Exam 3 Flashcards
What is poikilocytosis?
Red blood cells have abnormal shapes.
What is anisocytosis?
Red blood cells (RBCs) abnormal sizes.
Define anemia.
A reduction in the total number of erythrocytes in the circulating blood or a decrease in the quality or quantity of hemoglobin.
What are the common causes of anemia?
(4)
- Impaired erythrocyte production
- Blood loss (acute or chronic)
- Increased erythrocyte destruction
- Combination of these factors
What characterizes megaloblastic anemias?
Red blood cells are abnormally large and underdeveloped due to impaired DNA synthesis during production.
What is pernicious anemia?
A type of megaloblastic anemia caused by vitamin B12 deficiency due to lack of intrinsic factor.
What is intrinsic factor (IF)?
A glycoprotein produced in the stomach that binds to vitamin B12 (cobalamin) for intestinal absorption.
What are microcytic-hypochromic anemias characterized by?
Abnormally small erythrocytes with reduced amounts of hemoglobin.
What is the most common nutritional disorder of microcytic-hypochromic anemia?
Iron deficiency anemia.
Iron deficiency anemia can arise from _______ or _______ .
Excessive blood loss
Inadequate dietary intake
What causes aplastic anemia?
(3)
Autoimmune disease against hematopoiesis
Chemical agent exposure
Unknown / idiopathic
What is sickle cell disease?
A group of inherited disorders affecting hemoglobin, causing red blood cells to become sickle-shaped.
What is disseminated intravascular coagulation (DIC)?
An acquired syndrome characterized by widespread activation of coagulation, leading to clot formation and risk of hemorrhage.
What are the hallmark cells of Hodgkin lymphoma?
Hodgkin and Reed-Sternberg (HRS) cells.
What is hereditary hemochromatosis (HH)?
An inherited condition characterized by iron accumulation in tissues and organs.
What are the most prevalent types of hemophilia?
- Hemophilia A (factor VIII deficiency)
- Hemophilia B (factor IX deficiency)
What is psoriasis?
A chronic immune-mediated inflammatory disorder affecting skin, scalp, and nails.
What causes Lyme disease?
The spirochete Borreliella burgdorferi transmitted by Ixodes tick bites.
True or False: Herpes simplex virus (HSV) can cause lifelong latency.
True
What are the two types of herpes simplex virus?
- HSV-1 (oral secretions)
- HSV-2 (genital infections)
What is the ABCDE rule used for?
To evaluate suspicious nevi for melanoma.
What does ‘A’ in the ABCDE rule stand for?
Asymmetry.
What is basal cell carcinoma (BCC)?
A surface epithelial tumor originating from basal or stem cells, often caused by UV radiation.
What is seborrheic keratosis?
A benign proliferation of cutaneous basal cells producing flat or slightly elevated lesions.
What triggers acne vulgaris?
Increased androgen levels during puberty affecting sebaceous glands.
What is the appearance and typical size of seborrheic keratosis lesions?
They vary from a few millimeters to several centimeters, often oval and greasy-appearing with a hyperkeratotic scaly ‘stuck on’ appearance.
What are effective treatments for seborrheic keratosis?
- Cryotherapy with liquid nitrogen
- Shave excisions
- Laser therapy
What triggers the development of acne vulgaris?
Androgens increase the size and productivity of sebaceous glands, promoting comedome formation.
What role does Cutibacterium acnes play in acne vulgaris?
Follicular proliferation of anaerobic C. acnes shifts from symbiotic to pathogenic strains, contributing to inflammation.
What is atopic dermatitis, and when does it typically onset?
It is the most common cause of eczema in children, usually beginning from 2 to 6 months of age.
What comorbidities are associated with atopic dermatitis?
- Asthma
- Allergic rhinitis
- Food allergies
What is the primary cause of impetigo in children?
It is caused by S. aureus and, less commonly, Streptococcus pyogenes.
How is molluscum contagiosum transmitted?
Through person-to-person direct contact, auto-inoculation, or contaminated fomites.
What are the two primary mechanisms for altered hormone levels?
- Inappropriate amounts of hormone delivered to the target cell
- Inappropriate responses by the target cell
What triggers the release of antidiuretic hormone (ADH)?
Released when the body perceives volume depletion, indicating not enough fluid.
What is diabetes insipidus associated with?
Insufficient ADH leading to polyuria and thirst (polydipsia).
What characterizes the syndrome of inappropriate antidiuretic hormone (SIADH) secretion?
High levels of ADH without normal physiologic stimuli for its release.
What is the role of thyroid hormones in the body?
They are crucial for metabolism, growth, and development.
What typically indicates hypothyroidism in terms of thyroid stimulating hormone (TSH)?
High TSH levels.
What are the symptoms of hypothyroidism?
- Constipation
- Bradycardia
- Dyspnea
- Lethargy
What triggers Graves Disease?
Stimulation of the thyroid by autoantibodies directed against the TSH receptor.
What defines diabetes mellitus type 1?
A disorder of pancreatic dysfunction and beta cell destruction leading to absolute insulin deficiency.
What are the risk factors for diabetes mellitus type 2?
- Obesity
- Poor diet
- Lack of regular exercise
What is insulin resistance?
A suboptimal response of insulin-sensitive tissues to insulin.
What are the key complications associated with diabetes mellitus?
