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Intro to Disease > Exam 4: Ch. 21-23, 25-27 > Flashcards

Exam 4: Ch. 21-23, 25-27 Flashcards

1
Q

largest organ in the body

A

liver

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2
Q

4 functions of liver

A
  1. metabolism (carbohydrates, protein, and fat)
  2. synthesis (proteins, clotting factors)
  3. storage (vitamin b12)
  4. detoxification and excretion
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3
Q

the liver has a double blood supply. what does this mean?

A

there is a portal vein and a hepatic artery that supply the liver

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4
Q

portal vein

A

supplies liver with 75% of its blood, is rich in nutrients, low in oxygen

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5
Q

hepatic artery

A

supplies liver with 25% of its blood, is high in oxygen and low in nutrients

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6
Q

bile

A

aqueous solution with various dissolved substances (conjugated bilirubin, bile salts, cholesterol, minerals)

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7
Q

where does bile come from?

A

RBC break down, iron is reused, and iron-free heme pigment or bilirubin is excreted in the bile

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8
Q

is bile always present?

A

yes, small quantities are always present

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9
Q

lecithin

A

lipid that also functions as a detergent, is also present in bile

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10
Q

where is bile stored?

A

gallbladder, it is released into the duodenum to help with digestion

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11
Q

3 manifestations of liver injury

A

cell necrosis, fatty change, and mixed necrosis and fatty change

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12
Q

4 common types of liver injury

A

viral hepatitis, fatty liver, alcoholic liver disease (hepatitis), cirrhosis

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13
Q

does hepatitis A contain DNA or RNA?

A

RNA

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14
Q

incubation period of hepatitis A

A

2-6 weeks

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15
Q

transmission methods of hepatitis A

A

person to person contact, and fecal contamination of food or water

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16
Q

is there prevention for hepatitis A?

A

vaccine, and immune globulin given after exposure to the virus

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17
Q

does hepatitis B contain DNA or RNA?

A

DNA

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18
Q

incubation period of hepatitis B

A

6 weeks to 4 months

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19
Q

transmission of hepatitis B

A

blood or bodily fluids

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20
Q

how is hepatitis B diagnosed?

A

with an antigen-antibody test

  • infected people are HBsAg positive and lack anti-HBs
  • immune people have anti-HBs
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21
Q

can hepatitis B be carried?

A

yes, 10% of those infected become carriers

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22
Q

is there prevention for hepatitis B?

A

vaccine, and immune globulin given after exposure to the virus

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23
Q

which type of hepatitis is seen the most in the US?

A

hepatitis C

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24
Q

does hepatitis C contain DNA or RNA?

A

RNA

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25
Q

transmission of hepatitis C

A

blood and bodily fluid

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26
Q

how is hepatitis C diagnosed?

A

with an antigen-antibody test

  • infected people have the virus present and an active infection
  • if anti HCVs are detected it does not confer immunity
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27
Q

can hepatitis C be carried?

A

yes, 75% of those infected become carriers

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28
Q

is there prevention for hepatitis C?

A

no

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29
Q

who is at risk for hepatitis C?

A

IV drug users, people that received transfusions before 1992, healthcare workers exposed to blood or bodily fluids

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30
Q

does hepatitis D contain DNA or RNA?

A

RNA

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31
Q

what makes hepatitis D different from other types?

A

it is a small and defective virus that can’t produce its own virus coat, so it can only infect people that have hepatitis B

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32
Q

what are most of the cases of hepatitis D in the US from?

A

sharing used needles

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33
Q

does hepatitis E contain DNA or RNA?

A

RNA

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34
Q

transmission of hepatitis E

A

oral-fecal contact, and contaminated water

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35
Q

is there prevention for hepatitis E?

A

no

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36
Q

fatty liver

A

fat accumulates as a result of liver injury, common in heavy drinkers and alcoholics, and damage is reversible

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37
Q

alcoholic liver disease

A

group of structural and functional changes in the liver resulting from excessive alcohol consumption

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38
Q

severity of alcoholic liver disease depends on what?

A

amount and duration of alcohol consumption

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39
Q

3 stages of progression of alcoholic liver disease

A
  1. alcoholic fatty liver-mild
  2. alcoholic hepatitis-degenerative changes and necrosis of liver cells
  3. alcoholic cirrhosis-diffuse scarring, disturbed liver function
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40
Q

cirrhosis

A

scarring of the liver from any cause with derangement of liver function and regeneration
-can result from any liver injury

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41
Q

manifestations of cirrhosis

A

liver failure, portal hypertension, ascites

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42
Q

ascites

A

accumulation of fluid in peritoneal cavity

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43
Q

portal-systemic anastomoses

A

procedure where portal vein is connected to systemic vein in the liver to control varices

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44
Q

varices

A

dilated veins as a result of portal hypertension

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45
Q

transjugular intrahepatic portosystemic shunt

A

a shunt is placed between hepatic and portal vein branches so the blood can bypass the cirrhotic liver

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46
Q

hepatic encephalopathy

A

deterioration of brain function characterized by confusion, disorientation, and eventually coma

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47
Q

what causes hepatic encephalopathy?

A

accumulation of toxic substances (ammonia, bacterial decomposition products) in blood that are usually detoxified and excreted by the liver

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48
Q

primary biliary cirrhosis

A

autoimmune disease that attacks the intrahepatic bile duct, this can lead to liver failure and require a liver transplant

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49
Q

secondary biliary cirrhosis

A

obstruction of large extra hepatic bile ducts (from gallstone, carcinoma), treated by reliving or bypassing the obstruction

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50
Q

Reye syndrome

A

virus that causes liver and brain damage, and aspirin is thought to increase the effects of this

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51
Q

characteristics of Reye syndrome

A

affects mainly infants and children, manifests with fatty liver and dysfunction, cerebral edema

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52
Q

cholelithiasis

A

gallstone formation in the bladder

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53
Q

cholelithiasis is highest in:

A

women, especially those who have had several children, use oral contraceptives, and that are obese

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54
Q

complications of cholelithiasis

A

biliary colic (pain) if the stone gets into ducts (common and cystic obstruction)

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55
Q

common duct obstruction

A

gallstone obstructs the common bile duct, causes obstructive jaundice

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56
Q

cystic duct obstruction

A

gallstone obstructs the cystic duct, doesn’t cause jaundice but acute cholecystitis may occur

