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OTU > Alt. Phys. Final > Flashcards

Alt. Phys. Final Flashcards

1
Q

What is an atherosclerotic plaque?

A

Hardening of the blood vessels caused by the plaque which is made up of lipids, cholesterol, calcium

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2
Q

Is atherosclerosis a chronic condition?

A

Yes

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3
Q

HDL vs LDL

A

HDL is good cholesterol and carries fats from periphery to the liver to be discarded. LDL contains less proteins and increases cholesterol in the blood

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4
Q

What is the proper order of development for atherosclerosis?

A
  1. endothelial damage and inflammation
  2. high levels of LDLs in the blood. Some enter the tunica intima
  3. LDL in the t.intima is oxidized into proinflammatory lipids. Attracts inflammatory cells+phagocytes into the endothelium
  4. LDLs will be engulfed by macrophages forming FOAM cells. FOAM cells collect to form fatty streak
  5. FOAM cells release cytokines and growth factors to stimulate proliferation and production of collagen
  6. formation of atherosclerotic plaque. Collagen fibers harden the blood vessel walls to form fibrous plaque
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5
Q

Arterial Disease is most commonly caused by______

A

Atherosclerosis

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6
Q

What is the most serious location for blockage in CAD?

A

left ventricle

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7
Q

CAD can lead to ______

A

LHF

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8
Q

PAD is especially present in___

A

smokers and those with diabetes

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9
Q

Stage 1 of CAD_______

A

absent, weak pulse in arteries supplying the legs and feet

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10
Q

stage 2 of CAD___-

A

intermittent claudication upon physical exertion

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11
Q

stage 3 of CAD_______

A

claudication without physical exertion. coldness in 1 leg//foot compared to the other

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12
Q

Primary Hypertension

A

most common; influenced by genetic and environmental factors

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13
Q

Secondary hypertension

A

Secondary hypertension: caused by a systemic disease process that raises peripheral vascular resistance or cardiac output. Often renal

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14
Q

Isolated systolic hypertension

A

Elevation of only systolic pressure

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15
Q

Primary hypertension is caused by

A

genetics +environment

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16
Q

Which type of hypertension can be caused by hormone imbalances

A

Secondary

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17
Q

Asymptomatic aneurysms can also be called

A

congenital

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18
Q

Which of the following is not a complication of an aneurysm?
Blood leaking
Hemorrhage
Ischemia
Infarction

A

infarction

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19
Q

Thrombus_____

A

blood clot that remains attached to vessel wall

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20
Q

What are the steps to hemostasis?

A

Vasoconstriction, platelet plug, coagulation

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21
Q

Thrombosis _______

A

intravascular activation of coagulation cascade with blood vessel wall damage

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22
Q

Thrombophlebitis_______

A

thrombosis and inflammation in the veins

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23
Q

Thromboembolus______

A

detached blood clot

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24
Q

Causes of arterial thrombosis include all except
Vasculitis
Shock
Blood thickening
endothelial wall infection

A

blood thickening

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25
Q

Which type of embolism can be caused by post-femoral (“hip”) fracture?

A

Fat-emoblism

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26
Q

Which two types of embolism can be caused by an IV?

A

Air embolism and foreign substance

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27
Q

Explain the sequences of events from atherosclerosis to thrombosis to myocardial infarction

A

atherosclerosis = most common cause of thrombus formation. Forces, inflammation, apoptosis or enzymes to the plaque will cause it to rupture leading to increased inflammation with release of multiple cytokines platelet activation, production of thrombin and vasoconstriction. This will cause decrease in lumen size, O2 which will lead to MI

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28
Q

Ischemia =

A

reduction of blood supply to tissues

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29
Q

Hypoxia =

A

low O2 in blood (inadequate supply to an area)

