DAY2 Flashcards
number of new cases of a disease divided by the number of persons at risk
incidence
number of deaths due to a disease divided by total population
mortality
another term for illness
morbidity
total number of cases existing of a disease
prevalence
highest incidence rate of cancer in men and women
men: prostate women: breast
highest mortality rate of cancer in men and woment
lung for both
endocrine system compared to nervous system exception:
- Serve internal communication via Chemical means
- SLow and chronic control
- continue long after stimulate stops
- precisely targeted and specific
- precisely targeted and specific
this is a charcteristic of the nervous system which also includes internal communciation via electrical and chemical; fast acute control; stops quickly after stimulus stops
negative feedback exception:
- the fundamental mechanism that keeps a variable close to its set point
- thermoregulation
- thyroid hormone synthesis
- deliver
- delivery
This positive feedback. In addition ovulation is positive feedback. Self amplyfying cycle in which a physiological change leads to even greater change in the same direction
Hormones from anterior pituitary
TSH, ACTH, FSH, LH, PRL, GH,
Hormones from posterior pituitary
Oxytocin, ADH
TSH
Thyroid - growth of thyroid, secretion of thyroid hormone
ACTH
Adrenal Gland - growth, secretion of corticosteroids
FSH, LH
Ovaries, Testes -
FSH: ovarian follicles, increase estrogen
LH: Ovulation
PRL
Mammary Gland: milk synthesis, Increase sensitivity of LH
GH
Bone, muscle, adipose tissue - somatomedin secretion, widespread tissue growth
OT
uterus contraction, milk RELEASE
ADH
Kidneys - water retention, vasopressin (at high concentration)
Pineal Gland
melatonin and serotonin
Thymus
thymopoietin and thymosins
Thyroid
releases T3, T4, Calcitonin
Parathyroid
release PTH (parathyroid hormone)
T3 and T4
increase metabolic rate, heat production, increase circulation, development
calcitonin
decrease blood calcium levels, increase calcium levels in bone
PTH
increase blood calcium levels, decrease urinary calcium excretion (too much can cause osteoporosis)
Adrenal Medulla
epinephrine, norepinephrine, dopamine
Adrenal Cortex
aldosterone, cortisol, corticosterone, androgen and estrogen
epinephrine, norepinephrine, dopamine
complement effects of sympathetic nervous system, fight or flight
aldosterone
control electrolte balance (promotes sodium retention and potassium excretion), maintains blood pressure and volume
cortisol and corticosterone
fat/protein catabolism increase, gluconegenesis, stress resistance, tissue repair, inhibit immune system
androgen and estrogen
growth of pubic and axillary hair, bone growth, sex drive, male prenatal development
insulin (most tissues)
70% beta cells of pancreas
decrease blood glucose levels, increase glycogen, fat and protein synthesis
glucagon (target is liver)
alpha cells of pancreas
increase blood glucose levels, decrease glycogen, fat breakdown
T Cells are originated in…., matured in …….
bone marrow..thymus
T cell
cell mediated immunity
B cell
humoral immunity (relating to antibodies)
mature follicle ruptures in response to a surge in…
Leutenizing hormone
increases blood calcium, decrease urinary calcium
parathyroid hormone
decrease blood calcium, increase urinary calcium
calcitonin
used for male pattern baldness
finasteride (proscar)
painless bleeding and sudden, presenting as hematochezia with anemia symptoms (fatigue, lightheadedness, dyspnea on exertion)
diverticulosis
risk factors for diverticulosis
low fiber, high fat diet; advanced age (>80), connective tissue disorders (ehlers danlos syndrome)
diverticulosis is most common cause of……. in patients > ….. years of age
Lower GI bleeding(sigmoid)… 40
at what age should colon cancer screening
50 every 10 years
diagnostic test for diverticulosis
blood test
inflammation, LLQ abdominal pain, fever, nausea, vomiting, constipation… CBC may show leukocytosis
diverticulitis
what is diagnosis for diverticulitis?
colonoscopy, barium enema, abdominal xray (caution with colonscopy because of perforation)
treatment option for diverticulitis exception:
- bowel rest
- IV fluid
- IV antibiotics
- High fiber diet
- high fiber diet is for diverticulosis
peripheral ipsilateral facial paralysis with inability to close the eye on the involved sign; forehead has no wrinkles, corner of mouth droops… what CN is effected
Bell’s Palsy… CNVII.. LMN
what is effected if the opposite side and lower side of face is impacted
Upper Motor Neurons
Bells Palsy is a complication of…..
AIDS, LYME DISEASE, SARCOIDOSIS, TUMORS, DIABETES
Bells Palsy is 3x more likely to occur in …
pregnant women than non-pregnant women
CNVII relates to taste?
