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unit 3 exam Flashcards

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1
Q

Name all hormones secreted by the anterior lobe of the pituitary gland

A

Growth hormone, thyroid stimulating hormone, follicle stimulating hormone, luteinizing hormone, prolactin, ACTH, lipotropin, melanocyte stimulating hormone

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2
Q

Name all hormones secreted by the posterior lobe of pituitary gland

A

ADH and oxytocin

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3
Q

What are causes of hypofunction or hyperfunction

A

inflammation (usually chronic but can be acute) or tumor originating in endocrine glands

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4
Q

Name the hormones the thyroid gland produces

A

Thyroxine (T4) and triiodothryonine (T3) and calcitonin

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5
Q

What do the thyroid hormones do

A

they are necessary for normal growth and development, regulate basal metabolism, increase metabolic activity and protein synthesis, influence renal decelopment

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6
Q

what is the function of parathyroid hormone

A

regulate calcium and phosphate metabolism

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7
Q

how is calcium and phosphate regulated

A

stimulating resorption of calcium and phosphate from bone, reabsorption of calcium and excretion of phosphate by the kidneys, combined action with vitamin D, and absorption from GI tract

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8
Q

What is the function of mineralocorticoid

A

regulate reabsorption of sodium and excretion of potassium by kidneys, regulate blood pressure

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9
Q

Why is there changes in the endocrine system from age

A

Concentration of hormones needed dont change, but the way we achieve the equilibrium hormone levels do

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10
Q

Where are changes in the system seen from aging

A

pituitary, adrenal, and thyroid function. ———glucose homeostasis, reproductive function, and calcium metabolism——–

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11
Q

If a patient has a lack of progress in PT, what should the therapist note

A

it should signal the possibility of a systemic origin of musculoskeletal symptoms

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12
Q

If a patient has muscle weakness, atrophy, myalgia, and fatigue that persists despite rest, what diseases could be manifested?

A

thyroid or parathyroid disease, acromegaly, diabetes, cushing syndrome, or osteomalacia

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13
Q

What are the functions of cortisol

A

regulates metabolism of proteins, carbs, and lipids to elevate blood glucose levels. essential to norepinephrine-induced vasoconstriction. dampening body’s inflammatory response to foreign agents.

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14
Q

What is acromegaly

A

Excessive secretion of growth hormone after normal completion of body growth

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15
Q

Graves disease is..

A

most common type of hyperthyroidism, increase in T4 production

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16
Q

Pathogenesis of hyperthyroidism

A

people with graves have circulating autoantibodies called TSIs that react against thyroglobulin

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17
Q

What do TSIs do

A

Stimulate enlargement of thyroid gland and secretion of excess thyroid hormone

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18
Q

Symptoms of hyperthyroidism

A

Larger thyroid, nervousness, heat intolerance, weight loss, increased appetite, sweating, diarrhea, tremor, palpitations, afib, increase risk of myocardial infarction, and congestive heart failure

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19
Q

What role does the Mu receptor take part of

A

respiratory depression

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20
Q

Management of hyperthyroidism

A

antithyroid medication, radioactive iodine, and surgery

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21
Q

Type 1 hypothyroidism is..

A

reduced thyroid mass, impaired hormonal synthesis or release of hormones, or elevated TSH hormone

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22
Q

symptoms of type 1 hypothyroidism

A

slowing of body processes, bradycardia, decreased GI tract motility, slowed neuro, decrease in body heat, absence of hydrochloric acid, development of anemia, lipid metabolism is altered

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23
Q

Type 2 hypothyroidism

A

result of failure of pituitary gland to synthesize and release adequate amounts of TSH

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24
Q

What are mixed agonist-antagonists

A

they exhibit some agonist and antagonist-like activity, there’s less risk of the side effects associated with Mu receptors

