Exam 3 Blue Boxes Flashcards
(187 cards)
1
Q
Where is squamous cell carcinoma commonly induced on?
A
the exposed, unpigmented vermillion borders of the lips
2
Q
What are cancers of the tongue and mouth associated with?
A
age, tobacco, and alcohol
3
Q
How do cancers of the oral mucosa present?
A
as leukoplakia or red patches
4
Q
Squamous cell carcinoma risk increases with ___.
A
age
5
Q
What happens when bacteria metabolize sugar to organic acids and erode the adjacent enamel?
A
tooth decay
6
Q
Is decay into enamel painful?
A
NO
7
Q
Is tooth decay into dentin painful?
A
YES
8
Q
What happens to decay that extends into the pulp?
A
it often causes infection and the tooth may be lost
9
Q
What is the bacterial colonization of the sulcus that causes local inflammation called?
A
periodontitis
10
Q
What gets damaged in periodontitis that tends to migrate deeper into the alveolus?
A
the gingival attachment
11
Q
Does gingivitis cause permanent damage to the bone structures?
A
NO - but periodontitis does
12
Q
Periodontitis exposes ___ and the tooth becomes sensitive to pain.
A
dentin
13
Q
What is the major source of tooth loss in adults?
A
periodontitis
14
Q
What embryologic layer is the GI tract derived from?
A
endoderm
15
Q
What portion of the GI tract is supplied by the celiac artery?
A
foregut: esophagus down to the second part of the duodenum
16
Q
What portion of the GI tract is supplied by the superior mesenteric artery?
A
midgut: from the third part of the duodenum to the Cannon’s point in the transverse colon
17
Q
At what point does the midgut end in the transverse colon?
A
at Cannon’s Point
18
Q
What portion of the GI tract is supplied by the inferior mesenteric artery?
A
hindgut: from Cannon’s point in the transverse colon to the rectum
19
Q
Where is visceral pain in the midgut felt?
A
the periumbilical region
20
Q
Where is visceral pain felt in the hindgut?
A
the suprapubic area
21
Q
Where is pain from acute appendicitis felt?
A
in the periumbilical region, then later in the right iliac fossa
22
Q
Why does pain from acute appendicitis later localize to the right iliac fossa?
A
because of inflammation of the peritoneal surface
23
Q
Where is pain from the foregut felt?
A
in the epigastrium
24
Q
What contributes to the motility of the GI tract?
A
peristalsis
25
What is the role of the circular layer of muscle in the GI tract?
constriction of the luminal diameter
26
What is the role of the longitudinal layer of muscle in the GI tract?
shortening of the length of the GI tract
27
The autonomic nervous system is primarily ___ innervation.
parasympathetic
28
____ disease is failure of the ganglionic cells to migrate, usually in the rectum and distal colon.
Hirschsprung's
29
___ disease causes chronic and severe constipation and patients may develop progressive dilation of the bowel.
Hirschsprung's
30
In the severe form of Hirschsprung's disease, there are no ganglionic cells present in the bowel leading to an _____.
aganglionic megacolon
31
Opiates can cause severe ____.
constipation
32
Reflux through the gastroesophageal sphincter that allows gastric acid into lower esophagus is called ___.
Barrett's esophagus
33
When the columnar, mucus-secreting epithelium of the esophagus undergoes re-epithelialization over time, it is referred to as ____.
metaplasia
34
The risk of dysplasia and invasive adenocarcinoma are conferred from ____.
Barrett's esophagus
35
What does the mucosa of the stomach secrete?
hydrochloric acid and protective alkaline mucus
36
___ is the inflammation of the stomach due to an imbalance between stomach secretions.
Gastritis
37
____ is the complete loss of mucosa and may extend into the proximal duodenum.
Ulceration
38
___ is the loss of part of the thickness of mucosa.
Erosion
39
Gastritis and peptic ulceration may be caused by alcohol, drugs, or ____.
Helicobacter pylori
40
What is parasympathetic innervation carried by?
the Vagus nerve
41
The release of ____ acts on parietal cells and allows the production of acid.
acetylcholine
42
What cells does acetylcholine act on in the stomach?
parietal cells
43
Gastrin is released from ___.
G-cells
44
____ are produced in response to rising gastric pH levels.
Gastrin
45
___ act via CCK2 receptors on parietal cells.
Gastrin
46
What does histamine do in the stomach?
increase acid secretion
47
____ reduces the secretion of gastrin in the stomach.
Somatostatin
48
Somatostatin is released from ____.
