Pathophysiology Deck Flashcards
(343 cards)
1
Q
Elevated oxygen levels result in this condition
A
bronchopulmonary dysplasia (BPD)
2
Q
The human body is composed of approximately ___% water
A
60% water
3
Q
Three fluid compartments in the body
A
Intracellular fluid (ICF)
Extracellular fluid (ECF)
Interstitial fluid (ISF)
4
Q
Two-thirds of the body’s water content is contained mainly within the ___ fluid
A
ICF - Intracellular fluid
5
Q
High osmotic pressure in the bloodstream favors fluid movement from the _____ into _____
A
From ICF and ISF into the bloodstream (ECF)
6
Q
Oncotic pressure, also called colloidal osmotic pressure, is a type of osmotic pressure exerted specifically by _____ in the bloodstream
A
Albumin
7
Q
What is osmolality is based on?
A
1 mole (gram) of a substance dissolved in 1 kilogram of water
8
Q
What is osmolarity based on?
A
The number of particles suspended in a solution.
9
Q
A solution often used as a temporary replacement for blood
A
LR - lactated Ringers
10
Q
Starling’s Law of Capillary Forces
A
Two major opposing forces at every capillary membrane: hydrostatic pressure + osmotic pressure (and oncotic pressure)
11
Q
Stimulates the release of ADH
A
High plasma osmolarity
12
Q
Blocking ACE in the RAAS prevents WHAT?
A
Angiotensin I from becoming angiotensin II. This prevents vasoconstriction and adrenal stimulation.
13
Q
The net effect of the RAAS is…
A
Raise blood volume and increase blood pressure
14
Q
Produced in response to fluid volume overload stretching the heart’s ventricles
A
BNP (B-type natriuretic peptide)
15
Q
Both BNP and ANP promote what
A
Natriuresis - increasing glomerular filtration rate
16
Q
Edema is excess fluid in what compartment(s)
A
ISF and ICF
17
Q
Two causes of edema (types of pressures)
A
Elevated hydrostatic pressure in bloodstream or diminished osmotic force in bloodstream
18
Q
What are the major solutes in the body?
A
Potassium, magnesium, phosphates, and protein
19
Q
In the RAAS, adrenal gland produces _____ and _____
A
Aldosterone and ADH
20
Q
Key cell type in blood vessels of the kidneys which are part of RAAS and are the first trigger for releasing renin
A
Juxtaglomerular (JG)
21
Q
In a pt with pulmonary edema in respiratory acidosis, ___ is elevated because, as H+ moves inside of cells in an attempt to get it out of the bloodstream, ___ moves from cells into the bloodstream.
A
K+
22
Q
In diabetic ketoacidosis, _____ is consumed by the additional keto acids present in the bloodstream. Because it is one of the measured anions, its consumption _____ the anion gap.
A
HCO3-
Increases
23
Q
Two cations used to measure anion gap
A
Na+ and K+
24
Q
Two anions used to measure anion gap
A
Cl- and HCO3-
25
Dialysis relies on _____ to remove solutes
diffusion
26
If a patient's pH and PCO2 levels move in opposite directions, their disruption is _____ in nature. If a patient's PCO2 is normal, or if it is moving in the same direction as pH, the patient's disruption is _____ in nature.
respiratory, metabolic
27
Outer most part of your innate immunity
Skin and mucous membranes
28
Innate immunity also includes the _____ system - a set of protein that set to dice or break foreign cells.
complement ("That's a nice virus you've got there, would be a shame if something happened to it!")
29
Before a particular B or T cell is exposed to antigen, it is referred to as _____.
naive
30
B cells divide into ___ and ___ after attaching to an antigen.
Memory cells and antibodies
31
This makes phagocytic cells more likely to engulf pathogens (like salting peas - it makes them tastier)
Antigens
32
3 things that antibodies do
1. Neutralize viruses
2. Increase phagocytic cell activity against viruses
3. Recruit the complement system (innate immunity)
33
Two types of T cells
Helper T cells and cytotoxic T cells
34
Selective (Helper) T cells divide into ___ and ___
Memory cells and de facto cells
35
Helper T cells produce proteins called ___
cytokines
36
Cytokines activate ___ and ___
B cells and cytotoxic T cells
37
_____ are what make secondary immune responses stronger and more prolonged than primary responses.
Memory cells
38
Eldery individuals have decreased population of ___ (in their immune systems)
naive T cells
39
Near skin surface, there are phagocytic cells called ___
dendritic cells
40
capillaries are made of ___ cells
endothelial cells
41
Skin cells release ___ to signal when there is an "invasion"
chemokines (chemical + kinetic)
42
Mast cells release ___ in response to a threat
histamine
43
Histamine acts on endothelial cells (capillaries) and causes ___ leading to ___
vasodilation, swelling
44
Neutrophils act on bacteria using ___
phagocytosis
45
A congenital abnormality is one that is ___.
present at birth
46
For two parents who are carriers of a recessive trait, what are the odds of producing offspring that have that condition? Odds of being carriers? Odds of no disease/not carrier?