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57
Q

cholecystectomy

A

surgical removal of gallbladder, used to treat cholelithiasis

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58
Q

cholecystitis

A

inflammation of the gallbladder, gallstone obstructing the cystic duct or the neck of the gallbladder can cause this

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59
Q

benign adenoma

A

uncommon liver tumor, occur in women that take contraceptive pills

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60
Q

primary carcinoma of the liver

A

uncommon in US and Canada but common in Asia and Africa because of high incidence of hepatitis B carriers

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61
Q

metastatic liver carcinoma

A

common in developed countries, spreads from primary sites such as the GI tract, lung, and breast

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62
Q

jaundice

A

yellow discoloration of skin and sclera (whites of eyes) from accumulation of bile pigment in tissues

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63
Q

cause of hemolytic jaundice

A

increased breakdown of red blood cells, bilirubin released

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64
Q

cause of hepatocellular jaundice

A

liver injury impairs the conjugation of bilirubin, it builds up

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65
Q

cause of obstructive jaundice

A

bile duct obstructed by tumor or gallstone, impairing delivery of bile into duodenum

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66
Q

liver biopsy

A

needle inserted through abdominal skin directly into the liver to determine the cause of liver disease or evaluate extent of liver cell damage

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67
Q

individuals at risk for developing hepatitis C include the following except:

a. intranasal cocaine users
b. healthcare personnel exposed to blood and body fluids
c. intravenous drug users
d. children born to mothers who test HCV positive
e. children’s daycare personnel

A

a. intranasal cocaine users

hepatitis C is transmitted through blood and bodily fluids, options b-e all involve blood and bodily fluids

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68
Q

what does it mean to say the pancreas is both an endocrine and exocrine gland?

A

it secretes pancreatic juice into the duodenum (exocrine) and secretes insulin discharge directly into the bloodstream (endocrine)

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69
Q

Islets of Langerhans

A

small clusters of cells scattered throughout the endocrine tissue of the pancreas, responsible for secreting glucagon, insulin, and somatostatin

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70
Q

alpha cells

A

make up some pancreatic islets, secrete glucagon which raises blood glucose

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71
Q

beta cells

A

make up some pancreatic islets, secrete insulin which lowers blood glucose

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72
Q

delta cells

A

make up some pancreatic islets, secrete somatostatin which inhibits secretion of glucagon and insulin both

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73
Q

acute pancreatitis

A

pancreatic juices escape from the ducts into the pancreatic tissues, causing destruction and hemorrhaging. this happens because pancreatic juices continue to be secreted despite an obstruction, building up pressure causing the ducts to rupture

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74
Q

predisposing factors to acute pancreatitis

A

gallbladder disease/stones–gallstones can obstruct the pancreatic duct, causing rupture

excessive alcohol consumption–stimulates pancreatic secretions, and induces spasms in the pancreatic sphincter that results in high pressure

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75
Q

clinical manifestations of acute pancreatitis

A

severe abdominal pain, seriously ill, and high mortality rate

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76
Q

chronic pancreatitis

A

repeated episodes of mild inflammation of the pancreas, and each episode destroys some tissue which is replaced by scar tissue

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77
Q

manifestations of chronic pancreatitis

A

difficulty digesting and absorbing nutrients, not enough pancreatic tissue to produce enzymes, destroyed pancreatic islets can lead to diabetes

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78
Q

cystic fibrosis

A

hereditary disease that mainly manifests in infancy and childhood that involves mutation of CF gene on chromosome 7

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79
Q

mortality rate of cystic fibrosis

A

over 50% die before age 32

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80
Q

pathogenesis (how it develops) of cystic fibrosis

A

defective transport of chloride, sodium, and water across the cell membrane, and deficient electrolytes and water in mucus. mucus gets too think and obstructs pancreatic ducts, bronchi, bronchioles, and bile ducts

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81
Q

obstruction of pancreatic ducts causes:

A

atrophy and fibrosis

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82
Q

obstruction of bronchi causes:

A

lung injury

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83
Q

obstruction of biliary ducts causes:

A

liver scarring, nothing can get to liver so tissue dies and is replaced by scar tissue

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84
Q

treatment of cystic fibrosis

A

pills with pancreatic enzymes to compensate for lack of, treatment of pulmonary bacterial infections to preserve lung function, and eventual lung transplant

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85
Q

diabetes mellitus

A

two types, very common, and manifests as hyperglycemia (increased blood glucose)

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86
Q

type 1 diabetes

A

insulin deficiency, occurs primarily in children and young adults

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87
Q

type 2 diabetes

A

body doesn’t respond to insulin, most common type, mostly adult onset but increasing in obese children

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88
Q

what causes type 1 diabetes

A

damage to pancreatic islets leading to reduction or absence of insulin secretion

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89
Q

diabetic ketosis (ketoacidosis)

A

complication of type 1 diabetes, overproduction of ketone bodies

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90
Q

what causes type 2 diabetes

A

insulin secretion is normal or increased, but the tissues don’t respond correctly, and pancreas can’t increase insulin output to compensate

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91
Q

hyperosmolar nonketotic coma

A

complication of type 2 diabetes, blood sugar increases 10-20x normal value, and there is no ketosis. coma due to hyperosmolarity (water moves out of cells, cells dehydrated)

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92
Q

prediabetes

A

number of insulin-producing beta cells is beginning to decline, and provides an indication that weight loss, exercise, and healthy eating habits are needed or diabetes will occur

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93
Q

pharmacologic treatment for prediabetes

A

a-glucosidase inhibitors: improve glucose tolerance

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94
Q

pregnancy-associated diabetes

A

high level of placental hormones cause pregnant woman to be less responsive to insulin, and those that can’t secrete more develop gestational diabetes. usually relents after birth

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95
Q

metabolic syndrome

A

group of conditions identified in person with impaired glucose tolerance that can progress to diabetes

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96
Q

complications of metabolic syndrome

A

obesity, insulin resistance (diabetes), blood-lipid abnormalities, hypertension

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97
Q

insulin

A

influences carbohydrate, protein, and fat metabolism; its main stimulus for release is high blood glucose (it lowers blood sugar)

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98
Q

insulin promotes:

