exam 3 Flashcards
1
Q
primary minerals in bone
A
Calcium, phosphorus, magnesium
2
Q
collagen
A
- the protein that makes up cartilage
- gives bone tensile strength
3
Q
ground substace
A
gelatinous material that is a medium between bone and blood vessels
4
Q
transforming growth factor
A
initiates and commits precursor cells into osteoblasts (bone formation)
5
Q
osteoblasts
A
- bone forming
- synthesize collagen and proteoglycans
- once function is complete, they become osteocytes
6
Q
proteoglycans
A
complexes of polysaccharides that strengthen bone by forming compression resistant networks between collagen
7
Q
osteocytes
A
- bone maintaining
- coordinate osteoblast and osteoclast activity
8
Q
osteoclasts
A
- bone resorbing
- remodelers of bone
- contain lysosomes with hydrolytic enzymes
9
Q
sarcomere function
A
part of myofibril where muscle contraction is initiated
10
Q
sarcomere composed of?
A
actin (thin)
myosin (thick)
titin
nebulin
**converts chemical energy into movement
11
Q
ions involved in muscle contraction?
A
calcium directly controls contraction
K
Na
12
Q
Ryandine receptors
A
regulate calcium release within the muscle tissue rapidly
13
Q
isometric
A
static or holding contraction
muscle contracts without limb movement
14
Q
isotonic
A
lengthening or shortening contraction
muscle contracts with limb movement
15
Q
tendons attach..?
ligaments attach..?
A
tendons- muscle to bone
ligaments- bone to bone
16
Q
Renal capsule
A
tightly adhering capsule surrounding each kidney- each kidney is then embedded in a mass of fat
17
Q
comminuted fracture
A
bone breaks into more than 2 fragments
18
Q
greenstick fracture
A
perforates one cortex and splinters the spongy bone
19
Q
torus fracture
A
cortex buckles but does not break
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
21
Q
osteoarthritis
A
age related inflammatory joint disease of synovial joints
22
Q
osteoarthritis characterized by
A
- loss of articular cartilage
- sclerosis of underlying bone
- thickening of joint capsule
- formation of bone spurs (osteophytes)
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
24
Q
bone healing phases
A
inflammatory- hematoma forms
repair- calus forms
remodeling- callus resorbed; trabeculae formed
25
syndactyly
webbed fingers
26
vestigial tabs
extra digit
27
metatarsus adductus
forefoot adduction
| can be mild to severe
28
talipes equinovarus
"clubfoot"
- malformation of lower leg, ankle, and foot
- plantar flexed foot, inverted heel, and adducted forefoot
29
Creatinine
provides a good estimate of GFR; only one blood sample is required in addition to a 24-hour volume of urine.
30
BUN
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
31
Urine specific gravity/pH
SG= 1.016-1.022
| pH=5-6.5
32
Casts in urine
- accumulation of cellular precipitates
| - indication of the type of disease the kidney is experiencing
33
WBCs in urine
normally none is present, but presence of WBCs indicates infection
34
Renal Capsule
tightly adhering capsule surrounding each kidney- each kidney is then embedded in a mass of fat
35
Renal cortex
outer layer of each kidney
| contains all of the glomeruli, most of the proximal tubules, and some segments of the distal tubules
36
Renal medulla
inner part of the kidney that contains tubules and the collecting duct
consists of regions called the pyramids
37
Minor calyx
apexes of the pyramids project into a cup-shaped cavity that join together to form a major calyx
38
Major calyx
joins to form the renal pelvis
39
Renin-angiotensin-aldosterone system (RAAS)
Increases systemic arterial pressure, increases sodium reabsorption
40
Pyelonephritis
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
41
Hemolytic uremic syndrome
- 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
42
Nephrotic syndrome
- filtering units of the kidney are damaged, results in proteinuria, hypoalbuminemia, hyperlipidemia, edema
- primary vs secondary causes
- s/s: periorbital edema, malnourishment, immunocompromised
43
Glomerulonephritis
acute, chronic, poststreptococcal glomerulonephritis
| -proliferation and inflammation of the glomeruli are secondary to immune mechanism
44
Ectopic kidneys
failure to ascend from the pelvis to the abdomen
45
Hypospadias
urethral meatus is located on the ventral side or undersurface of the penis
46
Epispadias
urethral opening is on the dorsal side of the penis
47
Renal aplasia
kidneys are absent, do not develop. can be seen on ultrasounds
48
Hypoplastic kidney
- small with a decreased number of nephrons
- are unilateral or bilateral
- occurrence may be incidental or occur in families
49
Renal agenesis
- absence of 1 or both kidneys
- unilateral- usually the left kidney is absent
- remaining kidney hypertrophies
- can lead a normal, healthy life
50
Potter syndrome (bilateral renal agenesis)
- rare disorder that is incompatible with life
| - facial anomalies include wide set eyes, parrot beak nose, low set ears, receding chin
51
Polycystic kidney disease (PKD)
- 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
Seminiferous tubules
coiled ducts in the testes, consists of 80% of bulk of testicular volume, site of sperm production (spermatogenesis)
53
Epididymis
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
Vas deferens
duct with multiple layers and powerful peristalsis that transports sperm towards the urethra
55
Testes function
produce gametes (sperm) and produce sex hormones (androgens and testosterone)
56
Female sex hormones
estrogen and progesterone (main hormone of pregnancy)
57
Male sex hormones
testosterone, FSH, LH
58
External female genitalia
mons pubis, labia majora, labia minora, clitoris, vestibule, perineum
59
Vagina
elastic fibromuscular canal, layers, self cleaning, acidic environment for cleaning and protection, contains lactobacillus acidophilus
60
Uterus
hollow, pear-shaped organ, fundus, corpus, isthmus, cervix
61
Fallopian tubes
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
Ovaries
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
Menstrual cycle
- menarche: first menstruation
- menopause: cessation of flow
phases: menstruation, follicular phase, ovulation, and luteal phase.