D-cells
49
How can Helicobacter pylori survive the acidic environment of the stomach?
the bacterial enzyme urease
50
Urease produces ammonia, which ___ pH.
raises
51
What does a higher pH stimulate in the stomach?
secretion of gastrin by G-cells, which act on parietal cells to increase acid production
52
What happens during a Helicobacter pylori infection?
- H. pylori secrete urease
- Urease raises gastric pH
- Higher pH stimulates G-cells
- G-cells increase acid production
- excess stomach acid produced
53
How is a Helicobacter pylori infection treated?
triple therapy (2 antibiotics and a proton pump inhibitor)
54
___ is the mixing of chyme with pancreatic enzymes to break up foods.
Luminal digestion
55
___ include the enzymes of enterocytes.
Membrane digestion
56
___ is the autoimmune response to gluten (gliadin).
Celiac disease
57
Malabsorption of gluten that leads to weight loss, diarrhea, steatorrhea, anemia, and vitamin deficiencies are all symptoms of ____.
Celiac disease
58
What can become damaged in the GI tract from Celiac disease?
mucosa of small intestine and the loss of villi and elongation of crypts
59
What types of antibodies are found in the blood of those afflicted with Celiac disease?
anti-endomysial antibodies
| tissue transglutaminase antibodies
60
___ are malignant tumors in the glandular epithelium, mostly found in the colon or rectum.
Adenocarcinomas
61
Repeated liver cell destruction causes the liver to replace dead liver cells with collagen tissue regeneration. This scarring disease is called ____.
Hepatic cirrhosis
62
___ is the combination of nodules of regenerated liver cells separated by bands of scar tissue.
Cirrhosis
63
Do regenerated liver cells have reduced function?
YES
64
Regenerated liver cells have ___ synthesis of albumin and secretion of bile.
lower
65
The scarring and interruption of the sinusoidal system causes ____.
portal hypertension
66
In ___, blood cannot drain from the liver via the hepatic portal vein.
portal hypertension
67
What are the causes of liver cirrhosis?
- chronic alcohol abuse
- chronic hepatitis
- autoimmune diseases
- excessive storage of iron and copper due to metabolic disease
68
What two elements can cause liver cirrhosis if excessively stored?
iron, copper
69
Do adult livers have hemopoietic tissue?
NO
70
In ____, hepatic hematopoiesis can be re-established if normal marrow is inadequate for fetal function.
extramedullary hematopoiesis
71
___ is the accumulation of hematopoietic precursor cells in the spleen.
Extramedullary hematopoiesis
72
What organs are most frequently enlarged in extramedullary hematopoiesis?
liver and spleen
73
Where does hematopoiesis normally occur in adults?
bone marrow
74
What are the causes of extramedullary hematopoiesis?
- fibrosis of bone marrow
- replacement of bone marrow by malignancy
- hemoglobinopathy
75
Where does hematopoiesis normally occur in infants and children?
liver and spleen
76
A genetic disorder of hemoglobin formation is called a ____.
hemoglobinopathy
77
___ is the abnormal concentration and precipitation of bile, leading to the formation of stones in the biliary system.
Cholelithiases
78
What are these stones in the gallbladder or extrahepatic biliary system called?
callculi
79
Can stones become impacted?
YES
80
The complete blockage of the common bile duct, preventing bile secretion can cause ____.
jaundice
81
Gall bladders affected by stones become inflamed and cause pain. What is this condition called?
chronic cholecystitis
82
Damage to pancreatic acinar cells release pancreatic enzymes into local tissue. These enzymes cause death of tissue and severe inflammation. What is this condition called?
acute pancreatitis
83
Damage to what cells in the pancreas can lead to acute pancreatitis?
acinar cells
84
What enzyme cause death of local fat cells in fat necrosis of of the pancreas?
pancreatic lipases
85
What pancreatic enzyme can be detected in high levels in the blood?
pancreatic amylase
86
Is acute pancreatitis a life-threatening condition?
YES
87
Is renal failure acute or chronic?
could be either
88
Is irreversible renal failure fatal?
YES - unless there is renal replacement therapy
89
What are the current options for renal replacement therapy?
renal dialysis or renal transplantation
90
Hemodialysis and peritoneal dialysis are both options for ___.
renal dialysis
91
___ requires a suitable donor, a long wait.
Renal transplantation
92
What must a donor and a recipient have in common to be able to be "matched?"
HLA-compatibility
93
Can a patient survive with just one kidney?
YES
94
What is the most common cause of renal failure in affluent countries?
diabetic neuropathy
95
In patients with diabetic renal disease, what type (I/II) is usually present?
