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PATHO > Exam 4 Review > Flashcards

Exam 4 Review Flashcards

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1
Q

What is primary dysmenorrhea attributed to?

A

Excessive endometrial prostaglandin production

Prostaglandins are potent myometrial stimulants and vasoconstrictors that lead to painful periods.

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2
Q

Name the conditions that can cause secondary dysmenorrhea. (8)

A
  • Endometriosis
  • Endometritis
  • Pelvic inflammatory disease (PID)
  • Uterine fibroids (leiomyomas)
  • Polyps
  • Tumors
  • Ovarian cysts
  • Intrauterine devices (IUDs)

Endometriosis is the most common cause of secondary dysmenorrhea.

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3
Q

What is endometriosis?

A

The presence of functioning endometrial tissue that implants outside the uterus

Common sites of implantation include the pelvic peritoneum, ovaries, and uterosacral ligaments.

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4
Q

What hormonal fluctuations affect ectopic endometrial tissue in endometriosis?

A

The hormonal fluctuations of the menstrual cycle

Ectopic endometrial tissue responds similarly to normal endometrial tissue.

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5
Q

List some common symptoms of endometriosis.

A
  • Progressive dysmenorrhea
  • Dysuria
  • Dyspareunia
  • Constipation
  • Abnormal vaginal bleeding

Symptoms can vary in frequency and severity.

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6
Q

What are the devastating risks associated with endometriosis? (Not looking for risk factors)

A
  • Infertility
  • Cancers, especially ovarian

Women with endometriosis have a high risk for infertility and certain cancers.

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7
Q

What is Polycystic Ovarian Syndrome (PCOS)?

A

A condition characterized by irregular ovulation, elevated levels of androgens, and polycystic ovaries on ultrasound

PCOS is a leading cause of infertility in the United States.

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8
Q

What are the cardinal features in the pathogenesis of PCOS?

A
  • Hyperandrogenic state
  • Ovulatory dysfunction

These features significantly affect follicular growth.

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9
Q

What role does Follicle-stimulating hormone (FSH) play in relation to PCOS?

A

FSH regulates the menstrual cycle and stimulates egg production in the ovaries

In PCOS, FSH levels are decreased.

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10
Q

How does insulin resistance relate to PCOS?

A

Glucose intolerance/insulin resistance often runs parallel and aggravates the hyperandrogenic state

This contributes to the severity of signs and symptoms of PCOS.

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11
Q

True or False: Polycystic ovaries must be present to diagnose PCOS.

A

False

Polycystic ovaries do not have to be present for a PCOS diagnosis, and their presence alone does not establish the diagnosis.

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12
Q

What effect does obesity have on insulin resistance in PCOS?

A

Obesity adds to and worsens insulin resistance

This exacerbates the symptoms of PCOS.

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13
Q

What is Pelvic Organ Prolapse (POP)?

A

The descent of one or more structures: vaginal wall, uterus, or apex of vagina after hysterectomy

More than 50% of women have some version of POP on physical examination, but most are asymptomatic.

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14
Q

What are the common causes of POP?

A
  • Direct trauma (e.g., childbirth)
  • Pelvic floor surgery
  • Obesity
  • Constipation
  • Pelvic organ cancers
  • Damage to pelvic innervation, particularly the pudendal nerve

Risk factors in nulliparous women include heavy lifting and chronic medical conditions (chronic lung disease and refractory constipation).

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15
Q

What is a Cystocele?

A

Descent of a portion of the posterior bladder wall and trigone into the vaginal canal

Usually caused by childbirth trauma.

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16
Q

What symptoms are associated with a Cystocele?

A
  • Difficulty starting urination
  • Slow urine stream
  • Urinary incontinence
  • Pelvic discomfort
  • Frequent UTIs
  • Discomfort during sex
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17
Q

What is a Rectocele?

A

The bulging of the rectum and posterior vaginal wall into the vaginal canal

Childbirth may increase damage.

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18
Q

What is an Enterocele?

A

Herniation of the rectouterine pouch into the rectovaginal septum

Most large enteroceles are found in grossly obese and older adults.

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19
Q

What are Spermatoceles?

A

Benign cystic collections of fluid in the epididymis located between the head of the epididymis and the testis

Filled with milky fluid that contains sperm.

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20
Q

What is ovarian cancer often termed?

A

The ‘silent killer’

It is commonly asymptomatic until tumors have grown large.

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21
Q

What genetic predispositions are associated with ovarian cancer?

A
  • BRCA1
  • BRCA2

Found in 10% to 15% of cases.