1:4 Will get the condition (and receive both recessive genes)
2:4 (50/50) Will be a carrier
1:4 Will neither have the disease nor be a carrier
47
The four DNA nitrogen bases are ___.
adenine (A), thymine (T), guanine (G), and cytosine (C)
48
DNA base pairings
A+T and G+C
49
In RNA, ___ replaces ___ as a base.
uracil (U) replaces thymine (T)
50
RNA base pairings
A+U and G+C
51
The human genome is estimated to contain ___ genes.
20,000 - 25,000
52
An arrangement of three specific DNA bases is called a ___
codon
53
Common changes in DNA sequence are called ___
polymorphisms
54
A ___ occurs when a gene is damaged or changed in such a way that it alters the genetic code carried by that gene.
mutation
55
Each chromosome is divided into two sections, based on a point of narrowing of the linear chromosome, called the ___. The shorter segment, relative to the centromere, is known as the “___” arm, while the longer segment is known as the “___” arm.
centromere, P arm (short), Q arm (longer)
56
A ___ is an organized arrangement of all the chromosomes within a cell. The human one of these has ___ pairs of chromosomes.
karyotype, 23 pairs
57
DNA is copied to messenger RNA (mRNA) in the ___ in a process known as ___.
In the nucleus by transcription
58
mRNA moves to the ___ and then ___ occurs.
ribosomes, translation
59
Everyone has __ copies of each gene. Each individual gene is an ___ that is inherited from each parent.
2 copies, allele
60
T/F: Gene alleles must match
False - you can receive dominant and recessive alleles for each gene (i.e., no sickle cell, but are a carrier)
61
Genotype of Pp is called ___
heterozygous
62
Genotype of PP or pp is called ___
homozygous
63
CO2 mixes with water in the blood via a chemical reaction and forms ___.
bicarbonate (HCO3-) and a proton
64
What is the purpose of a buffer?
Prevents radical change in pH
65
Buffers are typically a ___ or a ___
weak acid or a conjugate base
66
The buffer that maintains the pH of human blood involves a ___ - ___ system.
carbonic acid (H2CO3) - bicarbonate ion (HCO3-)
67
When any acidic substance enters the bloodstream, the bicarbonate ions neutralize the hydronium ions forming ___
carbonic acid and water
68
When a basic substance enters the bloodstream, carbonic acid reacts with the hydroxide ions producing
bicarbonate ions and water
69
Third-spacing occurs due to decreased ___ pressure in the ___ space
oncotic, intravascular
70
If the anion gap is too high, your blood is more ___ than normal. If the anion gap is too low, your blood is more ___ than normal.
acidic, alkaline
71
In mild to moderate acidosis, treatment could be limited to supportive measures including ___ and ___.
IV fluids and respiratory support
72
Healthcare providers most commonly use anion gap to identify cases of ___.
metabolic acidosis
73
DKA occurs when glucose is unable to enter cells resulting in the ___ breaking down fat into ___.
liver, ketones
74
An elevated anion gap metabolic acidosis can be caused by ___ toxicity, ___, and ___ (MUDPILES). Non-Gap metabolic acidosis is due to GI loss of ___ or a failure of kidneys to ___.
elevated: salicylate toxicity, DKA, uremia
no-gap: bicarbonate (diarrhea), excrete acid
75
Normal PCO2
35-45 mmHg
76
Normal blood pH
7.35-7.45
77
Normal PaO2
75-100 mmHg
78
Normal HCO3-
22-26 mEq/L
79
Normal SaO2
(saturation) 95-100%
80
The central chemoreceptors, located on the ventral aspect of the medulla, are activated by an increase in ___ or ___.
CO2 or acidity
81
Kidneys compensate for hypercapnia by reabsorbing more ___ and excreting more ___
absorb HCO3-, excrete H+
82
The kidney compensates for respiratory alkalosis by reducing the amount of new ___ generated and by excreting ___. The process of renal compensation occurs within ___. The stimulus for the renal compensatory mechanism is ___ (not ___).
HCO3−/HCO3−
Occurs within 24 to 48 hours
Stimulus is PCO2, not pH
83
___ determines whether an acidosis is respiratory or metabolic in origin.
PCO2
84
Metabolic acidosis is due to alterations in ___, so the ___ is less than ___ since it _____ (is/is not) the cause of the primary acid-base disturbance
bicarbonate
pCO2 is less than 40
84
For a respiratory acidosis, the pCO2 is ___ due to ___.
greater than 40 to 45
decreased ventilation
85
How can hyperkalemia develop in metabolic acidosis?
H+ moves into the cells resulting in K+ moving into the extracellular fluid
86
A fall in pH is much LESS likely to raise the plasma potassium concentration in patients with ___ or ___
lactic acidosis
ketoacidosis
87
In metabolic alkalosis, PCO2 would ___. This is SECONDARY to ___.
PCO2 increases secondary to HCO3- increasing.
88
The kidneys can help combat alkalosis by ___. This process is slower than ___.
Increasing the excretion of bicarbonate ions through the urine. Slower than respiratory compensation.
