Exam 3

Question 1

Sequence of blood flow through the nephron

Answer 1

1. Abdominal aorta
2. Renal arteries (right and left)
3. Hilus (where it enters thru)
4. Afferent arteriole
5. Glomerulus (filters blood)
6. Proximal convoluted tubule
7. Loop of henle
8. Distal convoluted tubule
9. Efferent arteriole
10. Peritubular capillary
11. Renal veins
12. Inferior vena cava

Question 2

Negative feedback system for blood glucose concentration rises

Answer 2

1. Normal glucose concentration
2. Blood glucose concentration rises
3. Pancreas secretes more insulin and less glucagon
4. Cells remove glicose from blood and convert to glycogen
5. Blood glucose falls
6. Normal glucose concentration

Question 3

Negative feedback system for blood glucose concentration falls

Answer 3

1. Normal glucose concentration
2. Blood glucose concentration falls
3. Pancreas secretes less inulin and more glucagon
4. Cells convert glycogen to glucose and release it into the blood
5. Blood glucose rises
6. Normal glucose concentration

Question 4

Menstrual cycle

The endometrium sloughs off, accompanied by 1 to 2 oz of blood loss

Answer 4

Day 1-5 The menstrual phase

Question 5

Menstrual cycle

Estrogen is released from the maturing graafian follicle.
This estrogen causes vascularization of the uterine lining

Answer 5

day 6-13 Preovulatory phase

Question 6

Menstrual cycle

The anterior pituitary gland releases luteinizing hormone, which causes the rupture of the graafian follicle and release of the mature ovum

Answer 6

Day 14

Question 7

Menstrual cycle

The developing corpus luteum releases estrogen and progesterone. The corpus luteum shrinks and replaced by scar tissue called corpus albicans. At this point the hormone level decreases over several days and menstruation starts again

Answer 7

Day 15-28

Postovulatory phase

Question 8

S/S hypoglycemia

Answer 8

Low blood sugar

1. Faintness
2. Sudden weakness
3. Excessive perspiration
4. Irritability
5. Hunger
6. Palpitation
7. Trembling
8. Drowsiness
9. Sometimes mimic stroke

Question 9

Target organ of glucocorticoids

Answer 9

Anterior lobe of the pituitary gland

Question 10

Are secreted by the middle zone ( zona fasciculata). Exhibit anti- inflammatory properties.

Answer 10

Glucocorticoids

Question 11

Involved in glucose metabolism and provides extra reserve energy in times of stress

Answer 11

Cortisol

Question 12

Interventions performed with caution to arm post radical mastectomy

Answer 12

1. Elevate on pillow with hand and wrist higher than the elbow and the elbow higher than the shoulder joint. This facilitates the flow of fluids through the lymph node and venous routes and prevent lymphedema ( accumulation of lymph in soft tissue)
2. Not have any procedures involving the arm on the affected side
   - b/p
   - injections
   - iv infusion of fluids
   - blood draw
3. Avoid lifting heavy objects w/ effected arm for 6 to 8 weeks
4. Avoid sleeping on the involve arm

Question 13

Involves the developing the muscles of the perineum to improve voluntary control over voiding. In preparation for the removal of urethral catheter, the health care provider may order a clamp- unclamp routine to improve bladder tone.

Answer 13

Bladder training

Question 14

Tighten the muscles of the perineal floor. The patient develop awareness of the appropriate muscle group by trying to stop the flow of urine during voiding. Once the patient has identified the correct muscles and the feeling of their contraction, direct her to tighten the muscles of the perineum, hold for 10 seconds, and then relax for 10 seconds, building to groups of 20, 4 times a day.

Answer 14

Kegel exercise

Pubococcygeal exercise

Question 15

Establish a voiding schedule. Monitor the patient’s voiding for a few days to identify patterns, or schedule voiding times to correlate with the patient’s activities. Typical voiding times are on arising, before each meal, and at bedtime. Modify the schedule until continence is established.