Type II
96
What is one of the earliest signs of diabetic renal disease?
proteinuria
97
What can proteinuria progress to?
nephrotic syndrome and progressive chronic renal failure
98
The thickening and increase of what two components are demonstrated in diabetic renal disease?
thickening of mesangial basement membrane and increase in mesangial matrix
99
Diabetes can cause progressive scarring of glomeruli. What is this condition called?
diabetic glomerulosclerosis
100
In normal ____, the balance between the deposition of new mesangial matrix and removal of old matrix is tightly controlled.
glomeruli
101
What chemical mediator induces the increased deposition of mesengial matrix in response to high glucose levels?
TGF-beta
102
Does mesengial matrix have a different composition than normal matrix?
YES
103
What types of collagen are present in increased amounts in mesangial matrix?
Type I and Type III
104
What types of collagen are not easily removed from the glomerulus?
Type I and Type III
105
What other factors can contribute to the characteristic proteinuria seen prior to renal failure?
- direct podocyte injury
| - changes in the slit pore membrane
106
Hypertension and increased infections to the kidney are vascular diseases that ___ suffer from in tandem.
diabetics
107
Hypertension is most common in what populations of individuals?
middle-aged and elderly people
108
Is hypertension considered mostly idiopathic?
YES
109
Do younger patients suffer from hypertension?
YES - especially surrounding renal disease
110
Many types of renal disease can lead to ___.
hypertension
111
__ is often seen in patients with post-infectious glomerulonephritis.
Acute hypertension
112
Diabetic nephropathy or IgA nephropathy contribute to ___.
secondary hypertension
113
Can hypertension lead to renal failure?
YES
114
Chronic, untreated low-level hypertension can lead to chronic renal damage. What is this pattern called?
benign nephrosclerosis
115
Can benign nephrosclerosis lead to chronic renal failure?
YES - patient may even need a renal replacement
116
Do pituitary adenomas invade tissues?
NO
117
Do pituitary adenomas have fatal consequences?
YES
118
In a patient with a ____, they excessively produce hormones that are unable to be controlled by feedback mechanisms.
pituitary adenoma
119
Tumors of corticotrophs secrete excess ____; tumors of somatotrophs secrete excess ____.
ACTH; growth hormone
120
ACTH stimulates the adrenals to produce ____.
corticosteroids
121
What does overstimulation of the adrenals by ACTH lead to?
Cushing's disease
122
What does excess production of growth hormone lead to?
gigantism in children; acromegaly in adults
123
Do all pituitary adenomas produce additional hormones?
NO - some grow outwards to the sella turcica
124
What does growth into the sell turcica lead to?
compression of optic chiasma and nerves that can lead to vision problems and blindness
125
What are the consequences of a pituitary gland with a blocked arterial supply?
necrosis of cells and failure of hormone output
126
What is the necrosis of pituitary cells and failure of hormone output called?
panhypopituitarism
127
Are pituitary glands often destroyed by blocked arterial supply?
NO
128
The production of excess growth hormone in children is called ___; in adults, it is called ___.
gigantism; acromegaly
129
___ is the formation of tumor-like nodules in the thyroid gland.
Thyroid hyperplasia
130
____ synthesize and secrete thyroid hormone without a significant inactive storage phase.
Follicle epithelial cells
131
What disease causes the production of autoantibody, such as long-acting thyroid stimulator (LATS)?
Graves disease
132
What does LATS mimic? What does it cause?
TSH; stimulates the thyroid to secrete excess hormone
133
___ means that all follicles are affected.
Diffuse hyperplasia
134
____ hyperplasia is when tumor-like nodules arise in the thyroid gland; ____ hyperplasia is when all thyroid follicles are affected.
Nodular; diffuse
135
What kind of thyroid hyperplasia has epithelial cells that are larger and active, yet depleted of stored colloid located within the follicles?
Diffuse hyperplasia
136
Both patterns of thyroid hyperplasia produce ____.
thyrotoxicosis
137
In a normal thyroid, most follicles are ____ and epithelium is ____.
full of stored colloid; in inactive storage phase
138
In a normal thyroid the epithelium is in what kind of phase?
inactive storage phase
139
In a normal thyroid, what are the follicles full of?
stored colloid
140
How much of the thyroid is releasing hormone?
only a few are releasing hormone
141
What is the normal thyroid under the control of? Where is this hormone secreted from?
thyroid-stimulating hormone; anterior pituitary
142
In _____, the parathyroid glands are overworked.
hyperparathyroidism
143
What is the most common cause of hyperparathyroidism?
presence of a benign tumor in one of the parathyroid glands
144
What is a benign tumor in one of the parathyroid glands called?
parathyroid adenoma
145
What would likely cause the unresponsiveness to normal feedback mechanisms related to blood calcium levels?
a benign tumor in one of the parathyroid glands
146
Excess ____ stimulates excess erosion of bone by OCl, along with the release of bone calcium.
