Flashcards in test #44 5.4 Deck (222)
kidney is entirely derived from..
metanephric diverticulum (ureteric bud -- collecting duct system)
metanephric mesenchyme (glomeruli & tubules)
when does the metanephros develop
5-6th week of gestation
most common cause of unilateral fetal (antenatal) hydronephrosis
ureteric bud = initially solid cord, then canalizes (done by 10th wk)
metanephros can produce urine before ureteric bud canalizes --> hydronephrosis
last segment to canalize: ureteropelvic junction (between kidney and ureter)
cause of antenatal hydronephrosis obstruction
-ureteropelvic junction (last to recanalize)
-posterior urethral valve (membrane in posterior urethra)
when is a fetus able to make urine
pilocytic astrocytoma on imaging
usu in cerebellum, but can't be in cerebral hemisphere
cystic component w/ a tumor nodule.
nodule: active part of tumor
most common malignant brain tumor in children
histology of medulloblastoma
small, blue cells. hyperchromatic nuclei, scant cytoplasm
can see homer-right rosettes
histology of ependymoma
perivascular rosettes w/ rod-shaped blepharoplasts (basal ciliary bodies) near nucleus
odds ratio vs relative risk
odds ratio: ad/bc
relative risk: [a/(a+b) / c/(c+d) ]
expressing support in interview
express concern independent of understanding.
express concern & interest for patient by acknowledging what the patient says. does NOT claim to know how the patient feels
facilitation in interview
interviewer encourages patient to talk more about experience. asking "and then what happened"
empathy in interview
expression of understanding of experience.
try to "walk in the shoes" to vicariously experience feelings, thoughts, actions.
differs from support, bc tries to project into the experience.
"i can imagine how that experience affected your perspective on life"
reflection in interview
when physicial repeats what patient tells him, i.e. by summarizing
"so, you're telling me you were molested as a kid"
confrontation in interview
interviewer draws attention to discrepancy in response
"although you say you were disturbed, you sound unaffected as you describe it"
mitral valve problems in rheumatic fever
early: mitral valve regurgitation
late: mitral valve stenosis
death with rheumatic fever
late: valvular heart disease --> valvular issues!
diffuse fibrous thickening & distortion of mitral valve leaflets.
commissural fusion at leaflet edges
stenotic orifice w/ diastolic murmur
rheumatic fever mitral valvular disease
mitral stenosis --> atrial dilation --> atrial mural thrombus --> stroke
most common cardiac manifestation of rheumatoid arthritis
almost all causes of mitral valve STENOSIS are caused by...
chronic rheumatic heart disease
infective endocarditis of mitral valve tends to be..
destructive and regurgitant
mitral valvular calcinosis
usually does not impair valve function
usu in women > 60w/o w/ myxomatous floppy mitral valve or elevated left ventricular pressure
ASD on ausculation
wide fixed S2 splitting.
does not change w/ respiration
suggests delayed closure of tricuspid valve, due to right bundle branch block
early diastolic decrescendo murmur
late systolic crescendo murmur w/ mid-systolic click
mitral valve prolapse
click: sudden tensing of chordae tendinae
most frequent valvular lesion
holosystolic high pitched blowing murmur
holosystolic harsh murmur, loudest in tricuspid area, accentuated w/