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25
What kind of opiate classification would you use if you need to treat severe pain
strong agonists
26
Where does metabolic inactivation of opioids take place
liver
27
What are the three mechanisms of action for opioids
spinal, supraspinal, and peripheral effects
28
Explain the spinal effects of opioids
the inhibitory effect (decreased transmitter release from presynaptic and decreased excitability of post synaptic neuron) mediated by opioid receptors
29
explain supraspinal effects of opioids
bind to receptors in midbrain and remove inhibition of pathways that decrease pain. Release setatonin and norepinephrine and inhibit ability of synapses to transmit painful impulses to the brain
30
Adverse effects of opioids
drowsiness, respiratory depression, orthostatic hypotension, GI distress
31
When do withdrawal symptoms show
6-10 hours after last dose
32
What is opioid induced hyperalgesia
may fail to respond to opioids or report increased pain sensitivity.
33
What are corticosteroids
naturally occurring hormones made by adrenal cortex
34
what are glucocorticoids
effect carb and protein metabolism, ----increase blood glucose and liver glycogen
35
what are mineralocorticoids (aldosterone)
regulate electrolyte and water metabolism
36
What are the anti-inflammatory effects of glucocorticoids
act on macrophages, lymphocytes, and endothelial cells to inhibit expression of cytokines, inhibit production of adhesion molecules diminish ability of leukocytes to enter inflamed tissues
37
What are adverse effects of glucocorticoids
Changes in mood, effects on skin and connective tissue, cardiovascular effects, steroid-induced myopathy, effect of growth and bone.
38
What are the applications of glucocorticoids
decrease inflammation, for immunosuppression, replacement steroid for adrenal insufficiency
39
Adverse effects of prolonged systemic corticosteroids
hyperglycemia, fluid retention, increase risk of infection, osteoporosis, bone fractures, peptic ulcer disease, gastritis, nausea, change in mood
40
pharmacological properties of NSAIDs
decreases inflammation, relieve mild to moderate pain, decrease fever, decrease blood clotting
41
what is the role of eicosanoids in health
have effects on every major system
42
What does aspirin inhibit
COX-1 and COX-2
43
What are the clinical applications of aspirin
pain and inflammation, fever, vascular disorders, and prevention of cancer
44
How does aspirin help pain and inflammation
provide analgesic effects similar to opioid drugs without harmful side effects
45
should children use aspirin for a fever
NO, can cause Reye syndrome
46
how does aspirin help vascular disorders
help prevent onset or recurrence of heart attacks by inhibiting thrombus formation in coronary arteries---- using daily can prevent stroke
47
What is the mechanism of aspirin
inhibit platelet induced thrombus formation through its ability to inhibit thromboxane biosynthesis
48
How does aspirin prevent cancer (mechanism)
inhibit COX-2 enzyme which inhibits the synthesis of prostaglandins that cause abnormal cell division inhibits platelet activation
49
What kind of CV problems can be caused by aspirin
increase BP and chance of thrombotic events, can lead to stroke, heart attack in susceptible individuals
50
Why would a patient prefer COX-2 selective drugs
Useful to patients who can't tolerate traditional NSAIDS or aspirin or preferred for patients who are at risk for prolonged bleeding and bruising that can happen with aspirin and NSAIDs
51
COX-2 inhibitors spare the production of _________
thromboxane
52
How do COX-2 drugs increase the risk of CV events
COX-2 inhibition can cause loss of prostaglandins that cause vasodilation and prevent thrombosis which allow PROthrombotic prostaglandins to dominate
53
What is thromboxane
a prostaglandin that facilitates platelet aggregation and clot formation
54
What is the major advantage of acetaminophen
les supper GI tract irritation
55
is acetaminophen considered an NSAID
NO, lacks anti-inflammatory and anti-coagulant properties
56
Name the body parts involved in the upper GI tract
mouth, esophagus, stomach, and duodenum
57
Name the parts involved in the lower GI tract
small intestine and large intestine
58
What are the most common GI problems in older adults
constipation, incontinence, and diverticular disease
59
What is a hiatal hernia
esophageal hiatus of diagram gets enlarged and causes the stomach to go through the hole
60
what are symptoms of a hiatal hernia
Heartburn or reflux
61
Contraindications for hiatal hernia
avoid flat supine position or valsalva manuever
62
What is GERD
reflux of gastric contents into esophagus accompanied by a failure of anatomic and physiologic mechanisms to protect the esophagus
63
clinical manifestations of GERD
heartburn, asthma, cough, laryngitis older that 70 years old can have dysphagia, vomiting, respiratory issues, weight loss, anemia, or anorexia.
64
What are the general functions of the liver
digestive, endocrine, excretory, hematologic, and immune
65
-Conversion and excretion of bilirubin, -produce clotting factors and storage of vitamins, - metabolize drugs, chemicals, and toxins, filters all of blood from GI system
examples of liver function
66
How much bile does the liver produce per day
600 ml
67
Functions of pancreas as an exocrine gland
secretion of digestive enzymes and pancreatic juices and neutralize
68
functions of pancreas as endocrine gland
secretion of glucagon ad insulin by islet of langerhans cells
69
bile helps in....
alkalinizing intestinal contents and plays role in emulsification, absorption, and digestion of fat
