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Advanced Patho NP > exam 3 > Flashcards

exam 3 Flashcards

1
Q

primary minerals in bone

A

Calcium, phosphorus, magnesium

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2
Q

collagen

A
  • the protein that makes up cartilage

- gives bone tensile strength

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3
Q

ground substace

A

gelatinous material that is a medium between bone and blood vessels

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4
Q

transforming growth factor

A

initiates and commits precursor cells into osteoblasts (bone formation)

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5
Q

osteoblasts

A
  • bone forming
  • synthesize collagen and proteoglycans
  • once function is complete, they become osteocytes
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6
Q

proteoglycans

A

complexes of polysaccharides that strengthen bone by forming compression resistant networks between collagen

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7
Q

osteocytes

A
  • bone maintaining

- coordinate osteoblast and osteoclast activity

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8
Q

osteoclasts

A
  • bone resorbing
  • remodelers of bone
  • contain lysosomes with hydrolytic enzymes
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9
Q

sarcomere function

A

part of myofibril where muscle contraction is initiated

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10
Q

sarcomere composed of?

A

actin (thin)
myosin (thick)
titin
nebulin

**converts chemical energy into movement

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11
Q

ions involved in muscle contraction?

A

calcium directly controls contraction
K
Na

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12
Q

Ryandine receptors

A

regulate calcium release within the muscle tissue rapidly

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13
Q

isometric

A

static or holding contraction

muscle contracts without limb movement

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14
Q

isotonic

A

lengthening or shortening contraction

muscle contracts with limb movement

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15
Q

tendons attach..?

ligaments attach..?

A

tendons- muscle to bone

ligaments- bone to bone

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16
Q

Renal capsule

A

tightly adhering capsule surrounding each kidney- each kidney is then embedded in a mass of fat

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17
Q

comminuted fracture

A

bone breaks into more than 2 fragments

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18
Q

greenstick fracture

A

perforates one cortex and splinters the spongy bone

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19
Q

torus fracture

A

cortex buckles but does not break

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20
Q

to diagnose RA

A

4 or more of the following

  • morning joint stiffness at least 1 hour
  • 3 or more joints
  • hand joints
  • symmetric arthritis
  • rheumatoid nodules
  • abnormal serum RF
  • radiographic changes
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21
Q

osteoarthritis

A

age related inflammatory joint disease of synovial joints

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22
Q

osteoarthritis characterized by

A
  • loss of articular cartilage
  • sclerosis of underlying bone
  • thickening of joint capsule
  • formation of bone spurs (osteophytes)
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23
Q

osteomalacia patho and manifestations

A
  • deficiency of vitamin D lowers the absorption of calcium from the intestines
  • vertebral collapse, bone malformation, waddling gait
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24
Q

bone healing phases

A

inflammatory- hematoma forms
repair- calus forms
remodeling- callus resorbed; trabeculae formed

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25
Q

syndactyly

A

webbed fingers

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26
Q

vestigial tabs

A

extra digit

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27
Q

metatarsus adductus

A

forefoot adduction

can be mild to severe

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28
Q

talipes equinovarus

A

“clubfoot”

  • malformation of lower leg, ankle, and foot
  • plantar flexed foot, inverted heel, and adducted forefoot
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29
Q

Creatinine

A

provides a good estimate of GFR; only one blood sample is required in addition to a 24-hour volume of urine.

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30
Q

BUN

A

varies as a result of altered protein intake and protein catabolism; poor measure of GFR; better indicator for hydration status; *increases with dehydration and kidney failure
normal is 10-20 mg/dl

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31
Q

Urine specific gravity/pH

A

SG= 1.016-1.022

pH=5-6.5

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32
Q

Casts in urine

A
  • accumulation of cellular precipitates

- indication of the type of disease the kidney is experiencing

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33
Q

WBCs in urine

A

normally none is present, but presence of WBCs indicates infection

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34
Q

Renal Capsule

A

tightly adhering capsule surrounding each kidney- each kidney is then embedded in a mass of fat

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35
Q

Renal cortex

A

outer layer of each kidney

contains all of the glomeruli, most of the proximal tubules, and some segments of the distal tubules

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36
Q

Renal medulla

A

inner part of the kidney that contains tubules and the collecting duct
consists of regions called the pyramids

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37
Q

Minor calyx

A

apexes of the pyramids project into a cup-shaped cavity that join together to form a major calyx

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38
Q

Major calyx

A

joins to form the renal pelvis

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39
Q

Renin-angiotensin-aldosterone system (RAAS)

A

Increases systemic arterial pressure, increases sodium reabsorption

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40
Q

Pyelonephritis

A

acute or chronic

  • infection of the ureter, renal pelvis, and/or renal parenchyma
  • flank pain, fever, chills, CVA tenderness, purulent urine
  • chronic leads to scarring of the kidneys- inflammation and fibrosis leads to CKD
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41
Q

Hemolytic uremic syndrome

A
  • most common cause of renal failure in children under 4
  • associated with bacterial, viral, or endotoxin agents
  • arterioles of the glomerulus become swollen and occluded with clots-damage RBCs as they pass into circ.
  • decreased GFR, hematuria, proteinuria
  • spleen removes damaged RBCs from circulation- causing acute hemolytic anemia
  • preceded by a prodromal GI illness with diarrhea
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42
Q

