EXAM #$ (2-of-2) Flashcards
(26 cards)
- Acromegaly
a. Usually caused by a _____ tumor in the _____ gland called a _____ _____. The tumor produces too much _____ and raises the level of _____ in the blood.
- Acromegaly
a. Usually caused by a non-cancerous tumor in the pituitary gland called a pituitary adenoma. The tumor produces too much GH and raises the level of GH in the blood.
- Diabetes insipidus
a. _____ _____ (_____) deficiency
i. Causes:
ii. Excessive _____
iii. Increased serum _____ levels
iv. _____
- Diabetes insipidus
a. Antidiuretic Hormone (ADH) deficiency
i. Causes:
ii. Excessive urination
iii. Increased serum sodium levels
iv. Thirst
- Cretinism/Myxedema
a. _____
i. In _____ – Cretinism
1. Impaired development of _____ and _____ system
2. Severe mental _____
3. _____ stature
ii. In _____ – Myxedema
1. Generalized _____
2. _____ sluggishness
- Cretinism/Myxedema
a. Hypothyroidism
i. In infancy or early childhood – Cretinism
1. Impaired development of skeletal and CNS system
2. Severe mental retardation
3. Short stature
ii. In Adulthood – Myxedema
1. Generalized apathy
2. Mental sluggishness
- Graves Disease
a. Classic triad
i. Thyrotoxicosis – diffuse hyperplasia of gland
ii. Ophthalmopathy with exophthalmos
iii. Localized dermopathy (over shins)
iv. Peak incidence __-__
v. More common in _____
vi. _____ disease (to _____ receptor)
- Graves Disease
a. Classic triad
i. Thyrotoxicosis – diffuse hyperplasia of gland
ii. Ophthalmopathy with exophthalmos
iii. Localized dermopathy (over shins)
iv. Peak incidence 20-40
v. More common in women
vi. Autoimmune disease (to TSH receptor)
- Goiter
a. Compensatory enlargement of the _____
b. Occurs as _____ or _____ form
c. Degree of enlargement is proportional to degree of _____
d. _____ form – in geographic areas that are deficient in iodine
e. _____ form – occurs with increased physiologic demand for thyroid hormone
f. _____ levels can vary
i. _____ _____ – when hyperthyroidism occurs
- Goiter
a. Compensatory enlargement of the thyroid
b. Occurs as diffuse or multi-nodular form
c. Degree of enlargement is proportional to degree of deficiency
d. Endemic form – in geographic areas that are deficient in iodine
e. Sporadic form – occurs with increased physiologic demand for thyroid hormone
f. Hormone levels can vary
i. Plummer Syndrome – when hyperthyroidism occurs
- Hyper-/Hypoparathyroidism
a. Causes
i. _____ ablation (thyroidectomy)
ii. _____ absence (DiGeorge)
iii. _____ hypoparathyroidism
b. Causes – _____
c. Symptoms:
i. Increased _____ _____
ii. _____ _____
- Hyper-/Hypoparathyroidism
a. Causes
i. Surgical ablation (thyroidectomy)
ii. Congenital absence (DiGeorge)
iii. Autoimmune hypoparathyroidism
b. Causes – hypocalcium
c. Symptoms:
i. Increased neuromuscular irritability
ii. Cardiac arrhythmias
- Cushing Syndrome
a. A.k.a. _____
b. Usually develops _____
c. Appearance:
i. Centripetal distribution of _____ tissue
ii. _____ _____
iii. _____ _____
d. Hyperglycemia/other symptoms of diabetes
e. Loss of _____ – thin, fragile skin
f. _____
- Cushing Syndrome
a. A.k.a. Hypercortisolism
b. Usually develops gradually
c. Appearance:
i. Centripetal distribution of adipose tissue
ii. Moon face
iii. Buffalo hump
d. Hyperglycemia/other symptoms of diabetes
e. Loss of collagen – thin, fragile skin
f. Osteoporosis
- Conn Syndrome
a. _____
i. Cause _____ _____ and _____ _____
ii. Conn Syndrome – _____ secreting adenoma
iii. Symptoms:
1. _____
2. _____
- Conn Syndrome
a. Hyperaldosteronism
i. Cause sodium retention and potassium excretion
ii. Conn Syndrome – aldosterone secreting adenoma
iii. Symptoms:
1. Hypertension
2. Hypokalemia
- Diabetes mellitus
a. Group of metabolic disorders leading to _____
b. Caused by defects in _____ _____, _____ _____ or both
c. Affects __% of US population
d. Leading cause of end-stage _____ disease, _____, and non-traumatic lower extremity _____
- Diabetes mellitus
a. Group of metabolic disorders leading to hyperglycemia
b. Caused by defects in insulin secretion, insulin action or both
c. Affects 7% of US population
d. Leading cause of end-stage renal disease, blindness, and non-traumatic lower extremity amputation
a. Hyperparathyroidism:
i. Causes increase in serum ionized _____
ii. Symptoms:
1. Painful bones – weakens bones can cause _____
2. Renal stones – excess _____ in urine
3. Abdominal groans – constipation, nausea, peptic ulcers, gall stones
4. Psychic moans – _____, _____ and _____
iii. Primary:
1. Adenoma – __-__%
2. Hyperplasia – __-__%
3. Carcinoma – less than __%
iv. Secondary:
1. Conditions that suppress serum _____ levels
a. Hyperparathyroidism:
