Flashcards in test #20 4.10 Deck (124)
describe alcoholic cirrhosis
form of micronodular cirrhosis, associated w/ hepatocyte death followed by fine fibrosis of liver.
will result in increased portal HTN.
pathogenesis of ascites in patients w/ cirrhosis. rx (2)?
1. mechanical compromise of portal vein (fibrotic tissue)
2. vasoactive agents cause dilation of splanchnic arterial vasculature & further intrahepatic vasoconstriction.
ascitic fluid formation --> overall, decreases systemic fluid pressure --> kidney's RAA --> Na+ and H20 retention.
rx: furosemide and spironolactone
male mesonephric ducts form (3)
internal genitalia: epididymis, ductus deferens, seminal vesicles.
urogenital folds form? in male & female?
male: ventral aspect of penis.
female: labia minora
genital swellings form? in male & female?
female: labia majora
urogenital sinus in males? females?
male: bladder, urethra, prostate, bulbourethral glands.
female: bladder, urethra, lower vagina, bartholin glands.
female paramesonephric ducts form?
internal genitalia: uterine tubes, uterus, cervix, upper vagina
DHT role in embryonic life? adult life?
embryonic life: formation of external male genitalia.
adult: secondary sex characteristics.
why are inferior MI associated w/ bradycardia? rx?
usu result from right coronary artery occlusion, which also feeds sinoatrial node.
rx: atropine. recall side effects though (i.e. myadriasis: acute-angle glaucoma)
risk for closed angle glaucoma?
asian's and inuits
aka uveitis. anticholinergics can help reduce pain & prevent adhesion formation
rx for bradycardia?
repeatedly reliving traumatic, life-threatening event in form of nightmare / flashbacks. avoid reminders. social detachment. poor sleep/concentration. hypervigilance. LONGER THAN 4 wks.
acute stress disorder
identical symptoms to PTSD, but symptoms from 2 days - 4 weeks.
behavioral or emotional symptoms in response to a psychosocial stressed that arose within 3 months. marked distress in EXCESS of that EXPECTED from exposure to stressor. functional expected.
differentiate PTSD from acute stress disorder? from adjustment disorder?
PTSD > 4 wks. acute stress 2 days - 4wks.
adjustment: distress in excess of what you'd expect for a given exposure.
repeated & prolonged kneeling causes..
PREPATELLAR bursitis. "housemaid's knee". see in roofers, carpenters, plumbers. pain erythema, swelling, inability to kneel on affected side.
located between patella & the overlying skin & prepatellar tendon. lined by synovium, contains little fluid.
popliteal and gastrocnemius bursitis associated w/
formation of Baker's cyst
anserine bursitis (pes anserinus bursitis)
pain along medial aspect of knee. overuse in athletes, or chronic trauma in patients w/ heavy body habitus. tenderness to palpation 4xm distal to anteromedial joint margin of knee.
low total K+: low intracellular stores w/ normal-HIGH extracellular levels.
acidosis, lack of insulin = pulls into extracellular environment.
osmotic diuresis = pulls K+ out of body
MUST REPLACE K+ during ketoacidosis.
what drug reduces morbidity and mortality in class III and IV heart failure patients?
spironolactone / epleperone (more selective)
(in addition to standard therapy of ACEIs, digoxin, diuretic)
less about its diuretic effect. more about blockade of aldosterone on heart remodeling.
elastase can be found..
in macrophage lysosomes & large, azurophil (primary) granules of neutrophils.
what does clara cell CCSP do?
inhibit neutrophil recruitment and activation.
where do goblet cells stop
are not in bronchioles downwards.
urge incontinence / overactive bladder syndrome caused by...
uninhibited bladder contractions (detrusor instability) rx: oxybutynin: antagonist muscarinic receptors, esp M3 on smooth muscle of bladder.
b1 receptors are located..
in heart & renal juxtaglomerular cells
methyldopa and clonidine. decrease sympathetic outflow and BP.
B2 stimulation causes..
bronchodilation, vasodilation, and tocolysis (baby extrusion)
5-HT, serotonergic neurons are located in brain...
raphe nucleus of brainstrem (midbrain, pons, medulla)
sleep-wake cycle, arousal.