Answer 15

Habit training

Question 16

Severe generalized edema, weight loss is evident. When questioned about his or her diet, the patient reports anorexia. Activity intolerance and fatique are reported. Urine is foamy

Answer 16

Anasarca

Question 17

The excess glucose accumulates in the blood stream, greater than normal amounts of glucose in the blood

Answer 17

Hyperglycemia

Question 18

Excess urination

Answer 18

Polyuria

Question 19

Abnormal presence of a sugar, especially glucose, in the urine

Answer 19

Glycosuria

Question 20

Increased hunger and consumption of food

Answer 20

Polyphagia

Question 21

Acidosis accompanied by an accumulation of ketones in the blood ( formerly called diabetic coma)

Answer 21

Diabetic ketoacidosis

Question 22

An overproduction of somatotropin ( growth hormone GH) after the onset of puberty. a condition that affects an estimated 6 people per 100,000. The cause may either 1. Idiopathic hyperplasia (in increase in the number of cells, without a known cause) of the anterior lobe of the pituitary gland or 2. Tumor growth. Unfortunately, growth changes that occur in acromegaly are irreversible, even with adequate medical or surgical intervention.

Answer 22

Acromegaly

Question 23

Usually results from an oversecretion of GH before the onset of puberty, as a result of hyperplasia of the anterior pituitary. The hyperplastic tissue may develop into a tumor. Another possible cause is a defect in the hypothalamus that directs the anterior pituitary to release excessive GH

Answer 23

Gigantism

Question 24

The condition may cause by genetic mutations; GH deficiency; and other unknown causes. is a condition caused by deficiency in GH. Most causes are idiopathic, but a smaller number can be attributed to an autosomal recessive trait. In some causes the patients lack ACTH, TSH, and ganodtropins

Answer 24

Dwarfism

Question 25

Butterfly shaped, with one lobe lying on either side of the trachea just below the larynx. The lobes are connected by the isthmus. Very vascular and receives approximately 80 to 120 mL of blood per minute. Adequate oral intake of iodine is necessary. Function is controlled by the release of TSH from the pituitary gland.

Answer 25

Thyroid gland

Question 26

Two main hormones that the thyroid gland secretes. Regulates: 1. Growth and development 2. Metabolism 3. Activity of the nervous system

Answer 26

Triiodothyronine (T3) | Thyroxine (T4)

Question 27

The third hormone released by the thyroid gland. It decreases blood calcium levels by causing calcium to be stored in the bones

Answer 27

Calcitonin

Question 28

Each testes one to three coils, which produce sperm cells. After puberty, millions of sperm cells are produced daily

Answer 28

Seminiferous tubules

Question 29

The removal of a piece of living tissue from an organ or other part of the body for microscopic examination

Answer 29

Biopsy

Question 30

Used to obtain fluid or to obtain tissue samples from the lesion.

Answer 30

Needle biopsy

Question 31

Aspiration of fluid or tissue by means of a needle

Answer 31

Needle aspiration biopsy

Question 32

The removal of the complete lesion with little or no margin of surrounding normal tissue removed as in polypectomy

Answer 32

Excisional biopsy

Question 33

The removal of a portion of tissue for examination, such as the bite biopsy performed during endoscopy

Answer 33

Incisional biopsy

Question 34

To assess suspect lesions of integument

Answer 34

Skin biopsy

Question 35

A carpal spasm that is induced by inflating sphygmomanometer cuff on the upper arm to a pressure exceeding systolic blood pressure for 3 minutes; a positive result may be seen in hypocalcemia and hypomagnesemia.

