exam 4 patho

Question 1

exocrine vs endocrine

Answer 1

exo: contains ducts (pancres-amylase/lipase)
endo: ductless-> circulation (insulin/glucagon)

Question 2

pineal gland

Answer 2

info abt light and dark-> melatonin (secreted at night)

Question 3

pituitary gland

Answer 3

master gland
Anterior: GH, ACTH, TSH, FSH, LH, prolactin
posterior (storage): oxy, ADH

Question 4

GH

Answer 4

bones/muscles (adrenal/cortical hormone)

height=genes+ GH

Question 5

ACTH

Answer 5

stim sec/synthesis of ACH

Question 6

FSH

Answer 6

males: inc sperm production
females: growth ovarian follicles/ovulation

Question 7

LH

Answer 7

male: stim sec testosterone
female: stim dev corpus luteum, release of oocyte (egg cell), prod estrogen/progesterone

Question 8

prolactin

Answer 8

prepares fem breasts for breast feeding (inc during PG/lact)

Question 9

Oxytocin

Answer 9

stored in post pit
stim contraction of PG uterus, milk, ejection at birth

should place baby immediately on breast-> stim oxy-> helps uterine contraction (protective)

Question 10

ADH

Answer 10

inc water reabsorption

Question 11

hypothalamus

Answer 11

regulated pituitary

Question 12

pancreas

Answer 12

has islets of langerhans

glucagon: alpha cells, inc BG
insulin: B cells, dec BG

Question 13

thyroid

Answer 13

at base of neck, below larynx
contains follicles
secretes calcitonin and T3/4

Question 14

calcitonin

Answer 14

sec from thyroid

dec blood/ca level by bringing ca to bones

Question 15

T3/4

Answer 15

inc metabolic rate. esp necessary for fetal/infant G&D. also, inc responsiveness to catecholamines

Question 16

PTH

Answer 16

inc serum Ca level (balances calcitonin)

Question 17

adrenal

Answer 17

in ea kidney. has medulla (epi/nor), and cortex: aldosterone, cortisol, androgen, estrogen

Question 18

EPI/NOR

Answer 18

in medulla of adrenal gland. released during stress

Question 19

aldosterone

Answer 19

in outer cortex. mineralcorticoid

Question 20

cortisol

Answer 20

in middle cortex. glucocorticoid.
fxn: metabolism, regulates BG level, growth, antiinflammatory,
dec effect of stress

Question 21

androgen/estrogen

Answer 21

released by innermost adrenal cortex layer
gonadocorticoids
minimal effect. masked by testes/ovaries.

Question 22

SIADH

Answer 22

CA: carcinoma/transients SIADH d/t pit surgery/some drugs
pathway: inc ECF, dilution serum Na, inc concentrate urine
S/S: hyponatremia (<115) confusion/lethargy/muscle twitch/seizure/coma/irreversible neuro damage
Tx: democlocycline, hypertonic, diuretics

Question 23

DI

Answer 23

opposite of SIADH
neurogenic: ADH is low 2* malfxn post pituitary
nephrogenic: normal ADH, but nephrons don’t respond
-> inc urine
S/S: AMS, insomnia, polydipsia, weight loss, nocturia, inc urine (4-18 l/day)
Tx: desmopressin, pitressin (synthetic ADH)
nephro tx: thiazide, prostaglandin

Question 24

DM definition

chronic inc BG ->

Answer 24

disorder of carbs/fat/protein metabolism. inc BG, 2* to inability to produce/utilize insulin
complications: heart dx, renal, PVD, eye probs

Question 25

Diagnostic criteria DM

Answer 25

``` FBS: normal <99 Pre: 120-125 Diabetic: >126 HbA1c: over 3 mos normal <5.7% pre 5.7-6.5 Diab: >6.5 ```

Question 26

Patho of type 1 DM

Answer 26

hyperglycemia-> osmotic fluid loss (intracellular dehydration)-> dolydipsia glycouria, polyphagia, dec body tissue, kussmauls breathing pruritis/paresthesia

Question 27

type 2

Answer 27

insulin resistance, pancreas ecretes more-> exhaustion hyperglycemia, pruritus, paresthesia, acute: HHS hyperglycemic/hyperosmolar syndrome HHNKS: hyper hyper non keto profound dehydration

Question 28

Complications of DM

Answer 28

hypoglycemia-> brain damage somogyi effect: nocturnal-> rebound hyperglyc tx: lower evening dose or bedtime snack dawn phenom: hyperglyc dt in GH at night tx: inc insulin in morning

Question 29

longterm affectd DM

Answer 29

athero, CAD, poor wound healing, CVA, candidiasis, PAD (DKA above knee, DM below knee), retinopathy, peripheral/autonomic neuropathy

Question 30

GFR rates

Answer 30

<15: failure <60 abnormak 60-90+ normal

Question 31

fxns of kidney

Answer 31

``` triggers RAAS (hypoxia/low BV) control BP: raas RBC prob: erythropoietin Vit D synth/ca balance glucose homeostasis (160-190) ```

Question 32

Renal fxn tests

Answer 32

``` BUN (7-18) liver and kidney creatinine: (.6-1.2) only kid. 24 hr urine collection urinalysis (UTI, dehy, Vit B/C, acetone-DKA, +proteins, ketones, crystals) intravenous pyelogram PSA ```

Question 33

phases of RF

Answer 33

initial oliguric diuretic recovery

Question 34

Tx CRF

Answer 34

``` Iv fluids (gentle rehy for geri/CHF) Dialysis COntrol electrolytes (inc phos,dec Ca) Diet: restrict phos Anemia (epoitin alfa/blod transfusion) ```

Question 35

CA uric acid stone

Answer 35

gout/myeloproliferation disorderds (leukemia), rapic weight loss pH urine <5.5 start alkaline ash diet (inc citrus fruits/veg) avoid: shellfish, anchovies, asp, mushrooms, organ meats

Question 36

CA struvite stone

Answer 36

(inc mg/phos/ammonia) alkaline/ammonia rich urine (inc UTI/neurogenic bladder) start w/ acid ash diet (inc vit C)

Question 37

CA ca stone

Answer 37

inc Ca, hyperparathyroidism, dietary excess | limit foods high in oxaloate: spinach, rhubarb, strawberry, choc, peanuts, tea