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BS2 > Exam 7 (Renal System, Immunity, Pain, Derm, Reproductive System) > Flashcards

Exam 7 (Renal System, Immunity, Pain, Derm, Reproductive System) Flashcards

1
Q

How is the bladder innervated?

A

· PNS and SNS
· Afferent SNS Nerves communicate that bladder is full

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2
Q

How is urine excreted?

A

· Involuntary Control via Bladder Neck Sphincter that closes during bladder filling
· Voluntary control via Urethral sphincter that releases urine from the bladder

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3
Q

What happens to renal system as we age?

A

· Decreased ability to filter blood due to
- decreased size/density
- narrowing of arteries
- increased fluid (which may impact sodium)
- decreased bladder capacity resulting in more frequent urination
- shift to nightime urine production

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4
Q

What happens to prostate as we age?

A

· Hypertrophy

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5
Q

Renin

A

· Enzyme that helps maintain sodium and potassium
· Converts Angiotension I into Angiotensin II

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6
Q

Albumin

A

· Protein that helps balance fluid in blood vessels and tissues

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7
Q

What is used to determine stage of chronic kidney failure?

A

Glomerular Filtration Rate (GFR): rate at which blood is filtered per minute

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8
Q

How can NSAIDS impact kidney function?

A

· May cause intrarenal/intrinsic kidney damage

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9
Q

What are the 3 most common causes of CKD/ESRD?

A

1) Diabetes
2) Hypertension
3) Glomerulonephritis

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10
Q

Uremia

A

· Build up of toxins in blood
· Presents during CKD/ESRD

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11
Q

Significance of Stages of Renal Failure

A

· 5 stages
· Stage 3: proper management can stop progression to later stages
· Stage 5: ESRD

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12
Q

Polycystic Kidney Disease (PKD) is a hereditary disorder that can lead to what?

A

ESRD

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13
Q

What is the most common bacterial infection acquired in hospitals and community?

A

UTIs

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14
Q

What sign/symptom is important to monitor for with urinary incontinence?

A

· Cervical spine pain (bc it could be cervical myopathy or cervical stenosis)

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15
Q

Steps to create an Action Plan

A

1) Define your goal
2) Reasons you want to achieve that goal
3) State the action
4) Define strategies
5) Define resources
6) Schedule a time to re-do action plan in 4 weeks

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16
Q

How does the body recognize a pathogen from self?

A

Normal cells contain cell markers but pathogens lack cell markers thus initiating an immune response

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17
Q

What WBC’s are NOT part of innate immunity?

A

T and B cells

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18
Q

What WBC is mostly found in pus?

A

Neutrophils

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19
Q

Why do macrophages live long but neutrophils die quickly?

A

Bc macrophages are APCs which help initiate the adaptive immune response while neutrophils are NOT APCs and are responsible for containing an infection

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20
Q

What happens when invaders get pasts the 1st line of defense?

A

Innate Immune System including Neutrophils and Macrophages go to work

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21
Q

An abnormal or low count of Natural Killer Cells (Lymphocytes) may result in?

A

An increased liklihood or herpes outbreak or infection

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22
Q

Direct Effect of Antibodies (Humoral Acquired Immunity, produced by B-cells)

A

1) Neutralize toxins/lysis
2) Agglutination of toxins
3) Precipitation (pulls out of solution to make more accessible for other cells)
4) Make more accessible to phagocytes or NK cells (dont actually do the killing, just exposing them)

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23
Q

What happens if you lose Suppressor or Helper T cells?

A

· Autoimmune response where body attacks itself bc Helper T Cells stimulate Suppressor T Cells which control down-regulation of immune system
(ex: HIV is the destruction of Helper- T cells)

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24
Q

What happens to T-cells as we increase age?

A

An increase in age results in a decrease in size of Thymus (where T-cells are produced) and thus a decrease in T-Cells

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25
Q

Summary of Immune Response

A

1) Pathogen invades
2) Innate Immunity (1st line of defense- skin,etc., 2nd line- neutrophils and macrophages)
3) Adaptive Immunity (B cells- antibodies, T-cells- helper, killer, supressor)
4) Complement System (indirectly activated by antibodies produced by B-cells)

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26
Q

How do antibiotics work?

A

· Stop bacteria from multiplying or kill them
· Interfere with bacteria ability to repair itself
· Weaken bacteria cell wall

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27
Q

“Neck Rule” of exercise with a mild illness

A

If symptoms above the neck don’t get worse in first 10 mins of exercise then its okay to continue with mild exercise for 30-45 mins

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28
Q

Guideline for returning to exercise with mild illness

A

· Wait at least 1 day after fever to start exercise again
· Same # of days off to ramp exercise back up

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29
Q

How are autoimmune disorders usually treated?