89
A hereditary disease, presents as an enlarged heart chamber and decreased blood-pumping efficiency, leading to heart failure. ___ chance of passing on to children.
familial dilated cardiomyopathy, 50%
90
Where would you find gene locus 3p22.1
3 = Chromosome 3
p = P-arm (petit arm)
91
The standard number of chromosomes in a human cell is __
46 (23 pairs)
92
How many chromosomes would need to be in one ovum and one sperm to create the first cell of the embryo?
23 - one from each parent to total 46 in a cell
93
Distinguish between gene and allele
Genes are DNA sections that code for specific proteins or functional RNA, playing a crucial part in biological functions. Alleles, however, are variations of these genes, leading to diverse traits such as eye color.
94
A condition in which a baby is born with one or more extra fingers.
Polydactyly
95
If one biological parent carries the genetic code for polydactyly, their babies have a ___ chance of being born with polydactyly.
50% (some forms are dominant)
96
Why are males more likely to have x-linked traits?
The Y chromosome is the other half of the XY gene pair in the male. However, the Y chromosome doesn't contain most of the genes of the X chromosome. Because of that, it doesn't protect the male.
97
What is meant by sickle cell trait vs sickle cell genotype?
Sickle cell trait = carrier
Sickle cell genotype = has the disease
98
Red-green colorblindness is a ___ trait
x-linked recessive trait
99
What is genotype of red-green colorblind father?
XcY (c is recessive)
100
Genotype of mother who is homozygous at the colorblind locus
XcXc
101
What is aneuploidy
(AN-yoo-PLOY-dee) - The occurrence of one or more extra or missing chromosomes leading to an unbalanced chromosome complement, or any chromosome number that is not an exact multiple of the haploid number (i.e., 23)
102
3 types of down syndrome
Complete, mosaic, translocation
103
An error during the formation of the egg or the sperm results in either one having an extra chromosome. The resulting cells will also have three copies of chromosome 21. Constitutes almost all Down syndrome cases.
Complete trisomy 21
104
Type of down syndrome that occurs when an error in cell division takes place early in development but after a normal egg and sperm unite. It can also occur early in development when some cells lose an extra chromosome 21 that was present at conception. Symptoms vary based on number of affected cells.
Mosaic trisomy 21
105
Type of down syndrome that occurs when only part of an extra copy of chromosome 21 is in the cells and gets "stuck" to another chromosome and transmitted as cells divide. Presentation is the same as complete trisomy 21.
Translocation trisomy 21
106
Main cause of death in down syndrome
Congenital heart disease (CHD)
107
Congenital heart defects occur in approximately ___ of live-born infants with Down syndrome (DS).
50%
108
Most common heart condition that occurs with down syndrome.
Atrioventricular septal defect (AVSD) is the most common congenital heart disease
...followed by isolated tetralogy of Fallot (TOF), AVSD with TOF, and isolated ventricular septal defect
109
What does ND-PAE stand for
Neurobehavioral disorders associated with prenatal alcohol exposure (ND-PAE)
110
What are some common findings in children with neurobehavioral disorders associated with prenatal alcohol exposure (ND-PAE)
1. Thinking and memory
2. Behavior problems
3. ADLs (playing with others, dressing, bathing, etc.)
111
Changes that have been observed in brains of those exposed to prenatal alcohol
Reduced brain volume
Altered cortical thickness
Altered white matter connectivity
112
Deficiency of this is thought to be a risk factor for spina bifida
Folic acid (B9)
113
Most severe form of spina bifida
Myelomeningocele is the most severe form of spina bifida. A portion of the spinal cord or nerves are exposed in a sac through an opening in the spine that may or may not be covered by the meninges.
114
Condition in which brain tissue extends into the spinal canal. (Congenital)
Arnold Chiari II malformation
115
Most common form of spina bifida. What does it affect?
Spina bifida occulta. Affects nerves, resulting in (possible) incontinence, constipation, back pain, muscle weakness.
116
Another name for vitamin B9
folate, folic acid
117
It is recommended that women take folic acid ___ pregnancy to help prevent ___
Before or during early pregnancy to help prevent spina bifida or other neural tube defects
118
Differentiate between a strain and a sprain.
A sprain is an injury to the ligaments and capsule of a joint in the body. A strain is an injury to muscles or tendons.
119
Differentiate between a spiral fracture and a transverse fracture.
Spiral Fracture: one part of the bone has been twisted at the break point. Transverse Fracture: the broken piece of bone is at a right angle to the bone's axis.
120
How is PTH related to bone degeneration?
When dietary calcium intake is insufficient, PTH stimulates bone resorption.
121
An insufficient intake of dietary calcium can lead to what hormone being increased in the body? What other vitamin might be used to counter this?
PTH - parathyroid hormone. Hyperparathyroidism is countered with calcitriol (active vitamin D)
122
Differentiate between osteoblasts and osteoclasts
Osteoblasts form new bones ("BAM! New bones!")
Osteoclasts dissolve old and damaged bone tissue
123
What is calcitriol?
Increases absorption of dietary calcium and phosphate from GI tract and promotes renal tubular reabsorption of calcium in the kidneys.
124
Opposes the action of parathyroid hormone.