- Diabetic ketoacidosis (DKA)
- Hyperglycemic hyperosmolar state (HHNKS)
- Microvascular disease
- Macrovascular disease
What characterizes diabetic ketoacidosis (DKA)?
Hyperglycemia, acidosis, and ketonuria.
What are common symptoms of diabetic ketoacidosis (DKA)?
- Kussmaul respirations
- Polyuria
- Thirst
- Abdominal pain
- Vomiting
What is Addison disease characterized by?
Inadequate corticosteroid and mineralocorticoid synthesis with elevated serum ACTH levels.
What are the symptoms of Cushing syndrome?
- Hypernatremia
- Hyperglycemia
- Hypokalemia
- Truncal obesity
- Moon face
- Buffalo hump
What defines anorexia nervosa?
Persistent restriction of energy intake leading to significantly low body weight.
What characterizes binge eating disorder?
Eating large amounts of food when not physically hungry, without compensatory behaviors.
What is the anorexia of aging?
A decrease in appetite or food intake in older adults due to multiple age-related changes.
What are nonmodifiable risk factors for coronary artery disease?
- Advanced age
- Male gender (or women after menopause)
- Family history
What modifiable risk factors contribute to coronary artery disease?
- Dyslipidemia
- Hypertension
- Cigarette smoking
- Diabetes and insulin resistance
- Obesity
- Sedentary lifestyle
- Atherogenic diet
What is hypertension?
A complex condition often asymptomatic, associated with increased risk for heart disease and stroke.
Known as the ‘silent killer’ due to its lack of symptoms.
List the major risk factors for hypertension.
- Genetic factors
- Environmental factors
- Obesity
- Increased dietary salt intake
- Psychosocial stress
- Endothelial dysfunction
- Vessel resistance abnormalities
These factors contribute to the pathophysiology of hypertension.
What is the role of LDL cholesterol in coronary risk?
Increased serum concentration of LDL indicates coronary risk; its relative risk depends on other factors like age, diabetes, and chronic kidney disease.
LDL delivers cholesterol to tissues.
What does HDL cholesterol do?
Responsible for ‘reverse cholesterol transport,’ returning excess cholesterol from tissues to the liver.
Low levels of HDL are a strong indicator of coronary risk.
Define stable angina.
Predictable chest pain relieved by usual interventions like nitroglycerin or rest.
Contrasts with unstable angina, which is not relieved by these measures.
What causes vasospastic angina?
Caused by vasospasm of coronary arteries, can occur with or without coronary artery disease.
Triggered by factors like hyperventilation, mental stress, smoking, and stimulants.
What is the distinction between NSTEMI and STEMI?
NSTEMI involves subendocardial infarction with ST depression, while STEMI involves transmural infarction with ST elevation.
NSTEMI occurs when the thrombus breaks up before complete distal tissue necrosis.
What is the effect of angiotensin II after a myocardial infarction?
Increases peripheral vasoconstriction, contributing to increased myocardial work and exacerbating myocyte contractility loss.
Angiotensin II is secreted in response to hemodynamic changes post-MI.
What is acute pericarditis?
Acute inflammation of the pericardium, often idiopathic or viral, with potential causes including myocardial infarction.
Pericardial effusion can occur, leading to cardiac tamponade if rapid accumulation happens.
Define heart failure (HF).
A condition where the heart cannot generate adequate cardiac output, leading to inadequate tissue perfusion or increased diastolic filling pressure.
Symptoms and signs are crucial for diagnosis.
What is preload?
The load on the heart created by the volume of blood received into the left ventricle at the end of diastole.
Excess preload can overstretch muscle fibers.
What is contractility?
The strength of the heart muscle’s contraction.
Affected by various factors, including heart failure.
What is HFrEF?
Heart failure with reduced ejection fraction, defined as an ejection fraction of <40%.
This condition results from decreased contractility.
What is the role of catecholamines in heart failure?
Sympathetic nervous system activation compensates for decreased cardiac output by increasing heart rate and peripheral vascular resistance.
This increases the workload on the heart.
What is the Renin-Angiotensin-Aldosterone System (RAAS)?
A system that increases preload and afterload while causing direct toxicity to myocytes.
It is activated in response to low blood pressure and poor kidney perfusion.
What are natriuretic peptides?
Hormones that counteract neurohumoral processes of heart failure by improving salt and water excretion.
ANP and BNP are examples that help decrease preload.
What is Kawasaki disease?
An acute systemic vasculitis that may lead to myocarditis and coronary artery aneurysms, primarily affecting children.
The etiology remains unknown but involves immune response mechanisms.
What is peripheral artery disease (PAD)?
Atherosclerotic disease of arteries that perfuse the limbs, causing pain with ambulation known as intermittent claudication.
Pain subsides with rest.
What is the consequence of untreated aortic stenosis?
Can lead to hypertrophic cardiomyopathy, myocardial ischemia or infarction, and heart failure.
It results from resistance to blood flow from the left ventricle.
Fill in the blank: Angiotensin II causes increased _______ and _______ in heart failure.
peripheral vascular resistance; blood pressure
Both contribute to increased afterload.
True or False: Heart failure with preserved ejection fraction (HFpEF) is characterized by an ejection fraction of less than 40%.
False
HFpEF is characterized by preserved ejection fraction; HFrEF is the condition defined by an EF of <40%.