Answer 35

Trousseau’s sign assesses for latent tetany

Question 36

Stimulates the activity of another endocrine gland

Answer 36

Tropic hormone

Question 37

Anterior pituitary gland Tropic hormone Bone, liver, adipose tissue-promotes growth (indirectly), control of protein, lipid and carbohydrate metabolism

Answer 37

Somatotropin or growth hormone (GH)

Question 38

Anterior pituitary gland Tropic hormone Adrenal cortex- stimulates secretion of glucocorticoids

Answer 38

Adrenocorticotropic hormone (ACTH)

Question 39

Anterior pituitary gland Tropic hormone Thyroid gland- stimulates secretion of thyroid hormones

Answer 39

Thyroid-stimulating hormone (TSH)

Question 40

Anterior pituitary gland Tropic hormone Testis and ovaries- control of reproductive organs

Answer 40

``` Gonadotropic hormones Follicle-stimulating hormone (FSH) Luteinizing hormone (LH) ```

Question 41

Anterior pituitary gland Direct effect on the mammary glands, which in return are stimulated to produce milk

Answer 41

Prolactin (PRL)

Question 42

Posterior pituitary gland Ovary and testis- promotes the release of milk and stimulates uterine contractions during labor

Answer 42

Oxytocin

Question 43

Posterior pituitary gland Kidneys- also called vasopressin, causes the kidneys to conserve water by decreasing the amount of urine produced, also causes constriction of the arterioles in the body, producing a systemic pressor effect, which results in increased blood pressure.

Answer 43

Antidiuretic (ADH)

Question 44

3 types of nitrogenous waste in protein metabolism

Answer 44

Urea Ammonia Creatinine

Question 45

Location of the kidneys

Answer 45

1. The kidneys lie behind the parietal peritoneum ( retro- peritoneal) just below the diaphragm, on each side of the vertebral column 2. Because of the position of the liver, the right kidney lies slightly lower than the left 3. Surrounded and anchored in place by a layer of adipose tissue.

Question 46

Functions of the nephron

Answer 46

A. Controlling body fluid levels by selectively removing or retaining water B. Helping to regulate pH of the blood C. Removing toxic waste from the blood

Question 47

Filtration Water and solutes (sodium and other ions, nitrogenous wastes ( urea, uric acid), creatinine), glucose, and other nutrients) filter through the glomeruli

Answer 47

Glomerulus

Question 48

Reabsorption | Water solutes

Answer 48

Proximal convoluted tubule

Question 49

Reabsorption | Sodium and chloride ions

Answer 49

Loop of Henle

Question 50

Reabsorption, secretion | Water, sodium and other ions: ammonia, potassium ions, urea, uric acid, creatinine, hydrogen ions, and some drugs

Answer 50

Distal convoluted and collecting tubules

Question 51

Aging on renal function, why and how

Answer 51

1. With aging the kidneys lose part of their normal functioning capacity 2. By age 70 the filtering mechanism is only 50% as efficient as at age 40. This occurs because of decreased blood supply and loss of nephrons

Question 52

May be done to confirm suspected infections, to identify causative organisms, and to determine appropriate antimicrobial therapy

Answer 52

Urine culture and sensitivity

Question 53

For female: keep your labia spread open, urinate a small amount into toilet, then stop the flow of urine, hold the urine cup a few inches from the urethra and urinate until the cup is about half full

Answer 53

Clean- catch technique

Question 54

A sterile urine specimen can be obtained either by inserting a straight catheter into the urinary bladder and removing urine or by obtaining a specimen via the catheter port of an in dwelling catheter, using sterile technique

Answer 54

Catheterization

Question 55

This blood test measures the amount of glucose that has become incorporated into the hemoglobin within an erythrocyte; these levels are reported as a percentage of the total hemoglobin. Normal hgba1c is approximately 4% to 6% of the total. There is an urgent need to reduce HBA1C values below 7% to reduce complications. A result greater than 8% represents an average blood glucose level of approximately 200mg/dL and signals a beed for changes in treatment