Calcitonin ("Oh NO you don't, calcium!")
125
What condition might someone have if you are giving them calcitonin? Why?
Osteoporosis. It counteracts PTH, which breaks down bones.
126
Back problem caused by overuse
Back strain
127
Back problem caused by an external force or shock
Back sprain
128
A back sprain is usually felt where
thumbs, wrists, knees, and ankles (joints)
129
A back strain is usually felt where
In the back, legs, feet, and arms
130
Type of back pain that develops over times is
Back strain
131
Most common etiology of bursitis
The most common etiology is prolonged pressure, whereby the bursa is stressed between a hard surface and bony prominence. (e.g., students who frequently rest their elbows on their desks and people who work on their knees without adequate padding)
132
Cells that play a role in the development of bursitis
Synovial cells
133
What is a "hip fracture"
A break in the upper quarter of the femur
134
Where is an intracapsular hip fracture?
The "neck" of the femur
135
Type of hip fracture that results from a traumatic hip dislocation
Head fracture
136
Where does a femoral neck fracture occur
1-2 inches from the hip joint
137
Oncotic pressure
Oncotic pressure is the osmotic pressure generated by large molecules (especially proteins) in solution (relevant to pressures at the capillaries and third spacing)
138
Most common cause of metabolic acidosis
Vomiting or NG suction (loss of stomach acids)
Diuretics (volume depletion, particularly potassium-wasting)
139
The movement of leukocytes out of the circulatory system and towards the site of tissue damage or infection
diapedesis/extravasation
140
A gene located on one of the numbered chromosomes
Autosomal
141
Joint degeneration of the hands is also called
osteoarthritis
142
Bouchard's nodes
Enlargement of the proximal interphalangeal (PIP) (middle joints of the fingers)
143
Risk factors for Bouchard's nodes
elderly, female, obesity, smoking (females only)
144
Bouchard's nodes pathology
Loss of joint cartilage and inflammation causes excessive bone formation
145
Rickets
Softening and weakening of bones in children, usually because of an extreme and prolonged vitamin D deficiency. RESULTS FROM DEFICIENT MINERALIZATION AT THE CARTILAGE OF GROWTH PLATES.
146
Osteomalacia
“Bone softening” in adults that is usually due to prolonged deficiency of vitamin D. ABNORMAL OSTEOID MINERALIZATION.
147
Symptoms of degenerative disc disease
N/T in arms and legs, neck and back pain
148
Most common symptoms of Paget's disease
Most people have no symptoms
149
Paget's disease
Excessive bone breakdown and regrowth
150
How does the fascia impact compartment syndrome?
Fascia does not stretch, so any swelling or bleeding within a compartment can lead to compartment syndrome
151
Muscle damage in compartment syndrome can lead to what other condition
rhabdomyolysis
152
Fat embolism syndrome is most common in patients with
orthopedic trauma
153
Non-traumatic risk factors for fat embolism
acute/chronic pancreatitis, bone marrow transplant, liposuction
154
Two causes of albinism
lack of ability to produce melanin or a defective gene
155
Vitiligo is associated with (cause)
autoimmune disorders
156
Melasma is associated with (cause)
hormones from pregnancy or medications
157
Melasma causes
dark patches on the skin
158
Most common skin cancer
basal cell carcinoma
159
Typically presents as a shiny, pink- or flesh-colored papule or nodule with surface telangiectasia
basal cell carcinoma
160
Scaling, ulceration, crusting, or the presence of a cutaneous horn
squamous cell carcinoma
161
Typically manifests as a dark brown-to-black papule or dome-shaped nodule, which may ulcerate and bleed with minor trauma
melanoma
162
3 zones of a burn (from inner to outter)
coagulation, stasis, hyperemia
163
The tissue (zone) that was destroyed at the time of a burn injury
Zone of coagulation
164
The area immediately surrounding tissue destroyed during a burn
Zone of stasis
165
Outermost zone of a burn injury. Microvascular perfusion is impaired/not impaired.
Zone of hyperemia. Perfusion is NOT impaired.
166
Will eventually progress and become necrotic within the first 48 hours following a thermal injury.
zone of stasis
167
A severe burn injury can result in the body being in this state
hypermetabolism
168
Hypermetabolism results in increased ___ requirements and increased ___.
increased nutritional requirements and basal metabolic rate (BMR)
169
What is the Rule of Nines used for
estimate body surface area of a burn
170
Most commonly used burn surface area estimator tool
Lund and Browder chart (assessor shades in the burnt area)
171
This tool classifies burns as minor, moderate, and major based on depth and surface area
American Burn Association (ABA)
172
Skin condition that mainly affects the scalp
seborrheic dermatitis
173
Condition that causes dry, itchy, inflamed skin. Chronic and has flares.
eczema/atopic dermatitis
174
Autoimmune skin condition that develops into scaly areas
psoriasis
175
Chronic hives with unclear etiology
urticaria
176
Form of lupus that mainly affects your skin
Discoid lupus erythematosus (DLE) - Systemic lupus (SLE) can affect any part of the body
177
Thrombus vs embolus, which one forms in a vein?