Nephrotic syndrome

A
  • filtering units of the kidney are damaged, results in proteinuria, hypoalbuminemia, hyperlipidemia, edema
  • primary vs secondary causes
  • s/s: periorbital edema, malnourishment, immunocompromised
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43
Q

Glomerulonephritis

A

acute, chronic, poststreptococcal glomerulonephritis

-proliferation and inflammation of the glomeruli are secondary to immune mechanism

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44
Q

Ectopic kidneys

A

failure to ascend from the pelvis to the abdomen

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45
Q

Hypospadias

A

urethral meatus is located on the ventral side or undersurface of the penis

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46
Q

Epispadias

A

urethral opening is on the dorsal side of the penis

47
Q

Renal aplasia

A

kidneys are absent, do not develop. can be seen on ultrasounds

48
Q

Hypoplastic kidney

A
  • small with a decreased number of nephrons
  • are unilateral or bilateral
  • occurrence may be incidental or occur in families
49
Q

Renal agenesis

A
  • absence of 1 or both kidneys
  • unilateral- usually the left kidney is absent
  • remaining kidney hypertrophies
  • can lead a normal, healthy life
50
Q

Potter syndrome (bilateral renal agenesis)

A
  • rare disorder that is incompatible with life

- facial anomalies include wide set eyes, parrot beak nose, low set ears, receding chin

51
Q

Polycystic kidney disease (PKD)

A
  • cyst formation and obstruction, accompanied by the destruction of renal parenchyma, interstitial fibrosis, and loss of functional nephrons
  • can be autosomal dominant or recessive
52
Q

Seminiferous tubules

A

coiled ducts in the testes, consists of 80% of bulk of testicular volume, site of sperm production (spermatogenesis)

53
Q

Epididymis

A

comma-shaped structure that curves over the posterior portion of each testis; structural function is to conduct sperm from the efferent tubules to the vas deferens.

54
Q

Vas deferens

A

duct with multiple layers and powerful peristalsis that transports sperm towards the urethra

55
Q

Testes function

A

produce gametes (sperm) and produce sex hormones (androgens and testosterone)

56
Q

Female sex hormones

A

estrogen and progesterone (main hormone of pregnancy)

57
Q

Male sex hormones

A

testosterone, FSH, LH

58
Q

External female genitalia

A

mons pubis, labia majora, labia minora, clitoris, vestibule, perineum

59
Q

Vagina

A

elastic fibromuscular canal, layers, self cleaning, acidic environment for cleaning and protection, contains lactobacillus acidophilus

60
Q

Uterus

A

hollow, pear-shaped organ, fundus, corpus, isthmus, cervix

61
Q

Fallopian tubes

A

uterine tubes, conduct ova from spaces around ovaries to uterus

  • if fertilized, the ovum (then called a blastocyst) implants itself in the endometrial layer of the uterine wall
  • if not fertilized, the ovum breaks down within 12-24 hours
62
Q

Ovaries

A

are the primary female reproductive organs, secrete female sex hormones (estrogen and progesterone), develop and release female gametes
-ovulation: the release of an ovum

63
Q

Menstrual cycle

A
  • menarche: first menstruation
  • menopause: cessation of flow
    phases: menstruation, follicular phase, ovulation, and luteal phase.
64
Q

normal RBC value

A

4.2-6.2 million

65
Q

normal value WBC

A

5-10 thousand

66
Q

normal value platelet

A

140k-340k

67
Q

Syphylis

A

caused by treponema pallidum, which is a corkscrew shaped anaerobic bacteria that can infect any body tissue and becomes systemic shortly after infection; on the increase with men doin the nasty with other men

68
Q

normal value Hct

A

36-43%

69
Q

normal value MVC

A

81-96 fL (size, -cytic)

70
Q

normal value MCHC

A

31-37 g/L (color, -chromic)

71
Q

normal value RDW

A

11.5-15% (width of RBC; will be normal in chronic diseases)

72
Q

normal value reticulocyte

A

1-2%

73
Q

neutrophils

A
  • ingest and destroy microorganisms

- serve as phagocytes in early inflammation

74
Q

eosinophils

A
  • Type 1 allergic reaction
  • asthma
  • atopic issues
  • parasitic infections
75
Q

basophils

A
  • secrete histamine

- exoparasites

76
Q

macrophages

A

“first responders” to infection

initiate wound healing and tissue remodeling

77
Q

monocytes

A

precursor to macrophages and dendritic cells

78
Q

what goes up in bacterial infections?

A

lymph

79
Q

what goes up in viruses?

A

neutrophils

80
Q

extramedullary hematopoiesis

A
  • blood cell production in tissues other than the bone marrow in adults
  • usually a sign of disease (pernicious anemia, sickle cell, thalassemia, etc.)
81
Q

megaloblastic (or megocytic) anemias?

A
  1. pernicious anemia (B12 deficiency)
  2. folate deficiency anemia

-DNA synthesis is defective

82
Q

conditions that increase the risk of pernicious anemia?