i. Causes increase in serum ionized calcium
ii. Symptoms:
1. Painful bones – weakens bones can cause fractures
2. Renal stones – excess calcium in urine
3. Abdominal groans – constipation, nausea, peptic ulcers, gall stones
4. Psychic moans – depression, lethargy and seizures
iii. Primary:
1. Adenoma – 75-80%
2. Hyperplasia – 10-15%
3. Carcinoma – less than 5%
iv. Secondary:
1. Conditions that suppress serum calcium levels
- Thyroid Nodules/Thyroid tumors
a. Thyroid Nodules:
i. _____ – more likely to be neoplastic
ii. In _____ patients - more likely to be neoplastic
iii. In _____ - more likely to be neoplastic
iv. Radiation treatment – increases incidence of thyroid _____
v. Nodules that take up radioactive iodine – more likely to be _____
- Thyroid Nodules/Thyroid tumors
a. Thyroid Nodules:
i. Solitary – more likely to be neoplastic
ii. In younger patients - more likely to be neoplastic
iii. In males - more likely to be neoplastic
iv. Radiation treatment – increases incidence of thyroid malignancy
v. Nodules that take up radioactive iodine – more likely to be benign
- Islet Cell tumors
a. Insulinomas
i. Most common
ii. Cause significant _____
b. Gastrinomas
i. Hyper secretion of _____
ii. Common affect – _____ ulcers
iii. Zollinger-Ellison Syndrome – hypergastrinemia from _____ or _____ tumors
- Islet Cell tumors
a. Insulinomas
i. Most common
ii. Cause significant hypoglycemia
b. Gastrinomas
i. Hyper secretion of gastrin
ii. Common affect – peptic ulcers
iii. Zollinger-Ellison Syndrome – hypergastrinemia from pancreatic or duodenal tumors
- Pheochromocytoma
a. Tumor composed of _____ cells
b. Malignancy determined by presence of absence of _____
c. Produce _____
d. Give rise to _____
i. _____ onset
ii. Associated with tachycardia, palpitations, headache, sweating, tremor and sense of apprehension
- Pheochromocytoma
a. Tumor composed of chromaffin cells
b. Malignancy determined by presence of absence of metastasis
c. Produce catecholamines
d. Give rise to Hypertension
i. Abrupt onset
ii. Associated with tachycardia, palpitations, headache, sweating, tremor and sense of apprehension
- Hydrocephalus
a. Accumulation of _____ in the _____ system
b. _____ produced by choroid plexus in _____, circulates into _____ space; absorbed by _____ _____
c. Causes – most commonly
d. Obstruction of _____
e. Impaired _____ by granulations
f. Affects:
i. _____ sutures fuse – enlargement of head
ii. _____ sutures fuse – Increase in intracranial pressure
g. Types:
i. _____ – localized obstruction; parts of ventricle(s) enlarge
ii. _____ – entire ventricular system expands
iii. _____ – enlargement of ventricles due to loss of brain tissue
- Hydrocephalus
a. Accumulation of excessive CSF in the ventricular system
b. CSF produced by choroid plexus in ventricles, circulates into subarachnoid space; absorbed by arachnoid granulations
c. Causes – most commonly
d. Obstruction of flow
e. Impaired resorption by granulations
f. Affects:
i. Before sutures fuse – enlargement of head
ii. After sutures fuse – Increase in intracranial pressure
g. Types:
i. Non-communicating – localized obstruction; parts of ventricle(s) enlarge
ii. Communicating – entire ventricular system expands
iii. Hydrocephalus ex vacuo – enlargement of ventricles due to loss of brain tissue
- Herniation
a. Occurs when the brain _____ beyond the limits of the cranial vault
b. Leads to _____ to affected areas; _____ and increased swelling/herniation
c. Types defined by which anatomic structures are involved:
i. _____– unilateral/asymmetric herniation under the edge of the falx cerebri
ii. _____ – temporal lobe against free margin of the tentorium cerebelli; compresses the third cranial nerve – get dilatation of pupils
iii. _____ – displacement of cerebellar tonsils through the foramen magnum; usually life threatening; compromises respiratory center of brain
- Herniation
a. Occurs when the brain expands (swells) beyond the limits of the cranial vault
b. Leads to ischemia to affected areas; infarction and increased swelling/herniation
c. Types defined by which anatomic structures are involved:
i. Subfalcine (cingulate) – unilateral/asymmetric herniation under the edge of the falx cerebri
ii. Transtentorial (uncinate) – temporal lobe against free margin of the tentorium cerebelli; compresses the third cranial nerve – get dilatation of pupils
iii. Tonsillar – displacement of cerebellar tonsils through the foramen magnum; usually life threatening; compromises respiratory center of brain
- Subarachnoid hemorrhage
a. Most common cause – rupture of _____
b. __-__% die with first rupture
c. Some recover
- Subarachnoid hemorrhage