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30
Q

Hypoxemia =

A

low O2 in blood

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31
Q

Infarction=

A

tissue death due to lack of O2

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32
Q

Necrosis =

A

cell death due to pathophysiology changes in cells

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33
Q

Most common cause of transient myocardial ischemia is

A

atherosclerosis

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34
Q

cause of unstable angina (sudden onset) =

A

Reversible myocardial ischemia: presence of a complicated plaque, thrombus formation, vessel occlusion, vasoconstriction

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35
Q

Treatment for unstable angina (sudden onset) =

A

immediate: oxygen, aspirin, vasodilators, pain relief
intermediate: bypass, drugs, clot dissolving drugs
long term: cholesterol lowering agents, lifestyle changes

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36
Q

Modifiable risk factors for atherosclerosis include ALL except

A

age, hypertension, smoking, diabetes mellitus type 2, lack of physical activity

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37
Q

Temporary loss of contractile function lasting hours - days =

A

myocardial stunning

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38
Q

Tissue is persistently ischemic and metabolic adaptation which prolong myocyte survival until perfusion is restored

A

hibernating myocardium

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39
Q

leads to myocyte hypertrophy and loss of contractility distal to site

A

myocardial remodeling

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40
Q

Which one of the acute coronary syndromes can be caused by necrosis?
myocardial stunning
hibernating myocardium
myocardial remodeling
transient ischemia

A

myocardial remodeling

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41
Q

Which one of the following cardiac complications of MI is due to necrosis of the conducting system?
Valve dysfunction
Pericarditis
Aneurysms
Dysrhythmias

A

Dysrhythmias

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42
Q

The T wave on the ECG is_____

A

ventricular repolarization, ventricular relaxation

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43
Q

The P wave on the ECG is______

A

Atrial depolarization and atrial contraction

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44
Q

The QRS segment of the ECG is_____

A

atrial repolarization, atrial relaxation, ventricular depolarization, ventricular contraction

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45
Q

Subendocardial MI is____

A

in b/w the endocardium and myocardium non STEMI

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46
Q

Transmural MI________

A

STEMI. MI is across the wall of the heart

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47
Q

Preload _____

A

volume of blood at the end of diastole (filling stage)

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48
Q

Afterload____

A

resistance in the that the left ventricles must overcome to pump blood out of the aorta.

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49
Q

Preload is increased in all of the following conditions EXCEPT
hypervolemia
hypertension
heart failure
regurgitation of valves

A

hypertension

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50
Q

RHF is most commonly caused by____

A

lung disease

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51
Q

LHF is most commonly caused by_______

A

ischemic heart disease

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52
Q

Which is more common RHF or LHF

A

LHF

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53
Q

Primary pulmonary hypertension is caused by_____

A

Idiopathic: imbalance in production of vasocontrictors & vasodilators

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54
Q

Secondary pulmonary hypertension is caused by_____

A

scar tissue or emphysema (COPD)

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55
Q

The end result of RHF is
pulmonary hypertension
pulmonary edema
peripheral edema
pitting edema

A

peripheral edema

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56
Q

Which of the following complications in not seen with RHF
pulmonary edema
jugular vein distention
dependent edema
ascites

A

pulmonary edema

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57
Q

Jugular venous distention

A

accumulation of fluid in the jugular vein, which returns blood from the head to the heart

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58
Q

Edema

A

excessive accumulation of fluid within interstitial spaces between tissue cells

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59
Q

Dependent edema

A

occurs in the feet & legs while standing and in the sacral regions and buttocks when lying down (supine). Dependent on gravity

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60
Q

Ascites

A

accumulation of fluid in the peritoneal
cavity. body fluid is trapped in the peritoneal
space from which it cannot escape

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61
Q

Pitting edema

A

occurs when a “pit” or indentation
is seen when pressure is applied

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62
Q

Which of the following is NOT a functional
change expected from acute myocardial
infarction?
A. Decreased contractility
B. Decreased stroke volume
C. Increased ejection fraction
D. Disordered heart rhythms

A

C. Increased ejection fraction

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63
Q

What is a possible consequence of thrombosis that occurs within the myocardium?
A. Aneurysm
B. Atherosclerosis
C. Ischemia
D. Hypertension

A

A. Aneurysm

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64
Q

Pericardial disease can be caused by_______

A

infection, trauma or surgery, neoplasm; disorders such as
uremia, rheumatoid arthritis, systemic lupus

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65
Q

Clinical manifestations of pericardial disease mimic those of ______

A

RHF

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66
Q

Acute pericarditis is a common CV complication of which disease?