anterior 2/3 of the tongue
Parkinson’s disease is attributable to…
decreased levels of dopamine
Parkinson Tetrad
Postural Instability
Rigidity (cogwheeling)
Tremors (pill rolling) (resting tremors)
Slowed movement
drug used for parkinsons
Levodopa with carbidopa
Carbidopa blocks the metabolism of levodopa in the periphery
Levodopa is a precursor to dopamine that crosses the blood brain barrier
hesitancy, weak stream, intermittent stream, incomplte emptying, urinary retention, bladder fullness
Benign Prstatic Hyperplasia
diagnosis for BPH
DRE, PSA, cystoscopy will see an enlarged prostate
herbs for prostate
Saw Palmetto
Herbs for UTI
Cranberry
herbs for PMS
evening primrose
herbs for anxiety and insomnia
passionflower
treatment for BPH exception:
- Terazosin (alpha 1 blocker)
- Finasteride (5 alpha reductate inhibitors
- Trans urethera resection prostate
- radiation therapy
- radiation is for prostate cancer
BPH is not cancer
most common cancer in men and second leading cause of cancer death
prostate cancer
diagnosis of prostate cancer
increased PSA levels, DRE, but definitive diagnosis is with ultra sound guided biopsy
dysuria, urgency, frequency, suprapubic pain and possibly hematuria
UTI (more frequestly in women than men) +E Coli cultures in 80%
UTI bugs.. SEEKS PP
Serratia E Coli Enterobacter Klebsiella Staphylococcus saprophyticus Pseudomonas Proteus mirabilis
systolic BP > 140 and diastolic BP >90 based on 3 measurements separated in time… with no know cause
Essential Hypertension…
when there is a cause associated it is called secondary hypertension
treatment of hypertension ABCD
ACE inhibitors
Beta Blockers
Calcium Channel BLockers
Diuretics
Secondary Hypertension….
cushings, conn’s, pheochromocytoma
Pain Amenorhea Vaginal bleeding….
PAVEctopic pregnancy
abdominal pain, + pregnancy test, tranvaginal ultrasound showing an empty uterus, confirm with hCG
Ectopic Pregnancy… usually tubal
autoimmune pancreatic beta cell destruction leading to insulin deficiency and abnormal fuel metabolism..
DM1 … risk is diabetic ketoacidosis (DKA)
dysfunction in glucose metabolism that is charcterized as varying degrees of insulin resistance
DM2 ..
HbA1c for diagnosis of diabetes…
- below 6.5%
- between 6 and 6.5
- over 6.5
- 125 and over
- over 6.5%
diagnosis must include 1 of the following for Diabetes..
fasting glucose over 126
random glucose over 200
HbA1c over 6.5
2 hour post prandial glucose over 200
medication for DM2
metformin
complications of DM2
macrovascular: arthrosclerosis, coronary AD, stroke
microvascular: retinopath, nephropathy, neuropathy
subacute granulomatous inflammation of the large vessels, including the aorta, external carotid (especially the temporal branch), vertebral arteries
Temporal artertitis (giant cell arteritis)
new headache (uni or bi), scalp pain, temporal tenderness, jaw claudication, fever, permanet monocular blindness, weight loss, myalgias.. fear of blindness
temporal artertits presentation
diagnosis of temporal artertitis
ESR blood test >50, ophthalmologic evaluation, temporal artery biopsy
bull’s eye red rash, flu like symptoms, facial nerve palsy, transmitted by ticks… later monoarthritis, migratory polyarthritis, cardiac,
Lyme Disease
treatment of Lyme’s
doxycycline, ceftriaxone
metabolic bone disease.. T Score -2.5 or lower
osteoporosis
diagnosis
DEXA scan… -2.5 or lower is osteoporosis, -1 to -2.5 osteopenia
28 year old female, binge eating, purgin, BMI 13, amenorrhea
Anorexia Nervosa
diagnostic method for bladder cancer
- urinalysis
- CT urography
- intravenous pyelogram
- cystoscopy with biopsy
all are possible.. but 4 is definitive
muscles involved with rotator cuff
infraspinatus, subscapularis, teres minor, supraspinatus… SItS
dark blood in the stool…
Gastric Bleeding… dark blood is far away…
Hematochezia is bright red blood .. external and internal hemorrhoids
fever, tachycardia, chronic cough, bloody sputum, weakness, weight loss, swollen lymph nodes
TB
frequent urination, unquenable thirst, 55 yo male.. possible?
diabetes…
first sign of infectious mononucleosis..
severe sore throat.. EPSTEIN BARRE virus.. red flag is enlarged spleen.. no contact sports
breast cancer risks…
nulligravida (never pregnant), early menarche, sister with breast cancer…. longer time in menstural bleeding means higher risk for cancer
KUB xray is…. kidney and…
ureters and bladder..
Dermatomes T4 C6 T10 L4 L5 S1 S2-S4
nipple thumb umblicus knee dorsum of foot achilles tenodon perineum
bronchoscopy is used for .. exception
- esophagus
- trachea
- lung
- bronchi
esophagus is a pathway for food… others are airways..
Apex of the heart..
5th ICS
MS patients will get worse….
hot weather, hot showers
antihistamine (H1) side effects especially 1st generation…
drowsiness… (benadryl)… 2nd generation (zyrtec, claritin)
H2 antihistamines in ST (zantac)
hypertension plus proteinuria plus edema
pre-elampsia
eclampsia
hypertension plus proteinuria plus seizure
AST:ALT > 2:1
- hepatitis
- liver cirrhosis
- alcoholic hepatitis
- liver cancer
- alcoholic hepatitis
chronic overdosing from salicylate (aspirin)
tinnitus
HEPC, HEPB, HIV transmission…
blood
colonoscopy uses for…
- Duodenal ulcers
- hemorrhoids
- colon polyps
- colon cancer
used for all except duodenal ulcer
signs of memingitis…
- High fever
- BLoody diarrhea
- stiff neck
- drowsiness
bloody diarrhea is not a sign
Kernig’s sign (can’t extend knee)
Brudzinski’s sign (flex neck and legs raise)
long term use of corticosteroid exceptions.. 1. exophthalmos 2. cushings syndrome 3. hirsutism 4 abdominal striae
exophthalmos is for grave’s disease..
the others are excessive corticosteroids..