a. Most common cause – rupture of saccular (berry) aneurysm
b. 25-50% die with first rupture
c. Some recover
- Epidural hematoma
a. Results from damage usually of middle _____ artery which run within the dura
b. Because it is _____ damage – accumulated rapidly
c. May represent _____ emergency
d. Usually occurs with _____ injuries – i.e. skull fractures
- Epidural hematoma
a. Results from damage usually of middle meningeal artery which run within the dura
b. Because it is arterial damage – accumulated rapidly
c. May represent neurosurgical emergency
d. Usually occurs with penetrating injuries – i.e. skull fractures
- Subdural hematoma
a. Occurs from trauma to the _____ that run from _____ through _____ space and _____ space to empty to _____ sinuses
b. Usually manifest within first 48 hours after injury
- Subdural hematoma
a. Occurs from trauma to the veins that run from cerebrum through subarachnoid space and subdural space to empty to dural sinuses
b. Usually manifest within first 48 hours after injury
- Gliomas
a. Are primary _____ _____
b. Types:
c. _____ – develop from astrocytes in brain; clinical presentation depends on grade of tumor; low grade lesions may progress slowly
d. Highest grade – _____- poor prognosis
e. _____ – evolve more slowly; patients may have years of symptoms, often seizures, have better prognosis than astrocytomas
f. _____ – usually arise from lining of ventricular system, location determines symptoms, usually even better prognosis
- Gliomas
a. Are primary brain malignancies
b. Types:
c. Astrocytomas – develop from astrocytes in brain; clinical presentation depends on grade of tumor; low grade lesions may progress slowly
d. Highest grade – Glioblastoma- poor prognosis
e. Oligodendogliomas – evolve more slowly; patients may have years of symptoms, often seizures, have better prognosis than astrocytomas
f. Ependymomas – usually arise from lining of ventricular system, location determines symptoms, usually even better prognosis
- Menigioma
a. Predominantly _____ _____
b. Usually attached to the _____
c. Can be on _____ surface of brain or in _____ system
- Menigioma
a. Predominantly benign tumors
b. Usually attached to the dura
c. Can be on outer surface of brain or in ventricular system
- Multiple sclerosis
a. Autoimmune _____ disorder
b. Presents as episodes of _____ deficits
c. Most common of the _____ disorders
d. Can present at any age – _____ or >__ presentation is rare
e. Women are __X as likely to develop disease
f. Develop plaques in _____ matter of brain
i. _____ plaques –have inflammation
ii. _____ plaques – no inflammation
- Multiple sclerosis
a. Autoimmune demyelinating disorder
b. Presents as episodes of neurologic deficits
c. Most common of the demyelinating disorders
d. Can present at any age – childhood or >50 presentation is rare
e. Women are 2X as likely to develop disease
f. Develop plaques in white matter of brain
i. Active plaques –have inflammation
ii. Inactive plaques – no inflammation
- Parkisonism
a. Any condition that causes a combination of the movement abnormalities seen in Parkinson’s disease — such as _____, _____ movement, impaired _____ or muscle _____ — especially resulting from the loss of _____-containing nerve cells (neurons)
- Parkisonism
a. Any condition that causes a combination of the movement abnormalities seen in Parkinson’s disease — such as tremor, slow movement, impaired speech or muscle stiffness — especially resulting from the loss of dopamine-containing nerve cells (neurons)
- Huntington disease
a. Inherited _____ dominant disease
b. Characterized by progressive movement disorders (_____, hyperkinetic movements involving all of body – chorea) and dementia
c. Pathologically – grossly – small, _____ brain, microscopically _____ of neurons and scarring
d. Age of onset – __th or __th decades of life
e. Motor symptoms usually _____ cognitive impairment
- Huntington disease
a. Inherited autosomal dominant disease
b. Characterized by progressive movement disorders (jerky, hyperkinetic movements involving all of body – chorea) and dementia
c. Pathologically – grossly – small, atrophic brain, microscopically loss of neurons and scarring
d. Age of onset – 4th or 5th decades of life
e. Motor symptoms usually precede cognitive impairment
- Mengiomyelocele/meningocele
A baby with meningomyelocele is born with the _____ _____ exposed. A sac on the baby’s mid to lower back may cover the exposed _____ _____.
- Mengiomyelocele/meningocele
A baby with meningomyelocele is born with the spinal cord exposed. A sac on the baby’s mid to lower back may cover the exposed spinal cord.