A
  • glucose entry into cells
  • utilization of glucose as energy
  • storage of glucose as glycogen
  • conversion of glucose into triglycerides
  • storage of triglycerides as fat
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99
Q

ketone bodies

A

created when glucose is absorbed but not used, body uses fat as energy which is broken down into fatty acid and glycerol. fatty acid broken into acetyl-CoA, which are converted into ketone bodies

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100
Q

ketosis

A

accumulation of ketone bodies in blood and excreted in urine with water and electrolytes

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101
Q

hyperglycemia

A

elevated blood glucose, can come from other conditions that impair glucose usage such as chronic pancreatic disease, endocrine diseases, certain drugs

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102
Q

treatment of type 1 diabetes

A

diet, insulin injections with custom dosage to keep blood glucose controlled

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103
Q

treatment of type 2 diabetes

A

weight reduction and diet usually helps alone, if not then oral hypoglycemic drugs are used

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104
Q

how diabetes is monitored

A

frequent periodic measurements of blood glucose, urine tests to detect glucose in urine, and measuring glycosylated hemoglobin

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105
Q

too much insulin causes what?

A

large drop in glucose leading to insulin shock

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106
Q

why is vigorous exercise bad for a diabetic patient taking insulin?

A

with high physical activity there is high glucose utilization, this means there will be more insulin in the blood, and too much insulin leads to insulin shock

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107
Q

glycosylated hemoglobin

A

excess glucose molecules attach permanently to RBC, that circulate in the body. concentration of these is proportional to glucose levels for past 6-12 weeks

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108
Q

in normal people, what percent of hemoglobin is glycosylated?

A

6%

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109
Q

in people with well and poorly controlled diabetes, what percent of hemoglobin is glycosylated?

A

7% in well controlled, 8% in poorly controlled

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110
Q

carcinoma of the pancreas

A

usually develops in the head of the pancreas, blocking the common bile duct and causing obstructive jaundice

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111
Q

islet cell tumors

A

usually benign, produce hyperinsulinism (too much insulin) and hypoglycemia (too little blood glucose)

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112
Q

insulin performs all of the following functions except:

a. promotes entry of amino acids into the cells
b. promotes storage of glucose in muscle and liver cells
c. promotes entry and absorption of glucose into cells for energy use
d. promotes breakdown of fat
e. lowers blood glucose

A

d. promotes breakdown of fat

insulin does promote amino acid entry, glucose usage and storage, and lowers blood sugar.

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113
Q

function of gastrointestinal tract

A

digestion and absorption of food

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114
Q

components of gastrointestinal tract

A

oral cavity, esophagus, stomach, small/large intestines, anus

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115
Q

how does cleft lip/palate develop?

A

when the two tissues that fuse at the midline experience maldevelopment

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116
Q

what kind of inheritance pattern does cleft lip/palate have?

A

multifactorial inheritance

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117
Q

when can cleft lip be surgically corrected?

A

soon after birth

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118
Q

when can cleft palate be surgically corrected?

A

when the child is 1-2 years old, followed by speech therapy to correct nasal speech

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119
Q

what is surgical correction of cleft lip and cleft palate called?

A

cheiloplasty

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120
Q

two types of teeth

A

temporary/deciduous (20) and permanent (32)

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121
Q

dental plaque

A

sticky film on teeth that forms with bacteria in the oral cavity mix with saliva

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122
Q

caries

A

tooth decay that forms as a result of plaque mixed with the action of bacteria

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123
Q

dental cavity

A

loss of tooth structure from bacterial action

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124
Q

gingivitis

A

inflammation of the gums due to masses of bacteria/debris accumulating around base of teeth

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125
Q

periodontal disease

A

inflammation of the gums extends to the tissues that support teeth, and form small pockets of infection between teeth and gums

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126
Q

stomatitis

A

inflammation of the oral cavity

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127
Q

causes of stomatitis

A

irritants such as alcohol, tobacco, and hot/spicy foods

infectious agents such as herpes virus, fungus, and bacteria

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128
Q

carcinoma of the oral cavity

A

develops in the squamous epithelium, and can be in the lips, cheek, tongue, palate, and back of throat

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129
Q

esophagus

A

muscular tube that extends from pharynx to stomach, with sphincters at both ends

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130
Q

upper esophageal sphincter

A

sphincter at the top of the esophagus that opens to allow passage of swallowed food

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131
Q

lower gastroesophageal/cardiac sphincter

A

sphincter between esophagus and stomach that opens to allow passage of food into the stomach

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132
Q

what causes esophageal diseases?

A

failure of cardiac sphincter to function properly (GERD), tears in esophageal lining, esophageal obstruction

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133
Q

symptoms of esophageal disease

A

dysphagia (difficulty swallowing), substernal discomfort, inability to swallow, regurgitation of food into trachea, choking

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134
Q

two major disturbances of cardiac sphincter

A

cardiospasm and incompetent cardiac sphincter

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135
Q

cardiospasm

A

cardiac sphincter fails to open properly, esophagus becomes dilated proximal to sphincter, treated by period stretching of sphincter or surgery

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136
Q

incompetent cardiac sphincter

A

sphincter doesn’t close properly, allowing gastric juices to leak into the esophagus

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137
Q

complications of incompetent cardiac sphincter

A

reflux esophagitis, ulceration and scarring, and Barrett’s esophagus

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138
Q

what can obstruct the esophagus?

A

carcinoma, tumor that narrows lumen and infiltrates tissues and trachea, food impaction, and stricture (scar tissue)

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139
Q

acute gastritis

A

inflammation of the gastric lining

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140
Q

how do NSAIDS cause acute gastritis?

A

they inhibit the COX enzyme. COX protects gastric mucosa and mediates inflammation. if COX is inhibited then inflammation is not controlled

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141
Q

how can alcohol cause acute gastritis?