70
How does hepatic failure occur
mass of liver cells diminished or cirrhosis, liver cancer, infection, or inflammation
71
What is palmar erythema
warm redness of skin over palms
72
what hormone is associated with spider angiomas
increase estrogen
73
When liver dysfunction causes increased serum ammonia and urea levels, it will IMPAIR THE CNS OR PNS
PNS
74
What is acute cholangitis
obstruction and stasis of bile from choledocholithiasis, biliary strictures, or malignancy can lead to a suppurative infection of the biliary tree
75
what is acute cholecystitis
inflammation of gallbladder, causes prolonged abdominal pain lasting more than 6 hours
76
asterixis
can't maintain wrist extension with forward flexion of upper extremities
77
symptoms of hepatic failure in MSK
thoracic pain, hepatic osteodystrophy
78
what is osteodystrophy
abnormal development of bone, osteomalacia and porosis, pain in wrist and ankles, and referred pain
79
Neuro symptoms of hepatic failure
confusion, sleep disturbances, muscle tremors, hyperreactive reflexes, and asterixis, hepatic encephalopathy or portosystemic encephalopathy
80
medications that are lipophilic have an increased area of distribution in older people secondary to an increase in the proportion of....
fat mass and decrease of lean mass
81
At >2.0 mg/dL, how does jaundice look like
Yellow discoloration of skin, sclerae, and mucous membrane
82
At 3.0 mg/dL, how does jaundice look like
Skin becomes yellow, urine gets dark, stool is light
83
When does cirrhosis occur
when inflammation causes liver tissue damage and/or necrosis
84
How is cirrhosis characterized
Progressive loss of normal tissue that's replaced with fibrosis and nodular regeneration
85
Is cirrhosis reversible
no
86
Elevated portal pressure gradient occurs when pressure of blood entering the liver is higher than pressure of blood in inf vena cava
portal hypertension
87
_________, __________, and __________ combine to form mechanical barriers to blood flow and increase resistance
Fibrosis, nodularity, and abnormal liver architecture
88
What syndrome is a complex neuropsychiatric syndrome and motor disturbances to coma and death?
Hepatic encephalopathy
89
what are the grades of hepatic encephalopathy
minimal, grade 1-4
90
Ascites
abnormal accumulation of fluid within the peritoneal cavity
91
What is hepatitis
acute or chronic inflammation of the liver caused by a virus, chemical, drug reaction, or alcohol abuse
92
How many different viruses does hepatitis have
six, A-G
93
What kind of hepatitis comprises several diseases with common clinical manifestations, usually asymptomatic, an ongoing injury for over 6 months
chronic hepatitis
94
What kind of liver failure is rare but fatal, rapidly progressing, cause is acetaminophen hepatotoxicity/?
Acute liver failure
95
what kind of hepatitis can be easily spread before symptoms appear, symptoms include malaise, fatigue, fever, nausea, and so on.
Viral hepatitis
96
Which hepatitis is transmitted via fecal-oral route, due to poor hygiene, highly contagious, greatest danger of transmission during incubation
Hepatitis A
97
Which hepatitis is highly infections, trasmitted via percutaneously or mucosal contact, and a sexually transmitted disease
Hepatitis B
98
Which hepatitis is commonly associated with injection use, period of infectivity before onset of symptoms, lifetime carrier, often symptomatic
hepatitis C
99
Which hepatitis is uncommon in the US, a coinfection of HBV, requires hepatitis B for its replication
Hepatitis D
100
Which hepatitis is transmitted by contaminated water via the fecal-oral route and clinically resembles HAV
Hepatitis E
101
What's the pathogenesis of alcoholic liver disease
fatty liver disease occurs with the accumulation of fat in hepatocytes
102
Chronic alcohol use results in bacterial overgrowth and disturbance of junctions between intestinal cells stimulates...
Immune system and inflammation
103
How does the liver respond to inflammation and injury
a fibrogenic scar
104
Alcoholic fatty liver disease is associated with
elevated AST and ALT enzymes, bilirubin less than 3 mg/dL, ultrasound may show steatosis
105
What is alcoholic steatohepatitis
inflammation on liver biopsy
106
What is associated with alcoholic hepatitis
elevated AST and ALT, increased bilirubin greater than 3 mg/dL, 50% have advanced fibrosis or cirrhosis on liver biopsy
107
What is nonalcoholic fatty liver disease
its without significant inflammation, related to diabetes and insulin resistance
108
What is the definition of pancreatitis
serious inflammation of pancreas and surrounding organs that can result in auto digestion of pancreas by its own enzymes
109
What pancreatitis is 80% of cases and mild course and few complications
interstitial pancreatitis
110
what pancreatitis is 20% of cases and has significant complications and higher mortality
necrotizing pancreatitis
111
what type of acute pancreatitis is characterized by absence of organ failure or local or systemic complications
Mild acute
112
what type of acute pancreatitis is characterized by transient organ failure with local or systemic complications and severe right upper quadrate pain
Moderately severe
113
What type of acute pancreatitis has severe cytokines and free radicals mediate a systemic response, leading to persistent multi-organ failure or death
severe
114
What pancreatitis has the development of irreversible changes in the pancreas secondary to chronic inflammation
chronic pancreatitis
115
Which cancer has the lowest 5 year survival rate after diagnosis
pancreatic cancer
116

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