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Pathophys > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

Islet of Langerhans cells

A

Alpha cells: glucagon
Beta cells: insulin and amylin
Delta cells: somatostatin and gastrin

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2
Q

Glucagon

A

stimulated by endocrine syst. in low glucose levels (hypoglycemia)
-acts in the liver as glycogen and increased blood glucose concentration by breaking down stored glucose

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3
Q

Insulin

A

uptakes cellular glucose and through a negative feedback loop
-triggered by hyperglycemia

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4
Q

Amylin

A

promotes satiety (fullness)
-delays gastric emptying

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5
Q

Somatostatin

A

regulates alpha and beta cell function by inhibiting the secretion of insulin, glucagon and pancreatic polypeptide
-prevents hypertrophy
-is NECESSARY

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6
Q

Gastrin

A

secreted gastric (hydrochloric acid) acid which helps to break down food

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7
Q

hormone degradation

A

when the hormone is deactivated while on the way to it’s target

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8
Q

down regulation

A

less receptors

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9
Q

Hyperglycemia

A

-polyuria
-polyphagia
-polydipsia
-fatigue
-weight loss

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10
Q

Hypoglycemia
<40 mg/dl blood glucose

A

-only glucose is needed
-cold and clammy
-fatigue
-diaphoresis
-tremors
-irritability
stupor/coma
-altered mental state
-seizure
-death

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11
Q

polydypsia

A

due to excess volume/ urine loss

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12
Q

polyphagia

A

cells thinking there is not enough sugar to be consumed

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13
Q

polyuria

A

due to a hyperosmolar state which magnetizes water

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14
Q

Metabolic Syndrome

A

-triglyceride: > or equal to 150
-Waist circumference: >40 in. in men, > 35 in. in women. (BMI >25)
-Low HDL level: <40 in men, <50 in women
-Hypertension: < 130/85
-Fasting Plasma Glucose: >100mg/dl

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15
Q

what can metabolic syndrome lead to

A

diabetes, stroke, heart disease

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16
Q

upper urinary system

A

2 ureters
2 kidneys

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17
Q

lower urinary system

A

bladder
urethra

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18
Q

nephron

A

the functional unit of the kidney

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19
Q

Type 1 Diabetes
-cause and information

A

-idiopathic (unknown cause)
-autoimmune/ genetic
-irreversible
-pancreatic dysfunctioning of cells or the cells are destroyed
-NO insulin production
-no glucose enters the cell –> hyperglycemia

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20
Q

Type II Diabetes risk factors

A

-age
-obesity
-sedentary lifestyle
-African Americans & native americans
-hypertension
-prediabetes

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21
Q

Type II diabetes and information

A

Insulin resistance: decreased effectiveness of the cells insulin receptors because of high blood glucose
- leads to hyperglycemia
-pancreatic islet cells become dysfunctional

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22
Q

Macroangiopathy

A

affects large blood vessels
-leads to tissue necrosis
-in small blood vessels: thickening and hardening of the capillary basement membrane (AKA glycation) and tissue necrosis

23
Q

Microvascular

A

Can Cause:
-retinopathy (blindness)
-neuropathy
-nephropathy (damages glomeruli)

24
Q

Macrovascular

A

Causes:
-cardiovascular (accelerated atherosclerosis)
-cerebrovascular (increased risk for ischemic/thrombotic stroke)
-peripheral vascular (damaged nerves - gangrene)
-Infection

25
Q

Hemoglobin A1C

A

tests the RBCs for how much glucose they have had in the past 90 days
- RBCs live for 120 days

> 6.5%

normal: <5.5%

26
Q

Eosinophilic Esophagitis

A

idiopathic chronic inflammatory disease of the esophagus
-WBCs collect in the inner lining causing inflammation and narrowing

Manifestations:
-dysphagia, food impaction, vomiting, stomach pain

Evaluation:
Biopsy

Treatment:
-No cure

27
Q

Constipation

A

difficult/ infrequent defecation
-caused by a sedentary lifestyle, low-residue diet, low fluid intake, medication, OPIOIDS, neurogenic disorders
Manifestations:
-straining, lumpy/hard stools, <3 bowel movements a week

Evaluation:
stool diary, description, current medication use

Treatments:
increase fiber intake, moderate exercise, drink more fluids

28
Q

Diarrhea

A

-loose/water stools
->3 stools in 24 hours

Manifestations:
dehydration, weight loss, electrolyte imbalance, fever cramping w/ infection

Evaluation:
-abdominal imaging, travel questionnaire
-biopsies

29
Q

Gi Bleed

A

-Upper: bleeding in the esophagus (bright red), bleeding from the stomach and duodenum (dark red)

-Lower: bleeding in the jejunum, ileum, colon, or rectum\
most common: hemorrhoids (bright red stool)

Manifestations: changes in HR and BP

Treatment: can resolve on its own depends on where bleed

30
Q

GERD

A

reflux of acid from the stomach into esophagitis
-vomiting, coughing, lifting, bending, obesity, can increased abdominal pressure

Manifestations: heartburn, acid regurgitation, dysphagia, laryngitis, upper abdominal pain within 1 hour of eating

Evaluation: biopsy, endoscopy

Treatment: weight reduction, smoking cessation, head elevation, avoiding tight clothing