A

it is a gastric irritant because it stimulates gastric acid secretion

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142
Q

H. pylori

A

small, curved gram negative organisms that colonize the surface of gastric mucosa, and they produce a substance that decomposes urea into ammonia which allows these organisms to flourish

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143
Q

H. pylori gastritis

A

when these organisms flourish they produce enzymes that break down mucus layer. it is common and increases with age, and spreads via person to person contact and fecal-oral route

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144
Q

H. pylori gastritis carries an increased risk of what?

A

gastric carcinoma and malignant lymphoma

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145
Q

peptic ulcer

A

develops when increased acid secretions and digestive enzymes causes mucus digestion and injury, commonly found in distal stomach or proximal duodenum

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146
Q

complications of peptic ulcers

A

hemorrhage, perforation, peritonitis, obstruction from scarring

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147
Q

treatment of peptic ulcers

A

antacids-block acid secretion
antibiotics-destroy H. pylori that cause mucus injury
surgery if needed

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148
Q

manifestations of stomach carcinoma

A

vague upper abdominal discomfort and iron-deficiency anemia (chronic blood loss)

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149
Q

diagnosis of stomach carcinoma

A

biopsy by means of gastroscopy

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150
Q

treatment of stomach carcinoma

A

surgical resection of affected part, surrounding tissue, and lymph nodes

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151
Q

prognosis of stomach carcinoma

A

relatively poor, often far advanced when diagnosed

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152
Q

acute enteritis

A

common intestinal infection that is short in duration. causes nausea, vomiting, abdominal discomfort, loose stools

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153
Q

chronic enteritis

A

less common intestinal infection, longer, and more difficult to treat

154
Q

Crohn’s disease (regional enteritis)

A

chronic inflammation and ulceration of mucosa, bowel wall thickens and scars, which must be treated with drugs and surgical resection

155
Q

ulcerative colitis

A

inflammation in large intestines and rectum that usually begins in the rectal mucosa and spreads throughout the entire colon

156
Q

complications of ulcerative colitis

A

bleeding, bloody stool, perforation, and colon cancer

157
Q

treatment of ulcerative colitis

A

antibiotics and corticosteroids for flare-ups, immunosuppressive drugs, surgical resection

158
Q

antibiotic-associated colitis

A

antibiotics destroy intestinal flora, causing diarrhea, abdominal pain, and fever

159
Q

diagnosis of antibiotic associated colitis

A

stool culture to look for a toxin in stool

160
Q

treatment of antibiotic-associated colitis

A

stop antibiotic treatment and give a drug that increases intestinal motility

161
Q

appendicitis

A

most common inflammatory lesion of the bowel, caused when secretions of the appendix drain poorly and bacteria invade the appendix wall causing inflammation

162
Q

manifestations of appendicitis

A

generalized abdominal pain localizing in right lower quadrant with rebound tenderness and rigidity

163
Q

treatment of appendicitis

A

surgical resection of the appendix

164
Q

Meckel’s diverticulum

A

out pouching at the distal ileum and usually asymptomatic, but can become infected causing similar complications to acute appendicitis

165
Q

food intolerance

A

causes crampy abdominal pain, distention, flatulence, loose stools

166
Q

lactose intolerance

A

unable to digest lactose into glucose and galactose for absorption due to lactase deficiency, and the lactose builds up and increases pressure of bowel

167
Q

gluten intolerance (Celiac disease)

A

body can’t tolerate gluten, causes chronic diarrhea impairing absorption of fats and nutrients and weight loss

168
Q

gluten

A

protein in wheat, rye, barley, and imparts elasticity to bread dough

169
Q

diagnosis of gluten intolerance

A

clinical features and biopsy of intestinal mucosa

170
Q

treatment of gluten intolerance

A

gluten-free diet

171
Q

irritable bowel syndrome

A

crampy abdominal discomfort, loud grilling bowel sounds, and disturbed bowel function without structural or biochemical abnormalities

172
Q

how to diagnose irritable bowel syndrome

A

by exclusion-rule out infections, food intolerance, and inflammatory conditions

173
Q

cause of obesity

A

any caloric intake that exceeds requirements is stored as adipose tissue and weight is gained-or endocrine or metabolic disturbances

174
Q

what percentage of Americans are obese

A

60%

175
Q

obesity carries a higher incidence of what?

A

diabetes, hypertension, cardiovascular disease and many other diseases

176
Q

treatment of obesity

A

reduction in food intake, increase in activity, or surgical interventions such as gastric bypass and gastric banding for those that can’t reduce food intake

177
Q

anorexia nervosa

A

false perception of fatness, with continual weight reduction by food restriction and excessive exercise. medical and psychological treatment needed

178
Q

bulimia nervosa

A

repeated episodes of binge eating followed by purging, that leads to dental problems, metabolic alkalosis, and electrolyte disturbances. can tear mucosa in esophagus due to purging

179
Q

cause of chronic malnutrition

A

intake of nutrients is insufficient to satisfy the body’s needs (inadequate food, poor distribution, or natural disaster, or inability to use food efficiently)

180
Q

people at risk for chronic malnutrition

A

people that experience parental neglect or lose weight rapidly

181
Q

tolerable body weight percentage loss?

A

5-10%, 30% can be fatal

182
Q

what role does alcohol play in chronic malnutrition?

A

it is very high in calories and has no nutrients-has 7 calories per gram

183
Q

diverticulosis

A

outpouching (diverticula) of mucosa through weak areas in muscular wall of large intestine, commonly seen in the sigmoid colon

184
Q

diverticulitis

A

inflammation incited by bits of fecal material trapped within outpouchings

185
Q

complications of diverticulitis

A

inflammation, perforation, bleedings, scarring, abscess

186
Q

difference between diverticulosis and diverticulitis

A

diverticulosis is just the out pouching on the intestines, diverticulitis is when those outpouchings become inflamed and irritated

187
Q

intestinal obstructions

A

conditions blocking normal passage of intestinal contents that is always considered a serious condition. the severity depends on the location of obstruction, completeness of obstruction, and interference with blood supply

188
Q

high intestinal obstruction causes:

A

severe cramps abdominal pain and vomiting with loss of water and electrolytes

189
Q

low intestinal obstruction causes:

A

less acute symptoms with mild, crampy abdominal pain and distention of abdomen (enlargement)

190
Q

common causes of intestinal obstruction

A

hernia, tumor, volvulus

191
Q

adhesions

A

adhesive bands of connective tissue that may cause loop of bowel to twist and cause an obstruction proximal to the adhesion

192
Q

hernia

A

protrusion of loop of bowel through a small opening in the abdominal wall, that pushes through peritoneum to form hernial sac