A

HIV

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67
Q

Acute pericarditis =

A

Roughening and/or inflammation of pericardial membranes
can lead to pericardial effusion/tamponade or constrictive pericarditis

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68
Q

constrictive (restrictive pericarditis)_

A

Fibrous tissue scarring with calcification
Pericardium becomes a hardened shell encasing the heart

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69
Q

Pericardial effusion=

A

Accumulation of fluid in the pericardial cavity; fluid is usually an exudate; develops suddenly
Can occur as a result of pericarditis and can lead to cardiac compression (called: tamponade)

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70
Q

Pericardial tamponade

A

Unable to accommodate more than a small volume of fluid
Accumulation of fluid in the pericardial cavity Restricts contractile ability of heart

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71
Q

Which cardiomyopathy can mimic restrictive pericarditis?

A

restrictive cardiomyopathy

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72
Q

In which cardiomyopathy is contractility normal?

A

hypertrophic cardiomyopathy

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73
Q

valvular dysfunction most commonly occurs in the ____

A

aortic and bicuspid/mitral valve

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74
Q

Rheumatic heart disease occurs from ___________infection

A

pharyngeal

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75
Q

Aschoff bodies are seen in ____

A

Rheumatic heart disease: myocarditis

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76
Q

Myocardium vibrating or twitching is seen with which dysrythmia

A

atrial or ventricular fibrillation

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77
Q

slowing of postural reflexes as part of the aging process; neurologic diseases such as Parkinson’s Disease are causes of which orthostatic hypotension?

A

primary/neurogenic orthostatic hypotension

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78
Q

Triad of Virchow

A

venous stasis, venous endothelial damage, hypercoaguable states

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79
Q

Delivers nutrient rich oxygenated blood from placenta to fetal heart with some of this blood going to the liver

A

umbilical vein

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80
Q

Delivers wastes and deoxygenated fetal blood to placenta

A

umbilical artery

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81
Q

Extension of umbilical vein which drains into inferior vena cava

A

Ductus venosus

82
Q

Opening in the septum between right and left atria which diverts most of blood in RA to LA (right-to-left shunt)

A

Foramen ovale

83
Q

Connects pulmonary trunk with aortic arch: allows blood to flow from pulmonary artery to aorta (systemic circulation) without going through the lungs (right-to-left shunt)

A

Ductus arteriosus

84
Q

after birth
umbilical vein becomes____
umbilical artery becomes______
formamen ovale becomes _____
ductus venosus becomes___
ductus arteriosus becomes___

A

round ligament of liver
umbilical ligaments
fossa ovalis and functionally closes
ligamentum venosum of the liver
ligamentum arteriosum

85
Q

more sever congenital heart defects are

A

cyanotic

86
Q

Acyanotic defects include

A

ASD, VSD, patent ductus arteriosus, AV canal defect

87
Q

cyanotic defect include

A

tetrology of fallot and transposition of the great arteries

88
Q

the most common type of congenital heart lesion is

A

ventricular septal defect

89
Q

Which defect causes a machine like mumrmer

A

paten ductus arteriosus

90
Q

Tetralogy of fallot

A
  1. VSD
  2. Pulmonary valve stenosis
  3. Right ventricle hypertrophy
  4. overriding aorta
91
Q