A venous thrombus is a blood clot that forms in a vein. An embolus is anything that moves through the blood vessels until it reaches a vessel that is too small to let it pass.
178
Type of hematoma typically caused by a skull fracture
epidural hematoma
179
A chronic disease of the central nervous system where the immune system attacks myelin
multiple sclerosis
180
An autoimmune condition that causes muscle weakness that gets worse with activity and better with rest.
Myasthenia gravis
181
A disease of the inner ear that can cause a person to get dizzy and have trouble hearing. Most often begins between the ages of 40 and 60. Set off by a build-up of fluid.
Meniere's disease
182
Three layers of a blood vessel (inner to outer)
Tunica intima, tunica media, tunica externa
183
These cells (layer) allow fluid to flow smoothly and are interspersed with valves that ensure the flow continues in one direction.
tunica intima
184
Typically the thickest layer of the veins. ___ muscle type. Innervated by ___ nervous system.
tunica media, smooth muscle, sympathetic nervous system
185
Layer of vein wall consisting of connective tissue and elastic fibers to provide strength. May be the thickest layer in ___ veins.
tunica externa
186
Laminar blood flow
Laminar flow occurs when blood moves in ordered, parallel layers through the arteries with no obstructions to agitate the layers.
187
Turbulent flow generates ___, creating ___.
sound, creates audible diagnostic clues
188
Cardiac output
Cardiac output is the amount of blood ejected from the left ventricle in one minute.
189
LaPlace's Law tells us that the inward pressure that is exerted by the vessel wall on the blood is directly proportional to the tensional stress in the wall and inversely proportional to the radius of the wall. Thus ___.
Thus the smaller the vessel the larger the pressure it can apply on the blood.
190
Equation for cardiac output
Heart Rate x Stroke Volume
191
Three compounds of the RAAS
(R) renin, (A) angiotensin II, (A) aldosterone
192
Unstable atoms that can damage cells, causing illness and aging.
free radicals
193
Most cholesterol in the body comes from where?
Your liver makes all the cholesterol you need. The remainder of the cholesterol in your body comes from foods from animals. Only about 20% comes from animal-based foods.
194
Cholesterol is a fat-like, waxy substance that helps your body make what 3 things
cell membranes, hormones, and vitamin D
195
Lesions on the skin containing cholesterol and fats
xanthomas
196
Vegans are frequently lacking ___ which results in ___. This can also happen to their tongue.
B12 deficiency results in pernicious anemia, glossitis can develop (tongue inflamation)
197
Patients with ___ anemia often present with jaundice in addition to anemia.
hemolytic
198
The most common hemoglobin disorders are ___ and ___
sickle cell disease and thalassemia (less hgb)
199
An inherited blood disorder where the body doesn't produce enough hemoglobin
thalassemia
200
___ thickening or hardening of the arteries caused by a buildup of plaque in the inner lining
atherosclerosis
201
___ is one of the key factors in atherosclerosis development in people with both types of diabetes mellitus.
chronic inflammation
202
The formation of ___ occurs when macrophages engulf an excess of many types of LDL which result in the death of the macrophages once they become oversaturated with the LDLs
foam cells
203
A cardiac cath can ___ or ___ heart problems
diagnose or TREAT (i.e., check pressures, functioning of valves, opening a narrowed artery, biopsy)
204
Most common cause of myocardial ischemia
atherosclerosis
205
___ coronary artery blockage ___% is associated with symptoms
severe blockage >70%
206
___ circulation provides protection against ischemic injury
collateral circulation
207
What is cTn lab test
troponin
208
Troponin is produced following
cardiac muscle damage
209
What is an older test that was used to check for MI?
CPK-MB
210
Type of MI that occurs in those with atherosclerotic plaque rupture and thrombosis
Type 1 MI
211
Type of MI that occurs from decreased oxygen supply from an acute illness causing tachyarrhythmia, hypoxia, or hypotension WITHOUT ATHEROTHROMBOSIS.
Type 2 MI
212
Stable angina
Stable angina (more common) – attacks have a trigger (such as stress or exercise) and stop within a few minutes of resting
213
Unstable angina
Unstable angina (more serious) – attacks are more unpredictable (they may not have a trigger) and can continue despite resting
214
An echocardiogram (echo) is used to diagnose what
problem with the heart VALVES
215
A fibrous sac that encloses the heart and great vessels
pericardium
216
Three stages of acute inflammation
vascular permeability, cellular chemotaxis, systemic responses
217
Hormones that begin vascular permeability stage of inflammation. pH ___
histamine and bradykinin. pH of surrounding fluid LOWERS and inhibits microbial growth
218
During cellular chemotaxis, ___ are released from ___ in a process known as ___. WBC also attract ___ and other WBC to the area.
WBC are released from bone marrow through leukocytosis. WBC attract platelets.
219
Why are lymph nodes involved with inflammatory process?
Due to systemic responses.
220
___ modulate the inflammatory reaction by amplifying or deactivating the process.
Cytokines
221
Elevation of this in the bloodstream indicates that active inflammation is occurring.