193
Q

inguinal hernia

A

common in men, loop of small bowel protrudes through a week area in inguinal ring and descends downward into the scrotum

194
Q

umbilical hernia

A

loop of bowel protrudes into umbilicus through defect in the abdominal wall

195
Q

femoral hernia

A

loop of intestine extends under inguinal ligament along course of femoral vessels into the groin

196
Q

reducible hernia

A

herniated loop of bowel that can be pushed back into the abdominal cavity

197
Q

incarcerated hernia

A

hernia that cannot be pushed back

198
Q

strangulated hernia

A

loop of bowel is tightly constricted obstructing blood supply to herniated bowel, requires prompt surgical intervention

199
Q

volvulus

A

rotary twisting of bowel impairing blood supply

200
Q

intussusception

A

telescoping of a bowel segment into an adjacent segment, from vigorous peristalsis or tumor

201
Q

mesenteric thrombosis

A

clot that blocks blood flow in a mesenteric vein-one of two veins that drains blood from intestines that can cause bowel infarction

202
Q

benign pedunculate polyps

A

tumors of the colon, the tips can erode causing bleeding, must be removed by colonoscopy

203
Q

carcinoma of colon

A

can be in cecum and right half of colon, or left half of colon

204
Q

carcinoma in cecum and right half of colon

A

doesn’t cause obstruction because veins are larger in this area, but the tumor can ulcerate and bleed, and leads to chronic iron-deficiency anemia

205
Q

carcinoma in left half of colon

A

causes obstruction and symptoms of lower intestinal obstruction

206
Q

imperforate anus

A

congenital anomaly where the colon doesn’t develop a normal anal opening-two types

  1. rectum and anus normally form but with no anal orifice-easily treated by incising tissue
  2. entire distal rectum fails to develop-harder to treat
207
Q

hemorrhoids

A

varicose veins of hemorrhoidal venous plexus that drains rectum and anus

208
Q

what predisposes to hemorrhoid development?

A

constipation and straining

209
Q

what relieves hemorrhoids?

A

diet high in fiber and rich in fruits and vegetables, medications such as stool softeners and rectal ointment, and surgery

210
Q

internal hemorrhoids

A

hemorrhoids in veins of lower rectum, may erode and bleed or become thrombosed

211
Q

external hemorrhoids

A

hemorrhoids in veins of anal canal and perianal skin, may become thrombosed and caused discomfort

212
Q

what diagnoses GI disease

A

endoscopic procedures, radiologic examination

213
Q

endoscopic procedures

A

directly visualize and biopsy abnormal areas such as esophagus, stomach, intestines

214
Q

radiologic examination

A

examines areas that can’t be visualized endoscopically, evaluates motility problems, identifies location and extent of disease

215
Q

a 45 year old patient has a large right-sided colon carcinoma with iron deficiency anemia. the anemia is most likely due to:

a. impaired absorption of nutrients due to tumor
b. chronic blood loss from ulcerated tumor surface
c. poor appetite
d. metastases to the liver
e. obstruction of colon by tumor

A

b. chronic blood loss from ulcerated tumor surface

right sided tumors do not obstruct, veins are large enough, but tumor can ulcerate and bleed

216
Q

major endocrine glands

A

pituitary, thyroid, parathyroid, adrenal cortex, pancreatic islets

217
Q

endocrine disorders

A

hypersecretion or hyposecretion

218
Q

pituitary gland

A

suspended by stalk from hypothalamus at base of brain that secretes tropic hormones that regulate other endocrine glands

219
Q

pituitary gland (anterior lobe) hormones

A

growth hormones, prolactin, thyroid stimulating hormone, follicle stimulating hormone

220
Q

pituitary gland (posterior lobe) hormones

A

antidiuretic hormone (concentrated urine), oxytocin (uterine contractions)

221
Q

panhypopituitarism

A

anterior lobe fails to secrete all hormones

222
Q

pituitary dwarfism

A

deficiency of growth hormone that causes retarded growth and development

223
Q

diabetes insipidus

A

failure of posterior lobe to secrete antidiuretic hormone, or failure of kidney to respond to it, can’t absorb water

224
Q

growth hormone overproduction

A

causes gigantism in children, acromegaly in adults, and visual disturbances

225
Q

prolactin overproduction

A

result of small pituitary adenoma, that causes amenorrhea (ceased periods) and galactorrhea (milk secretion from non pregnant breasts)

226
Q

functional pituitary tumors

A

produce hormones that cause clinical manifestations

227
Q

nonfunctional pituitary tumors

A

do not produce hormones but exert other effects

228
Q

many pituitary endocrine disturbances caused by:

A

anterior lobe pituitary tumors

229
Q

treatment of pituitary tumors

A

determined by type, size, and hormone produced-drugs to suppress growth, and surgical resection though the nasal cavity

230
Q

thyroid gland

A

two lateral lobes connected by isthmus, composed of thyroid follicles that produce and store hormones. regulated by thyroid stimulating hormone

231
Q

what do thyroid glands do

A

controls rate of metabolic processes, and regulates normal growth and development

232
Q

hyperthyroidism

A

toxic goiter, causes rapid pulse, increased metabolism, hyperactive reflexes, diarrhea, warm moist skin

233
Q

hypothyroidism

A

slow pulse, decreased metabolism, sluggish reflexes, constipation, cold dry skin

234
Q

nontoxic goiter

A

thyroid gland enlarges to increase hormone secretion

235
Q

treatment of nontoxic goiter

A

administer thyroid hormone, may need surgical removal

236
Q

chronic thyroiditis (Hashimoto thyroiditis)

A

autoantibody destroys thyroid tissue, results in hypothyroidism

237
Q

radiation for thyroid tumors

A

increases incidence of benign and malignant thyroid tumors after the latent period of 5-10 years, most are well-differentiated and easily treated

238
Q

parathyroid glands

A

regulate calcium levels, it is supposed to be in equilibrium with calcium level in the bone

239
Q

low blood calcium

A

causes tetany (increased neuromuscular excitability causing muscle spasms)

240
Q

high blood calcium

A

causes lowered neuromuscular excitability, causing less muscle movements

241
Q

hyperparathyroidism

A

from hormone secreting parathyroid adenoma that causes hypercalcemia (high blood calcium), renal calculi, and calcium deposit in tissues