Hypoxia

A

low oxygen in cells or tissue

92
Q

Hypoxemia

A

low oxygen in the blood

93
Q

Hypercapnia

A

high levels of CO2 in the blood

94
Q

Hypocapnia

A

very low levels of CO2 in the blood

95
Q

Pain receptors are only located in the ____ of the lungs

A

pleura

96
Q

Atelactasis

A

Total collapse of lungs leading to no alveoli ventilation

97
Q

Bronchiectasis

A

Persistent abnormal dilation of the pockets of bronchi
Bacterial infection can remain in affected bronchioles
common in smokers

98
Q

Aspiration

A

Passage of fluid and solid particles into the lungs (even bronchioles) to cause blockage
Fluid can cause chemical damage, e.g. bile & gastric juice burns the lungs

99
Q

Bronchiolitis:

A

Inflammation of the bronchioles which leads to bronchoconstriction
Most common in children

100
Q

Pneumoconiosis can be caused by

A

silica, asbestos, coal, fiberglass, aluminum

101
Q

T/F pneumoconiosis increases the risk of cancer

A

true

102
Q

The main event of surfactant deficiency disorder is

A

atelectasis

103
Q

Mesothelioma is most likely caused by

A

asbestos

104
Q

What is red hepatization

A

accumulation of so much inflammatory cells & debris that the lungs look like liver

105
Q

Most common cause of pulmonary thromboembolism is

A

DVT in thigh

106
Q

The unifying sign and symptom of obstructive lung diseases is

A

sign: wheezing symptom: dyspnea

107
Q

Asthma is a

A

type 1 hypersensitivity reaction

108
Q

Centri-acinar emphysema affects

A

smokers with chronic bronchitis

109
Q

Pan-acinar emphysema affects

A

older adults
deficiency in alpha1 antitrypsin
all structures are affected

110
Q

what is the first indication of lung damage

A

hypersecretion of mucus and productive cough

111
Q

What stores the hormones secreted by the hypothalamus?

A

Neurohypophysis

112
Q

What can bind to receptors and act like hormones?

A

Antibodies

113
Q

What causes low ADH secretion?

A

HPA tumor, infection or receptor resistance

114
Q

What causes high ADH secretion?

A

Tumors, head trauma, Sheehan Syndrome

115
Q

Autoimmune cause of hypothyroidism?

A

Hasimoto’s

116
Q

Autoimmune cause of hyperthyroidism?

A

Grave’s Disease

117
Q

What is the most common cause of thyroid cancer?

A

Ionizing radiation esp. in childhood

118
Q

What causes hyperparathyroidism?

A

Primary: adenomas or hyperplasia
Secondary: chronic hypocalcemia, low dietary calcium, malabsorption syndromes

119
Q

What is diabetes Insipidus?

A

Central: A reduction in ADH
Nephrogenic: Nephrons do not recognize ADH

120
Q

What is diabetes mellitus and explain the different types?

A

Type 1, type 2, gestational

121
Q

Explain the mechanisms of DKA

A

Severe manifestation of insulin deficiency that evolves quickly. Increased production in ketones with ketone smell in breath and urine.

122
Q

Explain the mechanisms for HHNKS

A

Large amounts of glucose is excreted in urine causing dehydration, increased blood concentration leading to blood becoming thick/sluggish. This can lead to coma, death and seizures. Evolves slowly

123
Q

Explain the effects of microvascular disease

A

Neuropathy, nephropathy, retinopathy

124
Q

Explain the effects of macrovascular disease

A

Attachment of advanced glycation end products to their receptor which promotes oxidative stress, inflammation, hyperlipidemia

125
Q

Why does hyperglycemia lead to increase infections? Explain

A

Loss of senses, glycosylated Hb leads to hypoxia and increases risk of infection, increased glucose for pathogens, reduced blood flow (reduced phagocytosis)

126
Q

What is a open fracture?

A

Break through intact skin, bone marrow is exposed to external environment

127
Q

What is a pathologic fracture?

A

occurs in bone which is weakened by a disease

128
Q

What is a comminuted fracture?

