells
A
remove foreign substances from blood
trap bacteria
117
Q
pit cells
A
natural killer cells
interferon y- tumor defense
118
Q
what stimulates pepsin?
what inactivates it?
A
acetylcholine stimulates

alkaline environment of duodenum inactivates
119
Q
what is saliva composed of?
A
water with mucous
sodium bicarb
potassium
chloride
salivary amylase

**has IgA**
120
Q
acute liver failure patho
A
hepatocytes become edematous, patchy areas of necrosis and inflammatory cell infiltrates disrupt the parenchyma
*hepatic necrosis irreversible
121
Q
acute liver failure s/s
A
anorexia, N/V, abd. pain, progressive jaundice
122
Q
consequences of portal HTN
A
varices
splenomegaly
hepatopulmonary syndrome
123
Q
MCC of ascites
A
cirrhosis
124
Q
hepatitis
A
autoimmune or viral inflammation of the liver
125
Q
phases of hepatitis
A
Prodromal: 2 weeks post exposure to jaundice
Icteric: jaundice phase
Recovery: when jaundice resolves
126
Q
manifestations of cirrhosis
A
nausea, anorexia, fever, abd pain, jaundice
127
Q
cirrhosis patho
A
-irreversible inflammatory fibrotic disease that disrupts liver function
-biliary channels blocked, causes portal HTN
128
Q
biliary cirrhosis
A
-begins in bile canaliculi and ducts
-primary: autoimmune- T lymphocyte mediated
-secondary: obstruction
129
Q
black pigmented cholelithiasis
A
form in gallbladder
chronic liver and hemolytic disease
130
Q
brown pigmented cholelithiasis
A
bacterial infection in bile ducts
bili stasis or bili parasites EW!
131
Q
manifestations of cholecystitis
A
inflamed gallbladder
- fever, leukocytosis, rebound tender, abd guarding
132
Q
pancreatitis patho
A
-damage to pancreatic cells and ducts that causes a leakage of pancreatic enzymes into pancreatic tissues
-the enzymes can leak into blood and cause injury to blood vessels and other organs
133
Q
chronic pancreatitis patho and manifestations
A
-destroyed acinar cells and islets of Langerhans
-pancreatic parenchyma destroyed
-s/s: may have continuous or intermittent abd pain
134
Q
intussusception
A
-telescoping or invagination of one part of the intestine to another
-MCC: ileum into cecum
135
Q
intussusception s/s
A
-abd pain
-vomiting soon after pain
-"currant jelly" stools (dark and gelatinous)
-infants: sausage shaped mass, colicky, flexes knees
136
Q
Hirschsprung disease
A
-obstruction of colon
-failure of neural crest cells to migrate to GI tract: "skipped segments"
137
Q
Hirschsprung disease manifestations
A
delayed meconium, poor feeding, poor weight gain, abd distention
138
Q
lower airways: pulmonary anatomy
A
trachea** who knew?!
bronchi
bronchioles
139
Q
carina
A
ridge where trachea divides into R and L bronchi
140
Q
hila
A
where R and L bronchi enters lungs
blood and lymph vessels
141
Q
goblet cells
A
produce mucous
142
Q
surfactant
A
lipoprotein that coats the inner surface of the alveolus
decreases surface tension which prevents collapse
143
Q
left shift oxyhgb dissociation curve
A
-Hgb increased affinity for O2
-alkalosis
-hypothermia
-hypocapnia (hyperventilation)
144
Q
right shift oxyhgb dissociation curve
A
-Hgb decreased affinity for O2
-acidosis
-hyperthermia
-hypercapnia (hypoventilation)
145
Q
emphysema patho
A
-abnormal permanent enlargement of the gas exchange airways
-destruction of alveolar walls without obvious fibrosis
-loss of elastic recoil
146
Q
primary emphysema?
secondary?
A
primary- deficiency of a1- antitrypsin

secondary- cigs, air pollution, childhood resp. infections
147
Q
emphysema manifestations
A
-thin
-dyspnea on exertion (may progress)
-little cough, little sputum
-tachypnea w prolonged expiration
-barrel chest
-tripod position
148
Q
Laryngotracheobronchitis
who?
when?
A
*croup
6 mo-3 years old
late autumn/winter
149
Q
causes of Laryngotracheobronchitis
A
commonly caused by a virus
-parainfluenza
-influenza A
-RSV
150
Q
manifestations of Laryngotracheobronchitis
A
usually after episode of rhinorrhea
sore throat
fever
seal like barking cough
hoarse voice
inspiratory stridor
151
Q
pulmonary edema patho?
MCC?
A
-excess water in the lung from disturbances of capillary hydrostatic pressure, capillary oncotic pressure, or capillary permeability
-MCC- L heart fail
152
Q
early asthmatic response
A
IgE causes mast cells to degranulate, releasing a large # of inflammatory mediators
-vasodilation
-increased cap. permeability
-bronchial smooth muscle contraction
-mucosal edema
153
Q
ARDS patho and manifestations
A
alveoli fill with fluid
-massive pulmonary inflammation
-increased cap. permeability
-pulmonary edema
-shunting
-V/Q mismatching
-hypoxemia
154
Q
manifestations of atelectasis
A
dyspnea
cough
fever
leukocytosis
155
Q
posterior pituitary- ADH
A
ADH
-controls plasma osmolality (ADH released when increased)
-causes water reabsorption in the kidneys
156
Q
too much ADH
A
SIADH
hyponatremia
hypoosmolality
urine hyperosmolality
hypervolemia
157
Q
too little ADH
A
DI (neuro, nephro, dipsogenic)
-inability of kidney to increase permeability to water
-3 P's
-inability to concentrate urine