31
Q

Pyloric Obstruction

A

narrowing or blocking of the opening between the stomach and the duodenum
-tumors and ulcers can cause obstruction

Manifestations:
epigastric fullness, nausea, epigastric pain
anorexia, weight loss, distention, vomiting
severe malnutrition, dehydration’

Treatment: nasogastric suctioning to relieve distention, surgery

Evaluation: abdominal ultrasound, endoscopy, blood test

32
Q

Intestinal Obstruction

A

caused by anything that prevents the normal flow of chyme through the intestinal lumen
-small bowel obstructions are caused by postop adhesions, tumors, crohn’s disease, hernias

Manifestations: colicky pains, nausea and vomiting, sweating, tachycardia, rebound tenderness

Treatment: early identification, replace fluid and electrolytes, decompression of lumen with suction, surgery

Evaluation: CT, X ray, enhanced imaging

33
Q

Duodenal Ulcers

A

commonly caused by H. pylori infections

Manifestations:
chronic epigastric pain, pain begin 2/3 hours after eating, pain is rapidly relieved by antacids or food ingestion, bleeding

Treatment: the aim is to relieve causes and effects of hyperacidity, antacids neutralize gastric contents and relieve pain, surgery

Evaluation: endoscopy, biopsy

34
Q

Kidney Stones

A

masses of crystals, protein or other substances that are common urinary tract obstruction
-common stone types are CALCIUM oxalate or phosphate

Manifestations: moderate to severe pain that is radiating
lower urinary tract symptoms (urgency/frequency/incontinence) indicate obstruction of the lower ureter

Treatment: manage acute pain, promote stone passage, reduce the size of stones that are already formed, prevent new stone formation

Evaluation: urinalysis , imaging studies, history

35
Q

Renal Carcinoma

A

usually occurs in men between the ages of 50 and 60
-risk factors: obesity, cigarette smoking, uncontrolled hypertension

Manifestations: hematuria, dull aching flank pain, weight loss

Treatment: removal of infected kidney, chemotherapy, radiation, immunotherapy

Evaluation: tumor staging, imaging, lab tests

36
Q

Bladder Tumors

A

bladder cancer is most common in men >60 years
risks: people who smoke

Manifestations: gross painless hematuria

Treatment: cystoscopy with tissue resection, biopsy, chemotherapy, immunotherapy

Evaluation: uring cytologic study for screening, imaging, lab tests

37
Q

UTI Cystitis

A

inflammation of the bladder
-infection organisms is most commonly E. coli

Manifestation:
common- frequency, urgency, dysuria, painful , lower back pain, suprapubic pain
severe- hematuria, cloudy urine, back pain - more serious
elderly- confusion, abdominal discomfort

Evaluation: urine culture
Treatment: antibiotics

38
Q

Regeneration

A

when damaged tissue is replaced with healthy tissue of the original type
-by mitoses??

39
Q

Restoration also called resolution (or maturation)

A

restoration of function and complete healing if the damage is minor with no complications

40
Q

Repair

A

the replacement of destroyed tissue with scar tissue

41
Q

Scar tissue

A

composed primarily of collagen - its a substance that fills in the lesion, restoring tissue integrity and strength
-results in a LOSS of FUNCTION

42
Q

Wound Healing Phases

A
  1. Inflammation/ Hemostasis
  2. Proliferative/ Granulation
  3. Remodeling/ Maturation
43
Q

Inflammation/ Hemostasis

A

-coagulation (blood clot/ scab)
-platelets & macrophages & neutrophils
3 to 5 days

44
Q

Proliferation/ Granulation

A

-angiogenesis (formation of new blood vessels)
-epithelialization (sealing of the wound)
-fibroblast and collagen formation
-wound contraction (shrinking of wound)
-lymphocytes

45
Q

Remodeling/ Maturation

A

-weeks to months (2years?)
-continuation of cellular differentiation
-scar tissue formation (no function)
-scar remodeling
-contraction can occur by myofibroblasts

46
Q

Primary Intention

A

-margins are well approximated - abrasions
-3 to 5 days
-surgical incision and clean incision
most rapid healing
minimal tissue loss
-suture, staples, butterfly, and glue
high risk of getting infection

47
Q

Secondary Intention

A

would margins are not well approximated
-larger wound area requres granulation tissue to fill the gap
gaping would
open wound and requires alot of tissue replacement
longer period of time needed to heal

48
Q

Tertiary Intention

A

would healing is DELAYED
-a would that was open and is now closed
large infected or contaminated wound
increased granulation and late suturing with the wide scar
(dog or human bite)

49
Q

Dysfunctional Wound Healing

A

can occur at any stage
-ischemia
excessive bleeding
excessing fibrin deposition
predisposing disorders :
-diabetes
-obesity
-wound infection
-tobacco smoking

50
Q

Dysfunctional Wound Healing: reconstructive phase

A

Dysfunctional collagen synthesis leads to keloid or hypertrophic scar

51
Q

Dysfunctional Wound Healing: wound disruption

A

dehiscence (wound splitting open)
increases risk of infection

52
Q

Dysfunctional Wound Healing: impaired contraction

A

contracture (usually at joints and causes a loss of joint function)

53
Q

fasting plasma glucose

A

> 126 md/dl

normal : <100

Pathophys (2 decks)

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