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22
Q

What role do BRCA1 and BRCA2 play in breast cancer?

A
  • BRCA1: Tumor-suppressor gene
  • BRCA2: Helps repair damaged DNA

Mutations in these genes can lead to uncontrolled cell proliferation.

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23
Q

What are common risk factors for breast cancer?

A
  • Age
  • Gender
  • Personal and family history
  • Environmental factors (e.g., smoking, obesity)

Adipose tissue secretes leptin that promotes breast cancer cell proliferation.

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24
Q

What is Benign Prostatic Hyperplasia (BPH)?

A

Enlargement of the prostate as nodules form and grow

Causes bladder outflow obstruction over time.

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25
What are the symptoms of prostate cancer?
* Slow urinary stream * Hesitancy * Incomplete emptying * Frequency * Nocturia * Dysuria ## Footnote Symptoms are progressive and do not remit.
26
What is Erectile Dysfunction (ED)?
Inability to achieve or maintain an erection ## Footnote May indicate endothelial damage.
27
What is the most common sexually transmitted virus in the United States?
Human papillomavirus (HPV) ## Footnote Most prevalent among teens and young adults.
28
What can Chlamydia cause?
* Acute urethral syndrome * Nongonococcal urethritis * Mucopurulent cervicitis * Pelvic inflammatory disease (PID) ## Footnote Leading cause of preventable infertility and ectopic pregnancy.
29
True or False: Gonorrhea symptoms are always present in infected individuals.
False ## Footnote Many infected individuals may not show symptoms.
30
What is the recommended treatment for infants exposed to gonorrhea at birth?
Systemic treatment is indicated for all newborns with known exposure ## Footnote Prophylactic ophthalmic antibiotics are required to prevent gonococcal eye infection.
31
What are obstructive pulmonary diseases characterized by?
Infiltration of the lung by inflammatory cells with the release of cytokines that contribute to airway damage and mucus production
32
What is the most common obstructive pulmonary disease?
Asthma and chronic obstructive pulmonary disease (COPD)
33
What initiates the early asthmatic response?
Antigen exposure to the bronchial mucosa
34
What are the main mediators released during the early asthmatic response?
* Histamine * Prostaglandins * Leukotrienes
35
What does the late asthmatic response involve?
Release of toxic neuropeptides contributing to increased bronchial hyperresponsiveness
36
What is Status Asthmaticus?
Severe bronchospasms with progressive obstruction of expiratory airflow
37
What defines chronic bronchitis?
Hypersecretion of mucus and chronic productive cough lasting at least 3 months for 2 consecutive years
38
What is a key characteristic of emphysema?
Destruction of alveoli walls and abnormal permanent enlargement of air spaces
39
What is cor pulmonale?
Right-sided heart failure due to increased workload from pulmonary disorders
40
What are examples of restrictive lung diseases?
* Aspiration * Pulmonary edema * Acute respiratory distress syndrome (ARDS) * Pneumoconiosis
41
What causes pneumoconiosis?
Inhalation of inorganic dust particles, such as silica, asbestos, and coal
42
What is the most common cause of pulmonary embolism (PE)?
Deep vein thrombosis (DVT)
43
What are the risk factors for pulmonary embolism referred to as?
Triad of Virchow
44
What are the two main categories of lung cancer?
* Non-Small Cell Lung Cancer (NSCLC) * Small Cell Lung Carcinomas (SCLC)
45
What type of lung cancer accounts for about 30% of bronchogenic carcinomas?
Squamous cell carcinoma
46
What is adenocarcinoma characterized by?
Development from atypical adenomatous hyperplasia to invasive carcinoma
47
What is the prognosis of small cell lung carcinomas?
Worst prognosis due to rapid growth and early metastasis
48
What does tobacco smoke contain that contributes to lung cancer?
Over 7000 chemicals, including 69 classified as carcinogens
49
What is pediatric obstructive apnea syndrome (OSAS)?
Partial or complete upper airway obstruction during sleep, more common in obese children
50
What is surfactant deficiency disorder (SDD) also known as?
Respiratory distress syndrome
51
What is cystic fibrosis caused by?
Mutations of the cystic fibrosis transmembrane conductance regulator (CFTR) gene
52
What is the most common viral respiratory tract infection in children under 2?
Bronchiolitis
53
What is the most common cause of sudden unexpected infant death?
Sudden infant death syndrome (SIDS)
54
Fill in the blank: SIDS risk factors include sleeping on _______.
soft bedding
55
List some risk factors associated with SIDS.