A

Fracture with 2 or more pieces of bone

129
Q

What is a impacted fracture?

A

Pressure/weight that causes breaks

130
Q

What is a greenstick fracture?

A

Break in only the cortex of the bone

131
Q

What is an avulsion fracture?

A

Fragment of bone connected to a ligament or tendon breaks off the main bone

132
Q

Dislocation

A

total loss of contact between articular cartilage

133
Q

Subluxation

A

Partial loss of contact between articular cartilage and surface of bone

134
Q

Strain

A

Injury or tear in a tendon/muscle

135
Q

Sprain

A

Injury or tear in a ligament

136
Q

Most common fractures in osteoporosis?

A

Compression fractures

137
Q

Most common location of fractures in osteoporosis?

A

Thoracic vertebrae

138
Q

Osteoporosis is more obvious in ____

A

trabeculae bone

139
Q

Explain the mechanisms of OPG, RANKL, RANK

A

Osteoblasts produce OPG and RANKL
Osteoclasts have RANK receptors
OPG is increased by the presence of estrogen

140
Q

Explain DMD

A

Loss of dystrophin which leads to slow motor development, progressive weakness, muscle wasting. X-linked recessive disease

141
Q

Explain DDH

A

Congenital abnormality of the femoral head, acetabulum or both. Risk factors include: female, oligohydramnios. Barlow vs Ortolani test. Treatment includes Pavlik harness

142
Q

Where does OA occur more frequently?

A

hips, knees, lower lumbar +cervical vertebrae, CMC, TMT joints

143
Q

In RA activation of CD4 helper cells leads to what?

A

stimulation of macrophages, fibroblasts, RANKL and osteoclasts which leads to pannus formation and joint destruction

144
Q

What is the chronic form of gout called?

A

Tophaceous gout

145
Q

Which bacteria causes osteomyelitis?

A

Staph. aureus

146
Q

What are the secondary causes of bone cancer?

A

Prostrate cancer, breast cancer, kidney cancer, lung cancer, thyroid cancer

147
Q

Osteosarcoma is located where?

A

Metaphysis region of long bone

148
Q

Chondrosarcoma presents itself where?

A

Joint space and can expand to surrounding tissue

149
Q

Where does Ewing Sarcoma presents itself?

A

Diaphysis of long or flat bones

150
Q

Cardiogenic shock

A

caused my MI, LHF, VFIB

151
Q

Hypovolemic shock

A

insufficient intravascular fluid volume due to hemorrhage, burns or diarrhea

152
Q

Neurogenic shock

A

alterations of the CNS from SC injury

153
Q

Anaphylactic Shock

A

type of hypersensitivity reaction(type 1) caused by bees, peanuts latex etc.

154
Q

Compensation for cardiogenic shock

A

RAAS, ADH, catecholamine release

155
Q

Massive vasodilation is seen in which type of shock?

A

neurogenic

156
Q

Bleeding from venipuncture sites due to simultaneous clotting and hemorrhage is known as what?

A

DIC

157
Q

What is an ectopic source of a hormone?

A

Nonendocrine source independent of biological controls

158
Q

What is the primary cause of kidney failure?

A

Diabetes mellitus

159
Q

What is allergic contact dermatitis?

A

Type 4 T-cell/ delayed hypersensitivity reaction. Due to metals, poison ivy, latex

160
Q

What is irritant contact dermatitis?

A

Non-immunological, non-specific irritants such as acids, detergents and water

161
Q

Where does seborrheic dermatitis develop?

A

sebaceous glands of scalp, eyebrows, eyelids,

162
Q

What is koebner phenomenon?

A

plaque and papule formation at the site of trauma

163
Q

Where are the bumps most likely to form in herpes-zoster?

A

dermatomes along the thoracic and lumbar back region

164
Q

Which ringworm infection is resistant to topical anti-fungals?

A

Tinea capititis

165
Q

Where is candidiasis most likely to form?