A
  • genetics/endocrine disorders
  • gastrectomy, ileal resection, tapeworms
  • chronic gastritis and H. pylori
  • PPI’s
83
Q

folate deficiency anemia is most commonly found in what individuals?

A

alcoholics and malnourished

84
Q

microcytic, hypochromic anemias

A
  • iron deficiency anemia

- thalassemia

85
Q

RDW in IDA vs. thalassemia

A

RDW increased in IDA

RDW normal in thalassemia

86
Q

manifestations of IDA

A

fatigue, weak, SOB
pale earlobes, palms, conjunctiva
brittle, ridged, spoon shaped nails (koilonychia)
burning mouth, agranular stomatitis

87
Q

hemolytic anemia manifestations

A
  • may be asymptomatic
  • jaundice
  • aplastic crisis
  • splenomegaly
  • erythroid hyperplasia (abnormal increase in # of erythrocytes)
88
Q

what levels are low in IDA and thalassemia hemogram?

A

HbG and MVC

89
Q

polycythemia vera

A
  • overproduction of RBC’s frequently with increased levels of WBC’s and platelets
  • acquired mutation of JAK2
90
Q

etiology of infectious mono

A
  • viral infection of B lymphocytes

- commonly caused by EBV

91
Q

acute leukemia

A

presence of undifferentiated or immature cells (usuall blast); short survival

92
Q

chronic leukemia

A

cell is mature, but does not function properly

93
Q

ALL (acute lymphoblastic leukemia)

A

most common in kids

Philadelphia chromosome

94
Q

AML

A

mutation in receptor tyrosine kinase FLT3
most common adult leukemia
down syndrome increases risk

95
Q

CML

A

polycythemia vera

philadelphia chromosome

96
Q

CLL

A

affects monoclonal B lymphocytes
adults >50 usually
lymphadenopathy is most common finding, but typically asymptomatic at diagnosis

97
Q

G6PD deficiency manifestations

A 
icterus neonatorum- jaundice (from stressful deliver)
acute hemolytic anemia
pallor
dark urine
back pain
between hemolytic episodes: no anemia
erythrocyte survival is normal
98
Q

pathophysiology of sickle cell

A
  • presence of abnormal hemoglobin (Hb S)
  • RBC’s solidify and stretch into an elongated sickle shape
  • can alter blood pH
99
Q

vasoocclusive crisis

A

“pain crisis”

  • sickling in microcirculation
  • painful, symmetric
  • hand-foot syndrome
100
Q

aplastic crisis

A

transient cessation in RBC production occurs as a result of viral infection

101
Q

HSV1 /HSV2

A

not a reportable disease, recurrent infections/outbreaks mostly with type 2, risk of transmission even during latent periods
**neonatal herpes is potentially fatal (need to do c section)

102
Q

Gonorrhea

A

infection by neisseria gonorrhoeae, transmitted by contact with infected epithelium (dirty sex), can be asymptomatic but can also exhibit dysuria, increased discharge, abnormal menses, or dyspareunia.

103
Q

Chlamydia

A

Most common STI in the US; caused by chlamydia trachomatis; gram-negative bacteria

104
Q

Syphyllis

A

caused by treponema pallidum, which is a corkscrew shaped anaerobic bacteria that can infect any body tissue and becomes systemic shortly after infection; on the increase with men doin the nasty with other men

105
Q

Stages of syphlis

A

a. ) Primary-12 days to 12 weeks; hard chancre is formed
b. ) Secondary-6 weeks post chancre, fever, malaise, joint pain, skin rash (brown on hands)- goes away, remains dormant
c. ) Latent- infection present, but pt is asymptomatic
d. ) Tertiary- most severe stage; formation of gummas, destructive systemic manifestations, neurosyphilis

106
Q

Phimosis

A

inability to retract foreskin from the glans of the penis; frequently caused by poor hygiene

107
Q

Paraphimosis

A

inability to replace or cover the glans with the foreskin; frequently caused by poor hygiene

108
Q

Menopause

A

cessation of ovulation; reduced production of estrogen, and increased production of LH and FSH

109
Q

Primary amenorrhea

A

failure of menarche and the absence of menstruation by 14 years old without the development of secondary sex characteristics or by age 16 regardless of presence of secondary sex characteristics

110
Q

Secondary amenorrhea

A 
pregnancy (main cause)
dramatic weight loss
malnutrition or excessive exercise
hypothyroidism 
PCOS
111
Q

Cervical cancer

A

almost exclusively caused by cervical HPV infection, with early detection and treatment prognosis is excellent; do a pap smear getting cells from the cervical os or transformation zone

112
Q

Endometriosis

A

functioning endometrial tissue implants outside the uterus, responds to hormone fluctuations of the menstrual cycle; scar tissue causes infertility

113
Q

Polycystic ovarian syndrome (PCOS)

A

a hormone disorder causing enlarged ovaries with small cysts on the outer edges; leading cause of infertility in the US; 2/3= little to no ovulation, elevated androgens, or polycystic ovaries

Advanced Patho NP (3 decks)

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