parathormone
147
What is the condition called where excess bone erosion leads to a high level of blood calcium?
hypercalcemia
148
___ leads to bone pain, x-ray abnormalities, and an increased risk of kidney stones.
Primary hyperparathyroidism
149
____ is the secondary response of parathyroid glands to low Ca in patients with kidney failure.
Secondary hyperparathyroidism
150
In ____, the parathyroids become enlarged, secrete excess parathormone and attempt to bring serum Ca levels back to normal.
secondary hyperparathyroidism
151
___ stimulates the release of calcium into the blood.
Parathormone
152
What is it called when the parathyroid glands become enlarged?
parathyroid hyperplasia
153
What does the secretion of excess parathormone aim to do?
attempt to bring serum Ca levels back to normal
154
___ is when the parathyroid glands underwork and produce little to no hormone?
Hypoparathyroidism
155
When would a patient likely be afflicted with hypoparathyroidism?
after the surgical removal of all parathyroid glands during a total thyroidectomy
156
Destruction of the adrenal glands causes failure of secretion of all adrenal cortical hormones. This is called ___.
hypoadrenalism
157
What disease caused by hypoadrenalism has symptoms such as weakness, fatigue, skin pigmentation issues, postural hypotension, hypovolemia, and low blood sodium?
Addison's disease
158
Which is more common of the two? Hypoadrenalism or hyperadrenalism?
hyperadrenalism
159
___ is the condition where there is excess secretion of more than one cortical hormone.
Hyperadrenalism
160
Cushing's syndrome is caused by the excess secretion of ____; Conn's syndrome is caused by the excess secretion of ____.
glucocorticoids; mineralcorticoids
161
Excess hormone of the adrenal cortex can be produced by:
- benign tumor
- malignant tumor
- diffuse hyperplasia
162
A benign tumor of the adrenal cortex is called an ____.
adrenal cortical adenoma
163
A malignant tumor of the adrenal cortex is called an ____.
adrenal cortical carcinoma
164
An ____ can affect all 3 types of cortical hormones, including androgens.
adrenal cortical carcinoma
165
____ occurs when a tumor elsewhere in the body secretes excessive amounts of ACTH which in turn act to produce excess glucocorticoids.
Ectopic ACTH syndrome
166
What does an ectopic ACTH tumor stimulate to produce excess glucocorticoids?
zona fasciculata
167
The ____ in the pancreas contain endocrine cells which secrete hormones, namely insulin.
Islets of Langerhans
168
___ is a disease of insulin metabolism.
Diabetes Mellitus
169
___ diabetes begins in childhood and islet cells are destroyed due to an autoimmune response.
Type I
170
___ diabetes results in a loss of endocrine cells in pancreatic islets.
Type I
171
____ has a widespread effect on carbohydrate, protein, and fat metabolism and its absence leads to complex metabolic and structural diseases.
Insulin
172
____ diabetes occurs later in life and is caused by the resistance of target cells to the effects of insulin.
Type II
173
Which type of diabetes is NOT caused by a failure of insulin production by pancreatic islets?
Type II
174
Insulin-secreting tumors produce ____ with hypoglycemic symptoms.
hyperinsulinism
175
Is disease rarely produced from the excessive secretion of one of the isle hormones?
YES
176
What is the most common tumor of the diffuse neuroendocrine system?
small cell (oat cell) carcinoma
177
____ tumors retain the capacity to make and secrete hormone or hormone precursor molecules.
Small cell (oat cell) carcinoma
178
Small cell carcinomas secrete ____, which stimulate the uncontrolled secretion of hormones from the adrenal cortex.
ACTH
179
____ carcinomas are highly malignant tumors of the neuroendocrine cells of the bronchial tree.
Small cell (oat cell)
180
Do small cell carcinomas grow rapidly and infiltrate and destroy tissue?
YES - nearly all tissues
181
Where would you find neuroendocrine cells?
in the bronchial tree
182
Where are carcinoid tumors most common?
in the alimentary tract (especially in small intestine and appendix)
183
Do carcinoid tumors grow slowly?
YES
184
What do carcinoid tumors secrete? Does this have a systemic effect?
5-hydroxytryptamine; NO
185
Why does 5-hydroxytryptamine have no systemic effect when secreted from a carcinoid tumor?
because 5-hydroxytryptamine is passed from the tumor to the gut and into the hepatic portal vein, where it is inactivated by the liver via processing
186
Can carcinoid tumors spread to secondary sites away from the gut?
YES - when malignant
187
____ is when 5-hydroxytryptamine is able to enter the blood and produces metabolic effects.
Carcinoid syndrome