A

Mucous membranes and skin folds

166
Q

Seborrheic keratosis is___

A

benign proliferation of basal cells. No increased cancer risk but worsens with UV exposure

167
Q

Actinic keratosis ______

A

proliferation of keratinocytes due to prolonged UV exposure. Premalignant condition

168
Q

Keratoacanthoma

A

Growth of squamous cells arising from hair follicles. Pre-malignant condition

169
Q

Risk of cancer with nevi is ___-

A

possible

170
Q

Which pre-malignant conditions will lead to squamous cell carcinoma?

A

Actinic keratosis and keratoacanthoma

171
Q

Chovestk sign is seen in

A

hypoparathyroidism

172
Q

In which thyroid disorder is there an increased metabolic rate and weight loss?

A

hyperthyroidism

173
Q

What is addisonian crisis?

A

vascular collapse and shock

174
Q

Large amounts of glucose excreted in blood is seen in which endocrine disorder?

A

Hypoglycemia aka diabetes mellitus, HHNKS

175
Q

Overglycosylation of glycoproteins on
basement membrane of endothelium is seen in which endocrine disorder?

A

diabetes mellitus, hyperglycemia, microvascular disease

176
Q

Duchenne muscular dystrophy is
1. More commonly diagnosed in females
2. An autosomal recessive gene disorder
3. The most common form of muscular dystrophy
4. A disease of the skeletal system

A

the most common form of muscular dystrophy

177
Q

What are the risk factors for DDH?

A

Female sex, breech position, family history, oligohydramnios

178
Q

What is the most common joint disease?

A

osteoarthritis

179
Q

Eric had low levels in which hormones?

A

all HPA hormones (testosterone) except for oxytocin and prolactin

180
Q

Which hormone released by the hypothalamus is inhibitory

A

prolactin inhibitory factor

181
Q

How did doctors cure Eric’s pituitary tumor?

A

transphenoid surgery and radiation

182
Q

Eric’s aneurysm could have been caused by

A

radiation

183
Q

Eric’s stroke could have been caused by

A

radiation, high BP (multifactorial)

184
Q

Why is Eric prone to infections?

A

because he is deficient in cortisol

185
Q

Eric’s polyuria indicated that

A

he has diabetes insipidus

186
Q

Cellular edema due to shock causes a _____ in K+ and _________ in Na and H2O

A

efflux, infflux

187
Q

Cystic fibrosis effects the _______ on ________

A

Cystic Fibrosis transmembrane
conductance regulator (CFTR) GENE found on
chromosome 7

188
Q

The most common gene mutation of cystic fibrosis causes

A

protein processing mutations

189
Q

What happens without adequate CFTR protein?

A

chloride and water have problems LEAVING the cell

190
Q

Purplish brown macules that can develop into plaques and nodules and can be a cardinal sign of AIDS is known as

A

kaposi sarcoma

191
Q

The most common cause of pulmonary edema is

A

LHF

192
Q

Adrenal tumor that secretes catecholamines is called

A

pheochromocythoma

193
Q

decrease in LH, FSH, TSH AND ACTH are clinical conditions of

A

hypopituitarism

194
Q

glycosylated Hb leads to

A

hypoxia, increased risk of infection,

195
Q

resembles RHF, exercise intolerance, dyspnea, fatigue, anorexia, edema, jugular vein distention, hepatic congestion, hypoxia

A

pericardial disease

196
Q

Herberden’s and Bouchard’s nodes is characteristic of which disease?

A

Osteoarthritis

197
Q

exophthalmos, dermopathy, pretibial myxedema is characteristic of which endocrine disorder?

A

hyperthyroidsm

198
Q

Stephanie’s experience with trikafta was

A

succesful

199
Q

stephanie was diagnosed at 30 for cystic fibrosis

A

false

200
Q

Where is pressure higher in a fetus

A

pressure is higher in the right atrium and pulmonary artery

OTU (3 decks)

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