242
Q

treatment of hyperparathyroidism

A

removal of the adenoma that is causing the symptoms

243
Q

hypoparathyroidism

A

usually from accidental removal of parathyroid glands, causing hypocalcemia (low blood calcium), and neuromuscular excitability and tetany

244
Q

treatment of hypoparathyroidism

A

raise the calcium levels with a high calcium diet and vitamin D supplements

245
Q

adrenal cortex

A

paired glands above the kidneys that secrete glucocorticoids, aldosterone, and sex hormones

246
Q

overproduction of aldosterone

A

caused by aldosterone producing tumor of adrenal cortex, causing high sodium, blood volume, blood pressure, and low potassium

247
Q

overproduction of adrenal sex hormones

A

from sex hormone producing tumors and congenital adrenal hyperplasia (lack of enzyme needed for glands to produce necessary hormones)

248
Q

adrenal medulla

A

produces catecholamines that stimulate sympathetic nervous system (norepinephrine and epinephrine)

249
Q

pheochromocytoma

A

increased secretion of catecholamines (norepinephrine and epinephrine), that can cause cerebral hemorrhage from hypertension

250
Q

Addison’s disease

A

adrenal cortical dysfunction where all steroid hormones are deficient, autoimmune disorder

251
Q

glucocorticoid deficiency

A

causes hypoglycemia (low blood sugar)

252
Q

mineralocorticoid deficiency

A

causes low blood volume and low blood pressure

253
Q

hyper pigmentation

A

results from increased adrenocorticotropic hormone (ACTH)

254
Q

Cushing disease

A

excessive production of adrenal corticosteroids (glucocorticoid or mineralocorticoid), treated by tumor removal

255
Q

glucocorticoid excess

A

causes disturbed carbohydrate, fat, and protein metabolism

256
Q

mineralocorticoid excess

A

causes high blood volume and high blood pressure

257
Q

function of gonads

A

production of germ cells and sex hormones, controlled by gonadotropic hormones of pituitary gland follicle stimulating hormone and luteinizing hormone

258
Q

nonendocrine tumors

A

secrete ectopic hormones that mimic the actions of the true hormones, usually produced by malignant tumors, and commonly seen on lungs, pancreas, kidneys, connective tissues

259
Q

CNS

A

central nervous system, brain and spinal cord

260
Q

meninges

A

surrounding membranes of brain and spinal cord, contains neurons and neuroglia, sensory/afferent nerves, and motor/efferent nerves

261
Q

sensory nerves

A

afferent nerves, transmits impulses toward the nervous system (away from muscles)

262
Q

motor nerves

A

efferent nerves, transmits impulses away from the nervous system (towards muscles)

263
Q

3 meninges

A

dura-firm, outer covering
arachnoid-middle (contains CSF in subarachnoid space)
pie-thin, inner membrane

264
Q

subarachnoid space

A

space between the arachnoid and pia meninges that contains cerebrospinal fluid

265
Q

how many ventricles (cavities) does that brain have?

A

4

266
Q

where does the arterial blood supply of the brain come from?

A

large vessels that enter the base of the skull, and join to form arterial circle at the base of the brain

267
Q

where does the venous blood supply of the brain go?

A

from the brain into large venous sinuses in dura, and drain into the jugular veins

268
Q

forebrain develops what part of the brain?

A

cerebral hemispheres and diencephalon

269
Q

voluntary motor activity is controlled by..?

A

nerve impulses that originate in motor neurons of cerebral cortex (pyramidal system)

270
Q

involuntary motor activity is controlled by what?

A

the extrapyramidal system

271
Q

flaccid muscle paralysis

A

motor neurons are destroyed by disease, the reflex arc responsible for muscle tone is interrupted, and muscle is deprived of innervation (nerves)

272
Q

spastic muscle paralysis

A

the reflex arc responsible for tone is not disturbed, but cortical neurons (in cerebral cortex) stop voluntary control, resulting in increased muscle tone

273
Q

cerebral injury

A

large blood vessels on cerebrum (brain surface) may be torn, resulting in epidural, subdural, or subarachnoid hemorrhage

274
Q

anencephaly

A

neural tube defect in which the brain and cranial cavity fails to develop normally

275
Q

spina bifida

A

neural tube defect in which the meninges bulge out from the spine, causes alpha-fetoprotein to leak from fetal blood into amniotic fluid

276
Q

congenital hydrocephalus

A

from congenital obstruction of aqueduct or absence of openings in 4th ventricle, the head enlarges as the ventricles dilate because cranial structures are not fused

277
Q

acquired hydrocephalus

A

obstruction of cerebrospinal fluid by a tumor or adhesion blocking the opening of the 4th ventricle, where the ventricles dilate but the head does not enlarge because cranial structures are fused

278
Q

stroke

A

cerebrovascular accident-injury to brain tissue from disturbance of blood supply to the brain

279
Q

cerebral thrombosis

A

most common type of stroke, where a thrombus forms in a cerebral artery narrowed by arteriosclerosis

280
Q

cerebral embolus

A

blockage of cerebral artery by a fragment of a blood clot from the heart or from arteriosclerotic plaque

281
Q

cerebral hemorrhage

A

most serious type of stroke, usually from rupture of a cerebral artery in someone with hypertension

282
Q

what is the most serious type of stroke?

A

cerebral hemorrhage

283
Q

what is the most common type of stroke?

A

cerebral thrombosis

284
Q

predisposing factors to a stroke

A
  1. thrombus formed on wall of left ventricle next to a healing myocardial infarction
  2. thrombus formed on rough surface of diseased mitral or aortic valve
  3. small thrombus in left atrium of someone with atrial fibrillation
285
Q

ischemic infarct

A

infarct of brain tissue where no blood leaks into the brain

286
Q

hemorrhagic infarct

A

infarct of brain tissue into which blood leaks

287
Q

arteriosclerosis of extracranial arteries

A

sclerosis of a major artery from aorta that supplies the brain, can narrow the lumen and reduce cerebral blood flow

288
Q

common site of arteriosclerosis of extracranial arteries

A

carotid artery in neck

289
Q

diagnosis of a stroke

A

cerebral angiogram, CT scan, and MRI

290
Q

a CT scan can do what for cerebral infarcts and hemorrhages?