A

Using immunosuppresants and corticosteroids

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30
Q

Syndrome vs Disease

A

· Syndrome is a collection of signs and symptoms with no known actual cause (ex: CFIDS)
· No one test can diagnose a syndrome

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31
Q

Unique feature of Autoimmune

A

· Causes are unknown but probably a genetic and environmental link

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32
Q

Autoimmune Syndromes and a distinction between them

A

1) CFIDS
· More fatigue
· Symptoms for 6 months or more
2) Fibromyalgia
· More pain
· Symptoms for 3 months or more

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33
Q

3 Possible Outcomes of Infection

A

1) Pathogen is stopped by 1st line defense (ex. skin)
2)Subclinical Infection: pathogen enters body and causes a rise in antibodies and immune response but NO symptoms appear
3) Clinically Apparent Infection/Infectious Disease: obvious injury and accompanied by 1 or more symptoms

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34
Q

2 Types of Infectious Disease (Colonization vs Carrier)

A

1) Colonization: organisms is present in host but NOT causing symptoms (ex: MRSA)
2) Carriers: can transmit disease but no symptoms
- Temporary
- Chronic

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35
Q

Latent Infection

A

· Disease present but not actively reproducing and therefor not causing symptoms (ex: herpes, shingles)

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36
Q

Onset of symptoms is what part of the incubation period?

A

The end of incubation period

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37
Q

How do we classify pathogens?

A

· Classified by pathogenicity (ability to cause disease) which is measured using virulence (severity, case-fatality rate)
· ex: Ebola has a high virulence and high pathogenicity

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38
Q

Why is knowing the portal of exit crucial to infectious disease control?

A

Knowing this can help prevent transmission

39
Q

Airborne vs Droplet Precautions

A

1) Airborne: private room with negative pressure, N95 Respirator or PAPR
2) Droplet: mask when working with patient

40
Q

What is one of the first things to look for when an infection is suspected for an older adult?

A

Change in mental status

41
Q

What is a hallmark sign of a bacterial infection?

A

Suppuration of formation of pus (due to neutrophils)

42
Q

What would CSF from a lumbar puncture look like if meningitis was present?

A

Cloudy (due to increased WBCs) or red (due to blood)

43
Q

Trisomy

A

Individuals born with too many chromosomes, often dont survive past birth

44
Q

What genetic test is recommended as first line?

A

Exome Sequencing (sequences regions that encode proteins = genes)

45
Q

How many copies of the gene need to not work properly to show symptoms for Autosomal Recessive disorder?

A

Both copies (ex: cc)

46
Q

How many copies of the gene need to not work properly to show symptoms for Autosomal Dominant disorder?

A

Only 1 copy

47
Q

Term for when an individual has a a disease-causing variant but no symptoms?

A

Reduced Penetrance

48
Q

What is the chance of an affected father passing on an X-linked condition to his daughters or sons?

A

· 100% chance of father passing on to daughter (bc can only give “x” to daughter)
· 0% chance of father passing on to son (bc can only give “Y” to son)

49
Q

Who can pass on a Mitochondrial condition?

A

· Only oocyte/egg-producing individuals
· Sperm-producing individuals can inherit from their mother but cant pass it on

50
Q

Single Gene vs Multifactorial Diseases

A

· Single Gene: clear pattern of inheritence, one variant with a large effect (ex: Huntingtons)
· Multifactorial: clusters in family, several variants with small effects (ex: diabetes, HTN)

51
Q

What types of breast cancer account for a significant percentage of hereditary breast cancer?

A

BRCA1 and BRCA2

52
Q

“Anticipation” in genetic conditions

A

· Anticipation: increased severity and earlier onset of a condition as it is passed through generations (due to increasing expansion of the repeat gene)
· Ex: Huntingtons Disease

53
Q

What are the chances of an individual with CF passing it on to their child?

A

· 25% chance bc CF is a recessive condition

54
Q

High Impact Chronic Pain

A

Persistent pain with substantial restriction of life activities lasting 6 months or more

55
Q

Impact of depression on pain

A

Reduced pain threshold (feel pain sooner)

56
Q

Impact of chronic pain on sensitivity

A

Heightened receptor sensitivity

57
Q

According to the IASP definition of pain, does actual damage need to be present?

A

No

58
Q

Holistic Management of Pain Factors

A

1) Autonomy: help pts develop programs that work within their own lifestyle, needs and environment
2) Competence: educating pts on how to recognize barriers and still know how to exercise and progress through
3) Relatedness: interact with empathy and develop a rapport

59
Q

Pain Scales in Youth

A

· <6: use behavioral pain scales
· >6: use pt-reported outcome measures

60
Q

What type of pathway is nocioception?

A

· Bottom-up processessing with a 3 neuron pathway (nociceptor, sc, cortex)

61
Q

Function of the first order neuron in the nocicetpion pathway?

A

Converts energy into electrical signal and then to CNS

62
Q

Referred Pain

A

Brain may not be able to perceive the exact location of pain bc cutaneous and visceral neurons synapse on same neuron in spinal cord (ex: pain may feel like its coming from low back but really its the intestines)

63
Q

Where do peripheral vs central sensitization changes occurs?