C-reactive protein (CRP)
222
Prostaglandins are partially responsible for the ___ response of acute inflammation. This also causes swollen ___.
systemic response, swollen lymph nodes
223
Causes of chronic inflammation
Microorganisms that are difficult to eradicate (i.e., TB)
Hypersensitivity disorders - autoimmune diseases, MS, lupus
Prolonged exposure to toxic agents (coal dust)
224
Staph and strep are both caused by ___ that are part of ___
Bacteria that are part of the normal flora of the human body
225
Strep bacteria have ___ that resist ___
Capsules that resist WBC phagocytosis and secret substances that degrade tissue membranes
226
What are the vector and reservoir for Lyme disease bacteria?
Reservoir is deer and the vector is ticks
227
Lyme disease can spread to the facial nerve causing ___
Bell's palsy
228
Type of bacteria involved in Lyme's disease
bacterial parasites
229
What causes mono
Infectious mononucleosis is caused by the Epstein-Barr virus (EBV)
230
T-helper cells are also called
CD4 cells
231
Cytotoxic T cells are also called
CD8 cells
232
Systemic lupus (SLE) is more common in which gender? Which race?
Women, African Americans
233
What is a retrovirus?
A retrovirus has RNA as its genetic material and comes equipped with its own enzyme, called reverse transcriptase, that can convert its RNA into DNA so that the virus can give genetic instructions to the host cell.
234
What does HIV use CD4 cells for?
self-replication, then they are destroyed
235
Hemoglobin can attach to ___ oxygen molecules. Oxygen attaching to heme forms ___.
4 molecules, forms oxyhemoglobin
236
_____ is responsible for the stimulation of red blood cell (RBC) production, is secreted by ____ in response to _____
erythropoietin
the kidneys
low oxygen levels in the bloodstream
237
A fever typically causes oxygen saturation to ___
decrease
238
When both parents have Crohn’s, there is a ___ chance that their children will have the disease.
50%
239
Risk factors for Crohn's include ___, ___, and ___.
genetics, ethnicity, cigarette smoking
240
The appendix is a ___ organ
vestigial organ (has lost all of its original function via evolution)
241
The ___ drains the venous circulation of the GI system.
portal vein
242
The intestine, spleen, pancreas, stomach, and esophagus have venous networks that drain into the ___, which empties into the ___
portal vein, inferior vena cava
243
How does CRRT differ from hemodialysis and when would it be used?
CRRT is a slower, continuous process used for patients who are hemodynamically unstable and fluid overloaded. It takes smaller volumes of blood from the patient and filters it through a dialyzer over 24 hours
244
Most common form of bladder cancer
transitional cell carcinoma (TCC)
245
Two hormones produced in the posterior pituitary
ADH (vasopressin) and oxytocin
246
___ feedback regulates each of the hypothalamic-pituitary-hormone axes
Negative feedback
247
Pituitary hormones act on receptors located on ___ to ___
endocrine glands to secrete hormones
248
Anterior pituitary hormones
* Thyrotropin, or TSH
* Gonadotropins, or FSH and LH
* Somatotropin, or GH
* Corticotropin, or ACTH
* Prolactin, or PRL
249
Diabetes insipidus occurs due to a lack of ___ being secreted by the ___
ADH, posterior pituitary
250
Thyroid hormones
T3 (triiodothyronine, T4 (thyroxine)
251
___ is the regulator of body metabolism
thyroxine (T4)
252
How does iodine affect TSH levels
If iodine levels are decreased in the body, thyroid hormone synthesis is diminished, which the pituitary senses and then attempts to compensate for by increasing TSH.
253
Patients on these medications should have thyroid hormone levels monitored
lithium, phenytoin, rifampin
254
___ is an autoimmune disorder causing hyperthyroidism.
Graves' disease
255
Patients with hyperthyroidism can develop ___, which is life-threatening.
thyrotoxic crisis
256
Secreted from the adrenal cortex
corticosteroids/glucocorticoids, androgens, aldosterone (mineralcorticoids
257
Aldosterone is particularly active in ___. It causes reabsorption of ___ and ___, and secretion of ___.
RAAS, reabsorb Na+ and H2O, secrete K+
258
Secreted from the adrenal medulla
epi/nor-epi (catecholemines)
259
Adrenal insufficiency can be due to dysfunction of the adrenal gland or ___
Decreased ACTH (pituitary dysfunction)
260
___ is a hypofunction of the adrenal gland. More common in ___.
Addison's disease, women (3:1)
261
___ is a disorder of adrenal overactivity.
Cushing's syndrome
262
Muscle protein, triglycerides, and fat are broken down to assist with ___ in the liver.
gluconeogenesis
263
Hyperinsulinism
Pancreas attempts to compensate for insulin resistance by overworking, which leads to high levels of insulin. Able to compensate this way for many years.
264
Glucagon
Stimulates glycogen breakdown and gluconeogenesis
265
Opposes both insulin and glucagon. Keeps food from being absorbed too fast from GI tract.