Answer 55

Test called glycosylated hemoglobin HgbA1c

Question 56

A systemic metabolic disorder that involves improper metabolism of carbohydrates, fats, and proteins. Maintain proper glucose levels: blood glucose level (60 to 90 mg/dL) and the hemoglobin A1c level to less than 5% to 6%

Answer 56

Diabeties mellitus (DM

Question 57

Juvenile-onset diabetes, or insulin- dependent DM

Answer 57

Type 1

Question 58

Maturity-onset diabetes, or non-insulin dependent DM

Answer 58

Type 2

Question 59

Complications of DM

Answer 59

1. Blindness (retinopathy) 2. Renal failure (nephropathy) 3. Amputation of a lower extremity because of infection and decreased circulation 4. Cardiovascular complications: heart disease, hypertension, and stroke 5. Neuropathy: painful feet and fingers, loss of sensation, risk of injury because of loss of sensation 6. Risk of infection 7. Coma 8. End organ disease

Question 60

A metabolic disorder of the pituitary gland, develops when there is a decrease in oroductiin of ADH form the posterior pituitary or the action of ADH is diminished. Transient or permanent. A decreased in ADH causes increased urinary output, which in tuen results in dehydration and increased plasma osmolality—that is, a state of imbalance between the electrolyte and fluid components of the plasma. Characterized by polyuria and polydipsia

Answer 60

Diabetes insipidus

Question 61

Is a spectrum of clinical abnormalities caused by excess corticosteroids, particularly glucocorticoids. The body’s protective feedback mechanism fails, resulting in excess secretion of the adrenal hormones: glucocorticoids, mineralocorticoids, and sex hormones

Answer 61

Adrenal hyperfunction (Cushing’s Syndrome)

Question 62

Occurs when the adrenal glands do not secrete adequate amounts of glucocorticoids, mineralocorticoids, and androgens. The most common cause is an autoimmune response: adrenal tissue is destroyed by antibodies against the patient’s own adrenal cortex.

Answer 62

Adrenal hypofunction (addison’s disease)

Question 63

Increase appetite, moderate weight gain, edema, buffalo hump, moon face, obesity of trunk, hyperglycemia; need for decreased salt intake, increased potassium intake.

Answer 63

Nutrition and fluid balance | Cushing’s syndrome

Question 64

Nausea and vomiting, fluid and electrolyte imbalance, dehydration, weight loss, hypoglycemia; need for increased salt and decreased potassium intake

Answer 64

Nutrition and fluid balance | Addison’s disease

Question 65

Is a clinical sign of abnormal spasm of the facial muscles when elicited by light taps on the facial nerve, which is located at the angle of the jaw. This is seen in patients who are experiencing hypocalcemia

Answer 65

Chvostek’s sign

Question 66

Assesses for latent tetany, which is a carpal spasm that is induced by inflating a sphygmomanometer cuff on the upper arm to a pressure exceeding systolic blood pressure for 3 minutes; a positive result may be seen in hypocalcemia and hypomagnesemia. If untreated, the condition may progress to convulsions or lethal cardiac dysrhythmias.

Answer 66

Trousseau’s sign

Question 67

Pea sized, called “master gland” because through the negative feedback, it controls the other endocrine glands. It is divided into two segments: the anterior pituitary (adenohypophysis) and the posterior pituitary (neurohypophysis)

Answer 67

Pituitary gland (hypophysis)

Question 68

Secretes T3, T4: growth and development, metabolism, activity of the nervous system. Secretes calcitonin: decreases blood calcium levels by causing calcium to be stored in the bones.

Answer 68

Thyroid glands

Question 69

4 located posterior surface of thyroid, secrete parathyroid hormone (PTH): increases calcium in blood, and regulates the amount of phosphorus in the blood

Answer 69

Parathyroid gland

Question 70

Two glands above kidneys | Adrenal cortex, adrenal medulla

Answer 70

Adrenal glands

Question 71

Secretes steroids

Answer 71

Adrenal cortex

Question 72

Secretes epinephrine (adrenaline) and norepinephrine

Answer 72

Adrenal medulla