* Prone and side-lying sleeping positions * Overheated sleeping environment * Lower socioeconomic status * Mothers younger than 20 * Low birth weight or growth-restricted infants
56
What is gastroesophageal reflux disease (GERD)?
Reflux of acid and pepsin from the stomach to the esophagus causing esophagitis ## Footnote GERD involves abnormalities in lower esophageal sphincter (LES) function, esophageal motility, and gastric emptying.
57
What causes spontaneous relaxation of the LES?
Triggered by gastric distention after meals ## Footnote This relaxation can lead to acid reflux.
58
List some dietary and lifestyle factors that can trigger acid reflux.
* Food intake causing delayed gastric emptying * Acidic foods * Obesity * Vomiting * Coughing * Lifting * Bending * Pregnancy
59
What are the key components of gastric contents?
* Highly acidic (low pH=2) * Bile salts * Pancreatic or intestinal enzymes
60
What can severe reflux esophagitis lead to?
Precancerous lesions and adenocarcinoma ## Footnote Long-term consequences of untreated reflux esophagitis.
61
What is the most common cause of duodenal ulcers?
Helicobacter pylori (H. pylori) infection and NSAID use ## Footnote These factors increase acid and pepsin concentrations in the duodenum.
62
What are the characteristic differences between gastric and duodenal ulcers?
* Gastric Ulcer: 50-70 years, usually negative family history, increased cancer risk, immediate pain after eating * Duodenal Ulcer: 20-50 years, positive family history, not increased cancer risk, pain 2-3 hours after eating
63
What is ulcerative colitis?
A disease that begins in the rectum and may extend to the entire colon, characterized by mucosal lesions ## Footnote Lesions are not transmural and do not involve 'skip' lesions.
64
List the clinical manifestations of ulcerative colitis.
* Frequent diarrhea * Passage of small amounts of blood * Cramping pain * Urge to defecate
65
What distinguishes Crohn's disease from ulcerative colitis?
Crohn's disease involves discontinuous transmural involvement and 'skip' lesions ## Footnote It can affect any part of the GI tract.
66
What are common complications of diverticular disease?
* Abscess * Fistula * Obstruction * Bleeding * Perforation
67
What is cirrhosis?
Replacement of healthy liver tissue with scar tissue, leading to irreversible liver disease ## Footnote It alters biliary channels and blood flow.
68
What is the primary cause of alcoholic cirrhosis?
Toxic effects of alcohol metabolism in the liver ## Footnote Includes immunologic alterations and oxidative stress.
69
What is nonalcoholic fatty liver disease (NAFLD)?
Infiltration of hepatocytes with fat in the absence of alcohol intake ## Footnote Associated with obesity, insulin resistance, and type 2 diabetes.
70
What causes portal hypertension?
Disorders causing resistance to flow in the portal venous system ## Footnote Commonly due to cirrhosis.
71
What are the complications of portal hypertension?
* Esophageal varices * Ascites * Hepatic encephalopathy
72
What is cholelithiasis?
Presence of gallstones in the biliary tract ## Footnote Formed due to impaired metabolism of cholesterol, bilirubin, and bile acid.
73
What is acute pancreatitis?
Inflammation of the pancreas caused by bile acid reflux and gallstone obstruction ## Footnote Leads to cellular injury and inflammatory response.
74
What is cleft lip?
Incomplete fusion of the nasomedial or intermaxillary process during embryonic development ## Footnote It is the most common craniofacial malformation.
75
What are some risk factors for cleft lip and palate?
* Family history * Exposure to certain substances during pregnancy * Obesity and/or diabetes
76
What is infantile hypertrophic pyloric stenosis (IHPS)?
Acquired narrowing and distal obstruction of the pylorus, causing postprandial vomiting ## Footnote It is the most common cause of intestinal obstruction in infancy.
77
What causes Hirschsprung disease?
Failure of neural crest cells to migrate into the GI tract, leading to absence of parasympathetic plexuses ## Footnote Results in functional obstruction and megacolon.
78
What is Hirschsprung disease?
A congenital malformation resulting from failure of neural crest cells to migrate into the GI tract ## Footnote This leads to an absence of parasympathetic plexuses along variable lengths of the colon.
79
What happens in Hirschsprung disease?
Absence of neural stimulation in muscle layers of the colon causes failure to propel feces, leading to functional obstruction ## Footnote This results in abdominal distention and poor feeding.
80
What is megacolon?
The term used to describe the distended proximal colon in Hirschsprung disease ## Footnote It is often associated with the failure of the colon to propel feces.