Somatostatin
266
Diagnostic criteria for DKA
BS >= 250 mg/dL
pH < 7.3
HCO3- < 15 mEq/L
ketonuria + ketonemia
267
Respiratory presentation of DKA
hyperventilating
268
Two risk factors for spina bifida
Obesity and diabetes
269
Individuals who have sickle cell anemia have normal copies of the gene for ___. Prompting this gene to make hemoglobin in adults with sickle cell anemia compensates for their faulty adult form of the gene.
the fetal form of hemoglobin
270
Rhabdomyolysis causes kidney failure in ___% of cases. This is due to ___ in the blood from injured muscle tissue.
15%, myoglobin
271
Type of hip fracture that would likely show bone fragments on xray
The visible fragments indicate that there are multiple fracture lines and are characteristic of a COMMINUTED fracture.
272
Ian rolled his ankle at basketball practice. He is limping and struggling to put weight on it. His ankle joint is visibly swollen and bruised.
What injury has Ian sustained?
Ian's symptoms are more consistent with a grade II sprain since he has visible swelling and bruising, and, while he has not totally lost function of the joint, it is difficult for him to bear weight.
273
Acute phase of a burn injury begins ___ after the burn injury. It includes the start of ___ and ends with ___.
48–72 hours after, diuresis, closure of the burn wound
274
Rule of Nines
275
Vitiligo
Vitiligo is a pigmentation disorder in which areas of the skin lose melanin. It is characterized by irregular patches of white or pale skin, typically on the head, neck, axillae, and limbs.
276
Tinea ___ infection on the scalp is known as tinea capitis.
fungal
277
What condition is this: "I can see some things out of the corner of my eye, but when I look straight ahead, there is just a dark spot in the center."
Macular degeneration
278
Chronic alcoholism results in nutritional deficiencies and demyelination of the nerves, causing ___.
peripheral neuropathy
279
A/an ___ is likely to occur following a fracture of the temporal bone due to the location of the middle meningeal artery.
epidural hematoma (this may involve losing consciousness)
280
Myasthenia gravis is characterized by (eye) ___, (vision) ___, and episodes of skeletal muscle weakness.
ptosis (drooping of the upper eyelid), diplopia (double vision)
281
When there is a partial fracture, and the intact part of the bone bends, it is a ___. These fractures are usually seen in ___, because ___.
greenstick fracture
These fractures are usually seen in children, whose bones are still relatively soft.
282
___ burns may be white and the surrounding area is edematous. Pain is minimal or absent due to ___.
Full thickness
Due to the damage to nerve endings
283
A transient ischemic attack occurs when ___
a clot forms in a blood vessel in the brain, but the body naturally dissolves it within 24 hours
284
___ is characterized by episodes of muscle weakness, numbness, blurred vision, and fatigue.
Multiple sclerosis
285
Name the condition: "I can see things in front of me okay, but I have to turn my head to see anything in the periphery of my vision."
glaucoma
286
Hypertensive crisis: The patient's systolic blood pressure >___ mmHg combined with ___ indicates hypertensive crisis.
>180 mmHg, symptoms of organ damage (chest palpitations, a headache and blurred vision)
287
___ injury is the first step in the development of atherosclerosis. ___ formation is a second step in the development of atherosclerosis.
___ formation occurs after foam cell formation in the development of atherosclerosis.
Endothelial, Foam cell formation, Fatty streak formation
288
Like all T cells, CD4 cells mature with the ___.
thymus
289
A history of radiation exposure is a common risk for ___ and ___. Radiation affects DNA and may trigger cancerous changes in the bone marrow.
leukemias and lymphomas
290
___ anemia is caused by a failure of the bone marrow to produce adequate numbers of red blood cells.
Aplastic
291
What is this: Cancerous lymphoblasts crowd out healthy bone marrow tissue, making the bone marrow unable to produce adequate numbers of red blood cells or platelets.
lymphoblastic leukemia
292
Crackles are caused by ___ being present in the alveoli due to exudative edema.
additional fluid
293
Alcohol intoxication increases the risk for ___, placing the patient at higher risk for pneumonia.
aspiration
294
Is asthma a restrictive or an obstructive pulmonary disorder.
obstructive
295
Long-term consequence of uncontrolled asthma attacks
Asthma attacks trigger airway remodeling, leading to increasingly irreversible bronchoconstriction.
296
The free radicals introduced by smoking cause damage to the arterial endothelial cells, directly impairing ___ resulting in emphysema.
the alveoli
297
Pulmonary hypertension can lead to what heart condition
right-sided heart failure
298
Hepatitis C begins as an acute infection. Approximately __% will progress to a chronic infection.
70%
299
In cirrhosis, ___ cells overproduce collagenous fibrous tissue, which takes over the liver.
stellate
300
Pyelonephritis is an infection of the kidney and is most commonly caused by ___.
E. coli
301
Natriuresis develops as a result of ___.
the excretion of large amounts of sodium
302
An adult client who has hypervolemia reports a headache, muscle cramps, and vomiting. The nurse notices confusion. Which condition has the client developed?