A

1) Peripheral: occurs at nociceptor
2) Central: occurs at dorsal horn and above

64
Q

Somatosensory Receptor Types

A

· Type I/Ruffini
· Type II/ Pacinian
· Type IV/ Free nerve endings
· Merkel disc

65
Q

Benefit of overlap of receptive fields

A

Backup in case one nerve is damaged

66
Q

Thermoreceptors in the periphery vs spinal cord

A

· Periphery: 2 types that detect hot or cold but once the signal reaches the sc there is only 1 receptor and thus the brain does not know if its hot or cold

67
Q

At what point in the brain is pain finally perceived?

A

Cerebral Cortex

68
Q

Is nociception required for experiencing pain?

A

NO! Bc patterns can be stored in the cerebral cortex and when triggered can be felt like it exists within the body

69
Q

What is the normal inflammatory response to trauma in the periphery?

A

1) Trauma occurs
2) neurotransmitters and other things spill out and noxiously stimulate mechanoreceptors
3) Bradykinin spills out causing increased permeability in blood vessels
4) Increased permeability allows for plasma NOT blood to seep out
5) Substance P seeps out causing increased sensitization and hyperalgesia

70
Q

How does central sensitization differ from peripheral?

A

· Central sensitization includes increased responsiveness to innocuous stimuli resulting in allodynia (painful sensation to application of a non-harmful stimuli, ex: hurts putting a sweater on)
· Contralateral limb affected due to enlargement of receptive field

71
Q

The Convergence Projection Theory best represents what?

A

Referred pain

72
Q

Clinical relevance of temporal summation?

A

· Temporal Summation is the increasing of pain to the same stimulus over time
· Can be used to explain primary hyperalgesia (peripheral sensitization) and used clinically to assess sensitivity of the CNS

73
Q

Subjective vs Objective Examination

A

· Subjective: includes hx and ROS
· Objective: includes scan/screen and tests/measures

74
Q

Clinical vs Psychosocial Flags

A

· Clinical: Red and Orange flags
· Psychosocial: Yellow, Blue, and Black flags

75
Q

What cell holds us together and can transmit signals?

A

Desmosomes

76
Q

Impact of aging on light touch sensation? (Meissner’s Corpuscle: high sensitivity, low threshold, rapidly adapting)

A

As age increases, sensitivity decreases

77
Q

Primary vs Secondary Skin Lesions

A

· Primary: caused by internal forces
· Secondary: caused by external forces

78
Q

Urticaria (Hives)

A

· Red swellings of skin, itching
· Caused by release of histamines
· Treatment: remove cause, antihistamines

79
Q

What form of malignant melanoma metastasizes quickly?

A

Nodular Melanoma

80
Q

What nerve innervates the coccygeous?

A

Anterior Rami of S4, S5

81
Q

What innervates the Levator Ani muscles of the pelvic diaphragm (Layer 3)?

A

· Sacral efferent nerves and pudendal nerves
· Sacral Nerves innervate pelvic/superior surface
· Pudendal Nerves innervate perineal/inferior surface

82
Q

How do the diaphragm and pelvic floor move during respiration?

A

· Inhalation: diaphragm and pelvic floor drop down
· Exhalation: diaphragm and pelvic floor lift up

83
Q

Core Canister

A

· Top: diaphragm
· Bottom: pelvic floor
· Front and Sides: Transverse Abdominis
· Back: multifidus

84
Q

How does the NSDUH define Serious Mental Illness (SMI)?

A

· A mental, behavioral, or emotional disorder (excluding developmental and substance use disorders)
· Results in serious functional impairment, which interferes with or limits one or more major life activities

85
Q

Tardive Dyskinesia

A

· A potential side effect of anti-psychotic medication
· Symptoms: abnormal movements of jaw, lips, and tongue
· Gait changes
· Involuntary jerking of the arms and/or legs
* Symptoms can be improved with discontinuation of medication

86
Q

What type of depression is at an increased risk for suicide?

A

Seasonal Affective Disorder

87
Q

Cyclothymia

A

· Mild form of BPD Type 2
· Characterized by episodes of mild depression and hypomania (elevated mood that does not negatively affect function) lasting > 2 years

88
Q

What is important to screen for regarding BPD medications (anti-manics)?

A

· Lithium toxicity (bc not metabolized well)
· May appear as tremors

89
Q

Oncology

A

Study of neoplasms (new growth of abnormal mass of tissue, clonality, unregulated proliferation)

90
Q

Benign vs. Malignant vs Metastasis

A

· Benign: no risk of metastasis, generally does not recur locally
· Malignant: potential to recur locally, often spread to distant sites
· Metastasis: spread of abnormal cells to distant organs or sites

91
Q

Hyperplasia vs Metaplasia

A

· Hyperplasia: increase in number of cells
· Metaplasia: generally reversible change in cell type

92
Q

Physiologic vs Pharmacologic Dosing

A

· Physiologic: hormone replacement (exogenous dose)
· Pharmacologic: exogenous dose that is larger than normal endogenous dose

93
Q

Primary Uses of Immunomodulating Drugs

A

· Augment (HIV)
· Suppress (organ transplant, autoimmune diseases)

BS2 (7 decks)

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