A

it can distinguish between a cerebral infarct from a cerebral hemorrhage

291
Q

transient ischemic attack

A

TIA, brief episodes of neurologic dysfunction from plaque in carotid artery forming an embolus that reduces blood flow to the brain, 1/3 of patients eventually suffer a stroke

292
Q

treatment of transient ischemic attack

A

endarterectomy (surgical removal of part of the inner lining of an artery) or medical therapy

293
Q

cerebral aneurysm

A

congenital aneurysm of the circle of Willis, caused by a congenital weakness that allows the arterial lining to protrude and rupture, causing subarachnoid hemorrhage which is treated by surgically blocking the aneurysm

294
Q

arteriosclerotic aneurysm

A

cerebral artery dilates and compresses adjacent tissue, but rupturing is not common

295
Q

meningitis

A

infection affecting the meninges

296
Q

encephalitis

A

infection of the brain tissue

297
Q

meningoencephalitis

A

infection affecting both meninges and brain tissue

298
Q

three types of infections

A

bacterial, fungal, and viral

299
Q

viral infections that affect the CNS

A

measles, mumps, herpes simplex, intestinal and respiratory viruses

300
Q

manifestations of viral infections that affect the CNS

A

systemic symptoms, aseptic meningitis (serious inflammation of meninges), encephalitis, and spinal fluid abnormalities

301
Q

arboviruses

A

virus responsible for causing meningitis and encephalitis and it is transmitted by mosquitoes (West Nile is a type of encephalitis)

302
Q

Creutzfeldt-Jakob disease

A

also known as mad cow disease, caused by a small protein particle produced by gene mutation–cows became infected from animal feed mixed with infected sheep tissue, and then humans eat the infected beef

303
Q

alzheimer disease

A

progressive mental deterioration and emotional disturbances, and has no specific treatment but drugs can temporarily improve function

304
Q

multiple sclerosis

A

autoimmune disease in generally predisposed individual, caused by demyelination of nerve fibers and glial scarring, but can be initiated by a viral infection in a genetically predisposed person

305
Q

manifestations of multiple sclerosis

A

activated T lymphocytes, monocytes target myelin proteins and destroy the myelin sheaths

306
Q

parkinson disease

A

usually has an unknown cause, but manifests as progressive loss of neurons, rigidity of voluntary muscles, and tremors

307
Q

treatment of parkinson disease

A

can induce stem cells to produce more dopamine to treat the disease, because one of the characteristics is decreased dopamine

308
Q

huntington disease

A

progressive hereditary autosomal dominant disease, is uncommon but well-known

309
Q

manifestations of huntington disease

A

progressive mental deterioration, jerky movements. begins between age 30-50, and usually fatal within 15-20 years

310
Q

treatment of huntington disease

A

no way to stop progression but some drugs can ease symptoms

311
Q

degenerative disease of motor neurons

A

affects upper and lower motor neurons, causes weakness, paralysis, and respiratory problems. ALS is a big example

312
Q

ALS

A

amyotrophic lateral sclerosis. it affects both upper and lower motor neurons, causing flaccid paralysis of muscles and respiratory problems (loss of muscle tone and nerves)

313
Q

tumors of peripheral nerves

A
  • usually solitary and develop from Schwann cells
  • neuromas usually involve the acoustic nerve and are difficult to treat surgically
  • multiple tumors occur in multiple neurofibromatosis
314
Q

multiple neurofibromatosis

A

transmitted as the dominant trait, causing disfiguring skin nodules, thickened patches of skin, and hyperpigmentation

315
Q

brain tumors

A

metastatic tumors are more common that primary tumors

316
Q

primary brain tumors

A

glioma, astrocytoma, oligodendroglioma, lymphoma

317
Q

glioma

A

mostly poor prognosis with deep location in the brain, treated by surgery, radiation, and chemo

318
Q

spinal cord tumors

A

same kinds of tumors that arise in the brain, but they can extend from the vertebrae to compress or invade the spinal cord

319
Q

peripheral nerve injury

A

caused by traumatic injury (crush injury, lacerations, etc) or nerve entrapment (commonly the median nerve and may require surgical release)

320
Q

polyneuritis

A

sensory and motor dysfunction in hands and feet

321
Q

Guillain Barré syndrome

A

patchy demyelination of nerves and nerve roots with mild inflammation, this is an autoimmune reaction to myelin. causes progressive weakness followed by complete recovery

322
Q

neurologic manifestations of HIV

A

acute viral meningitis, AIDS encephalopathy, polyneuritis

323
Q

AIDS related tumors

A

primary tumor that metastasizes to nervous system, a primary tumor of the brain may occur, and usually responds poorly to treatment

324
Q

which statement is TRUE regarding stroke?

a. paralysis on right side of body results from stroke in right cerebral hemisphere
b. flaccid paralysis occurs from a brain injury that damages lower motor neurons
c. spastic paralysis occurs from brain injury that damages lower motor neurons
d. smoking and oral contraceptives in women have no impact on stroke risk
e. cerebral embolism is most serious type of stroke and is frequently fatal

A

b. flaccid paralysis occurs from brain injury that damages lower motor neurons
because flaccid paralysis is the only type of paralysis that results from lower motor neuron damage

325
Q

structure of bones

A

cortex (outer layer of compact bone), trabecular (inner spongy layer), and bone marrow (spaces between trabecular, fat and blood-forming tissue)

326
Q

bone is what type of tissue?

A

connective-composed of dense connective tissue framework with calcium phosphate salts, and is continuously broken down and reformed

327
Q

3 types of cells in bone

A

osteoblasts, osteocytes, osteoclasts

328
Q

3 types of joints

A

fibrous joint (non moving), cartilaginous joint (some moving) and synovial joint (freely moving)

329
Q

intramembranous bone formation

A

mesoderm transformed into osteoblasts that are converted into bone

330
Q

endochondral bone formation

A

cartilage model is converted into bone

331
Q

achondroplasia

A

congenital faulty endochondral bone formation, where there is impaired growth of extremities and skull bone formation. causes dwarfism with short limbs

332
Q

osteogenesis imperfecta

A

congenital malformation where all bones are thin and delicate and easily broken. presents with malformation of fingers and toes, polydactyly, can have multiple fractures at birth

333
Q

congenital clubfoot (talipes)

A

multifactorial inheritance pattern, and treated with manipulation and casts to make the foot grow normally

334
Q

congenital hip dislocation

A

multifactorial inheritance pattern, more common in females, where the acetabulum is too shallow and the femoral head is displaced out of socket. treated with manipulation and casts

335
Q

rheumatoid arthritis

A

systemic disease that affects connective tissues especially in the joints, and produces chronic inflammation and thickening of synovial membrane-autoimmune

336
Q

rheumatoid factor

A

autoantibody in blood and synovial tissues produced by B lymphocytes directed against a person’s own gamma globulin

337
Q

rheumatoid arthritis usually affects what joints?