Hyponatremia - Headache, confusion, vomiting, muscle cramps, and lethargy aresome of the symptoms of delusional hyponatremia in the presence of hypervolemia
303
The nurse is caring for a client who has been diagnosed with renal failure. Which mechanism of compensation for the acid-base disturbance does the nurse recognize in the client?
hyperventilation to reduce CO2
304
Prions are a type of ___
protein (infectious)
305
Predominant immunoglobulin after being exposed to an antigen
IgG
306
Treatment for grade II ankle sprain
Protect, rest, ice, compression, and elevation (PRICE)
307
The nurse is providing care for a client diagnosed with Pott's disease. Which possible complication does the nurse associate with the diagnosis?
Spinal deformity with instability - Feedback: A complication of M. tuberculosis is an advanced infection, and destruction of the vertebrae can lead to spinal deformity with instability, vertebral collapse
308
Which birthmarks are characterized by pink, patchlike lesions that occur from permanent blood vessel abnormalities?
port wine stains
309
___ is critical for language comprehension and is connected to Broca's area. Dysfunction of this area causes receptive aphasia.
Wernicke's area
310
___ refers to twisting and writhing movements and is associated with ___ disease.
Athetosis, Huntington's
311
The nurse is teaching a family member about providing home care for a client with a T1 spinal cord injury. The nurse stresses bowel and bladder management to avoid ___.
autonomic dysreflexia
312
The nurse is performing a physical assessment on a new client. The nurse notes diminished pulses, palpable coolness, and pallor in the lower extremities. The client reports numbness, tingling, and pain with ambulation. Which question by the nurse helps identify a possible serious complication?
Do you have pain when you rest your legs? Feedback: Determining if the client has pain when resting is an important question that can identify possible complications. Clients with this manifestation usually have critical limb ischemia, which can lead to necessary surgical amputation
313
A client is experiencing chest pain. On examination, a scratchy sound is heard through the stethoscope. Which intervention does the nurse think will help reduce the scratchy sound?
glucocorticoids - this is likely myocarditis and is a viral infection
314
Clients with current or prior symptoms of heart failure associated with underlying structural heart disease are classified under stage ___ heart failure.
stage C
315
Dobutamine is used to ___
augment cardiac output
316
The client has developed anemia. The mean corpuscular volume of the client is less than the normal value of 80 to 100, which is an indication of ___ anemia. Tachycardia and pale color are symptoms of this condition.
microcytic hypochromic anemia (micro hypo kidneys)
317
Almost one-third of platelets reside in the ___
spleen
318
Dumping syndrome is the gastrointestinal disorder that occurs due to ___
the removal of part of the stomach
319
Which part of the gastrointestinal (GI) tract is involved in the production of protective mucus
goblet cells
320
Radioactive iodine scan is used for detecting ___
hyperactivity of the thyroid gland
321
A female client with a ___ gland disorder may experience the absence of a menstrual cycle, which is known as amenorrhea
thyroid
322
___ stimulates the Leydig cells of the testes to secrete testosterone.
Luteinizing hormone
323
A pregnant mother with chlamydia can cause her baby to be born with ___
conjuntivitis
324
After exposure to HIV, PEP must be started within ___ to be effective
72 hours
325
With the development of ___, the symptoms of fatigue, weakness, fever, and malaise are often mistaken as a viral illness.
polymyalgia rheumatica
326
Proprioception is the awareness of one's body and body parts in space and in relation to each other. The ___ lobe regions of the cerebrum are responsible for governing proprioception.
parietal
327
___ is a condition that is seen in clients with injuries at the sixth thoracic vertebra or above. It results in the lack of normal sympathetic outflow from the T1-L2 region of the spinal cord, causing bradycardia and low blood pressure (hypotension).
Neurogenic shock
328
Lymphoma cells specifically arise from proliferation of ___
B or T lymphocytes
329
Secondary polycythemia is characterized by an elevated ___ level
erythropoietin
330
Frequent cause of a lung abscess
Staphylococcal endocarditis usually occurs initially, followed by the development of septic emboli, which travels to the lung and forms the abscess
331
___ helps stimulate clotting factors
Vitamin K
332
The kidneys are responsible for the ___ of insulin.
degradation
333
HLA-DR2 can cause someone to develop ___ in the kidney and lungs
Goodpasture's syndrome
334
Clients with spinal cord injuries are particularly vulnerable to the formation of ___ stones.
struvite
335
Hypospadias is the most common congenital disorder that occurs in newborns. In this condition ___
the position of the urethral surface of the penis is abnormal
336
___ is the collection of serous fluid in the scrotum that causes swelling and a feeling of heaviness.
Hydrocele - It is caused due to a traumatic injury or infection in the testis.
337
Inflammation and damage to the filtering part of the kidneys
glomerulonephritis
338
A condition where one or both kidneys become stretched and swollen as the result of a build-up of urine inside them
hydronephrosis
339
Chlamydia causes ___ in males
epididymitis
340
Type of cancer treated via cryotherapy
prostate cancer
341
Found mainly in blood and lymph fluid, this is the FIRST antibody the body makes when it fights a new infection
IgM (Must hurry)
342
Characterized by the development of binucleate Reed-Sternberg cells?
Hodgkin's lymphoma