81
Define intussusception.
A condition where part of the intestine telescopes into an adjacent segment ## Footnote This commonly occurs when the ileum telescopes into the cecum.
82
What is the direction of telescoping in intussusception?
In the direction of peristaltic flow ## Footnote The proximal portion (intussusceptum) moves into the distal portion (intussuscipiens).
83
What complications can arise from untreated intussusception?
Bleeding, necrosis, and bowel perforation ## Footnote These serious complications can occur if intussusception is not treated promptly.
84
What are the initial effects of intussusception on the intestine?
Compression leads to venous stasis, engorgement, edema, and exudation ## Footnote These effects can obstruct the flow of chyme through the intestine.
85
Fill in the blank: Hirschsprung disease is characterized by the absence of _______ along variable lengths of the colon.
parasympathetic plexuses
86
True or False: Intussusception can occur anywhere from the duodenum to the rectum.
True
87
What is a common clinical manifestation of a urinary tract infection (UTI) in older adults?
Confusion and poorly localized abdominal discomfort ## Footnote UTIs can be difficult to diagnose in older adults due to vague symptoms.
88
What are the two common factors that account for urinary tract infections? (Think pathogen vs body’s response)
* Virulence of the pathogen * Efficiency of the immune response
89
What is the most common causative organism of urinary tract infections?
Escherichia coli
90
What is Painful Bladder Syndrome (PBS) also known as?
Interstitial cystitis (IC)
91
What are the symptoms of Painful Bladder Syndrome?
* Bladder pain * Pressure in the bladder * Frequent or urgent need to urinate
92
What chronic conditions are often associated with Painful Bladder Syndrome?
* Fibromyalgia * Irritable bowel disease * Chronic fatigue syndrome
93
What may be responsible for the inflammatory response in Painful Bladder Syndrome?
An autoimmune reaction
94
What is the most common type of kidney stone?
Calcium oxalate
95
What are the three key pathophysiological factors for kidney stone formation?
* Supersaturation of the mineral in urine * Growth through crystallization or agglomeration * Lack of stone inhibitors
96
What microorganisms are usually associated with acute pyelonephritis?
* E. coli * Proteus * Pseudomonas
97
What is the most common cause of Acute Glomerulonephritis (AG)?
Infection
98
What are the severe symptoms of Acute Glomerulonephritis?
* Sudden onset of hematuria * Red blood cell casts * Proteinuria
99
What is the definition of Acute Kidney Injury (AKI)?
Acute and rapidly progressive decline in renal function
100
What is the most common reason for prerenal AKI?
Inadequate kidney perfusion
101
What are some causes of prerenal AKI?
* Hypovolemia * Reduced cardiac output (HFrEF) * Systemic hypotension * Acute MI
102
Name four types of intrarenal AKI?
* Renal vein thrombosis * Renal artery stenosis * Acute tubular necrosis * Glomerular: immune-complex diseases such as lupus nephritis
103
What is a common disorder associated with postrenal AKI?
Urinary tract obstruction This could be an affected bladder outlet (BPH), ureteral obstruction (tumors, stones, clots) Neurogenic bladder.
104
What is chronic kidney failure (CKD)?
Progressive and irreversible loss of renal function indicated by a decline in GFR
105
What is the most significant risk factor associated with CKD?
Diabetes mellitus
106
What are two factors that advance renal disease in CKD?
* Proteinuria * Angiotensin II activity
107
What hormone do the kidneys primarily produce that stimulates red blood cell production?
Erythropoietin (EPO)
108
What causes secondary hyperparathyroidism in CKD?
Decreased calcium levels triggering parathyroid hormone (PTH) secretion
109
What is a common acid-base imbalance in End-Stage Renal Failure (ESRF)?
Metabolic acidosis
110
What is hypospadias?
Condition where the urethral meatus is located on the ventral portion of the penis
111
What percentage of children younger than 5 with a UTI have Vesicoureteral Reflux (VUR)?
30-40%
112
What characterizes nephrotic syndrome?
* Excretion of 3.0 g or more of protein in urine per day * Hypoalbuminemia * Hyperlipidemia * Peripheral edema
113
What are primary causes of nephrotic syndrome?
* Membranous glomerulonephritis * Minimal change disease
114
What is the relationship between calcium and phosphate in CKD?
Calcium and phosphate have a reciprocal relationship; when one goes up, the other goes down.
115
What is the effect of decreased serum protein in nephrotic syndrome?
Leads to edema due to decreased oncotic pressure.

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