64
normal RBC value
4.2-6.2 million
65
normal value WBC
5-10 thousand
66
normal value platelet
140k-340k
67
Syphylis
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
normal value Hct
36-43%
69
normal value MVC
81-96 fL (size, -cytic)
70
normal value MCHC
31-37 g/L (color, -chromic)
71
normal value RDW
11.5-15% (width of RBC; will be normal in chronic diseases)
72
normal value reticulocyte
1-2%
73
neutrophils
- ingest and destroy microorganisms
| - serve as phagocytes in early inflammation
74
eosinophils
- Type 1 allergic reaction
- asthma
- atopic issues
- parasitic infections
75
basophils
- secrete histamine
| - exoparasites
76
macrophages
"first responders" to infection
| initiate wound healing and tissue remodeling
77
monocytes
precursor to macrophages and dendritic cells
78
what goes up in bacterial infections?
lymph
79
what goes up in viruses?
neutrophils
80
extramedullary hematopoiesis
- blood cell production in tissues other than the bone marrow in adults
- usually a sign of disease (pernicious anemia, sickle cell, thalassemia, etc.)
81
megaloblastic (or megocytic) anemias?
1. pernicious anemia (B12 deficiency)
2. folate deficiency anemia
-DNA synthesis is defective
82
conditions that increase the risk of pernicious anemia?
- genetics/endocrine disorders
- gastrectomy, ileal resection, tapeworms
- chronic gastritis and H. pylori
- PPI's
83
folate deficiency anemia is most commonly found in what individuals?
alcoholics and malnourished
84
microcytic, hypochromic anemias
- iron deficiency anemia
| - thalassemia
85
RDW in IDA vs. thalassemia
RDW increased in IDA
| RDW normal in thalassemia
86
manifestations of IDA
fatigue, weak, SOB
pale earlobes, palms, conjunctiva
brittle, ridged, spoon shaped nails (koilonychia)
burning mouth, agranular stomatitis
87
hemolytic anemia manifestations
- may be asymptomatic
- jaundice
- aplastic crisis
- splenomegaly
- erythroid hyperplasia (abnormal increase in # of erythrocytes)
88
what levels are low in IDA and thalassemia hemogram?
HbG and MVC
89
polycythemia vera
- overproduction of RBC's frequently with increased levels of WBC's and platelets
- acquired mutation of JAK2
90
etiology of infectious mono
- viral infection of B lymphocytes
| - commonly caused by EBV
91
acute leukemia
presence of undifferentiated or immature cells (usuall blast); short survival
92
chronic leukemia
cell is mature, but does not function properly
93
ALL (acute lymphoblastic leukemia)
most common in kids
| Philadelphia chromosome
94
AML
mutation in receptor tyrosine kinase FLT3
most common adult leukemia
down syndrome increases risk
95
CML
polycythemia vera
| philadelphia chromosome
96
CLL
affects monoclonal B lymphocytes
adults >50 usually
lymphadenopathy is most common finding, but typically asymptomatic at diagnosis
97
G6PD deficiency manifestations
```
icterus neonatorum- jaundice (from stressful deliver)
acute hemolytic anemia
pallor
dark urine
back pain
between hemolytic episodes: no anemia
erythrocyte survival is normal
```
98
pathophysiology of sickle cell
- presence of abnormal hemoglobin (Hb S)
- RBC's solidify and stretch into an elongated sickle shape
- can alter blood pH
99
vasoocclusive crisis
"pain crisis"
- sickling in microcirculation
- painful, symmetric
- hand-foot syndrome
100
aplastic crisis
transient cessation in RBC production occurs as a result of viral infection
101
HSV1 /HSV2
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
Gonorrhea
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
Chlamydia
Most common STI in the US; caused by chlamydia trachomatis; gram-negative bacteria
104
Syphyllis
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
Stages of syphlis
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
Phimosis
inability to retract foreskin from the glans of the penis; frequently caused by poor hygiene
107
Paraphimosis
inability to replace or cover the glans with the foreskin; frequently caused by poor hygiene
108
Menopause
cessation of ovulation; reduced production of estrogen, and increased production of LH and FSH
109
Primary amenorrhea
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
Secondary amenorrhea
```
pregnancy (main cause)
dramatic weight loss
malnutrition or excessive exercise
hypothyroidism
PCOS
```
111
Cervical cancer
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
Endometriosis
functioning endometrial tissue implants outside the uterus, responds to hormone fluctuations of the menstrual cycle; scar tissue causes infertility
113
Polycystic ovarian syndrome (PCOS)
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