A

small joints of hands and feet

338
Q

rheumatoid arthritis usually affects what age and gender?

A

young men and middle aged women

339
Q

osteoarthritis

A

“wear and tear” degeneration of weight bearing joints, causing degeneration of articular cartilage covering bones. normal aging process and seen more in older adults

340
Q

gout

A

disorder of purine metabolism where the product (uric acid) precipitates as crystals in joint fluid causing pain and swelling

341
Q

urate nephropathy

A

urate deposits plug tubules and damage the kidneys from an excess of uric acid

342
Q

simple fracture

A

bone is broken cleanly into two pieces

343
Q

comminuted fracture

A

bone is shattered

344
Q

compound fracture

A

the bone breaks the skin

345
Q

pathologic fracture

A

fracture through a diseased area in the bone

346
Q

treatment of a bone fracture

A

open reduction (internal fixation of a bone-steel plate, screws, etc) and closed reduction (plaster cast)

347
Q

osteomyelitis

A

infection of bone and adjacent marrow cavity as a result of bacteria that get into the bone by direct implantation from conditions that expose to direct infection such as trauma or surgery

348
Q

manifestations of osteomyelitis

A

fever, local pain, tendernedd

349
Q

diagnosis and treatment of osteomyelitis

A

x-rays used to show changes in bone, and treated with antibiotics and possibly surgery

350
Q

tumors of the bone are usually:

A

metastatic tumors from the prostate, breasts, and other organs

351
Q

multiple myeloma

A

growth of abnormal cells in the plasma cells

352
Q

primary malignant bone tumors

A

unusual, chondrosarcoma (cartilage) and osteosarcoma (bone forming cells)

353
Q

osteoporosis

A

generalized thinning and demineralization of the entire skeletal system-“porous bones,” and is most common in postmenopausal women because estrogen loss accelerates the rate at which osteoclasts break down bones

354
Q

avascular necrosis

A

interference in blood supply to the epiphysis of bones that results in necrosis and degeneration at the ends of bone. caused by disturbance of blood supply and causes local pain and disability

355
Q

common sites of avascular necrosis

A

femoral head, tibial tubercle, articular surface of femoral condyle

356
Q

intervertebral disks

A

fibrocartilaginous cushions interposed between adjacent vertebral bodies that function as shock absorbers

357
Q

curves of the vertebral column

A

cervical (forward, 7), thoracic (backward, 12), lumbar (forward, 5), and sacral (backward, 5)

358
Q

scoliosis

A

abnormal lateral (sideways) curvature of the spin that occurs in 4% of the population. one shoulder is higher than the other and the pelvis is tilted

359
Q

intervertebral disk disease

A

progressive wear and tear degeneration, and part of the disk is herniated. treated with surgery

360
Q

manifestation of intervertebral disk disease

A

sudden onset of back pain radiating down the leg

361
Q

diagnosis of intervertebral disk disease

A

CT scan or myelogram

362
Q

manubrium

A

upper portion of the sternum

363
Q

how do the ribs connect to the rest of the skeletal system?

A

they articulate posteriorly (in the back) to the thoracic vertebrae 1-12 and anteriorly (in the front) to the sternum, except ribs 11 and 12

364
Q

pectus excavatum

A

the lower 2/3 of the sternum is displaced posteriorly (it caves in), caused by unbalanced costal cartilage growth and if severe can compromise cardiac and pulmonary function

365
Q

pectus carinatum

A

part of the sternum projects outward, opposite of pectus excavated

366
Q

Marfan syndrome

A

connective tissue disease-gene mutation leads to excessive growth in height, long thin fingers and toes, and chest wall abnormalities, usually pectus excavatum

367
Q

myoneural junction

A

communication between a nerve and a muscle

368
Q

how does a muscle contraction work?

A

nerve stimulation releases acetylcholine that crosses myoneural junction and attaches to receptors on surface of muscle fibers and initiates the contraction, which causes myofilaments to slide together

369
Q

myositis

A

muscle inflammation, can be localized or generalized

370
Q

localized myositis is usually caused by:

A

muscle injury or overexertion

371
Q

generalized myositis is usually caused by:

A

systemic disease, or widespread degeneration and inflammation of skeletal muscle

372
Q

dermatomyositis

A

type of polymyositis associated with swelling and inflammation of skin

373
Q

polymyositis

A

chronic illness featuring progressive muscle weakness and inflammation with periods of increased symptoms, called flares or relapses, and minimal or no symptoms, known as remissions

374
Q

progressive muscular atrophy

A

rare disease characterized by progressive degeneration of skeletal muscle, secondary to motor nerve cell degeneration

375
Q

muscular dystrophy

A

primary muscle degeneration

376
Q

myasthenia gravis

A

chronic disease characterized by abnormal fatiguability of voluntary muscles due to myoneural junction abnormality-autoimmune dbseasewith antibodies that fight acetylcholine receptors

377
Q

the most common type of arthritis is osteoarthritis or rheumatoid arthritis?

A

osteoarthritis

378
Q

arthritis pain that begins in one joint is usually characteristic of:

a. rheumatoid arthritis
b. osteoarthritis

A

b. osteoarthritis

379
Q

joint pain accompanied by redness, swelling, warmth, and tenderness is usually characteristic of:

a. rheumatoid arthritis
b. osteoarthritis

A

a. rheumatoid arthritis

380
Q

which arthritis affects only joints and not internal organs?

A

osteoarthritis

381
Q

which type of arthritis affects weight-bearing joints?

A

osteoarthritis

382
Q

which type of arthritis affects small joints of the hands and feet?

A

rheumatoid arthritis

Intro to Disease (4 decks)

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