Final Flashcards
Define/example: Active acquired immunity
natural exposure to antigen
long-lived immunity - form memory cells
Ex: Immunization, contract chicken pox
Define/ex: Osmotic forces
WATER movement between ICF & ECF
thirst can activate osmoreceptors by an increase in osmotic pressure
define: antidiuretic hormone (ADH)
regulates water balance through ADH & thirst
stimulated by increase in plasma osmolality
thirst occurs when water loss equals 2% of an individuals body weigh or when osmotic pressure increases
How do GI losses cause metabolic acidosis?
vomitting induced metabolic acidosis causes retention of bicarb to maintain anion balance
the function of the nucleolus
contain DNA, RNA & binding proteins (Histones)
what is apoptosis?
programmed cell death
can occur when growth is excessive
How does carbon dioxide illicit tissue damage?
quickly binds to hgb so cells are unable to carry O2
S/S: normal SPO2, reddend cheeks?
physical findings for trisomy 21
Mental challenges epicanthal eye folds low nasal bridge flat low set ears protruding tongue poor muscle tone short stature
Patho behind type DM1
autoimmune association between DM1 & several major histocompatibility complex class II alleles
what genes are necessary for the function and maintenance of all cells?
Housekeeping genes
-includes those encoding histones, DNA, RNA polymerase, ribosomal RNA genes
in the elderly wound healing is affect by which factors
underlying chronic illness which impairs inflammation
Ex: DM
Where do B cells mature?
Bone marrow -
Type II hypersensitivity reactions
Tissue specific - adatptive immune response
antibodies bind to tissue-specific antigens that are attached to particular tissues on cell surface
purpose of Rhogam?
prevent alloimmunity & hemolytic disease of the newborn
- maternal antibodies can cross placenta and destroy fetal RBC
given to Rh- mom with Rh+ baby
describe acute rejection on a cellular level
Type IV hypersensitivity reaction
-Th1 cells release cytokines that activate infiltration macrophages that direct cytotoxic t cells directly attacking transplant
what are exotoxins?
produced by bacterial pathogens
released during microbial growth that affects nearby CT and cells
what do these hormones affect during stress?
ACTH
ACTH = adrenocorticotropic hormone
-regulates release of cortisol from the adrenal cortex
-stress increases ACTH secretion = increased cortisol levels
what do these hormones affect during stress?
Cortisol
cortisol is a steroid (glucocorticoid) released from the adrenal cortex
Lipid soluble
increases during stress d/t increased ACTH
what are reperfusion injuries?
damage from restoration of blood flow and oxygen can cause additional injury d/t oxidative stress
what type of anemia is Pernicious anemia? how does it cause paresthesia?
Megaloblastic anemia
caused by defective secretion of an intrinsic factor essential for the absorption of B12
paresthesia caused d/t myelin degeneration in the spinal cord
hormones secreted from the posterior pituitary
OXYTOCIN antidiuretic hormone (ADH)
ADH
What are the effects of low/high levels
high levels = vasoconstriction which incrase aterial BP
-need pharmacological vasopressin to cause enough vasoconstriction to matter
Name two cells that control fungal infections
T lymphocytes
Phagocytes
A pt who is adrenally insufficient has hypoglycemia during times of stress due to which chemical
cortisol
what is the final product of impaired cellular metabolism
buildup of cellular waste products
which substance is LEAST likely to stimulate a pro-inflammatory state?
IL-4
in children/infants, what percentage of dehydration causes hypotension
10%
exposure to which virus is a carcinogenic factor?
Epstein-barr virus (EBV)
The risk of developing cancers is increased with childhood exposure to which risk factors?
hint: 4 answers
- Chemotherapy/ drugs
- Ionizing radiation
- EBV
which granulocyte contains vasoactive amines such as histamine?
basophils
endothelium role in colt formation?
(SATA)
the surface of the endothelium produces plasma protease inhibitors
plasma protease inhibitors assist in preventing clot formation
thrombomodulin is a protein that is converted on the surface of endothelial cells
(2x plasma protease & thrombomodulin on surface of cells)
what causes pancytopenia in aplastic anemia?
suppression of the bone marrow to produce adequate amounts of erythrocytes, leukocytes, and thrombocytes
why is hemophilia A seen mostly in men?
x-linked recessive
chronic myelogenous leukemia (CML) can be described as?
translocation of genetic material from genes 9 and 22 creates an abnormal, fused protein identified as BCR-ABL1
Hemoglobin S (HbS) is a result of which amino acid mutation?
Valine replaces glutamic acid
pt has amenorrhea, galactorrhea, hirsutism, and osteoporosis. A CT scan of the head is ordered to assess for which condition
Prolactinoma
pituitary tumor that secrets prolactin
polyuria occurs with DM d/t?
Elevation in serum glucose produces an osmotic diuresis w/ symptoms of polyuria and thirst
what causes the microvascular complications in pts with DM
capillary basement membranes thicken, and cell hyperplasia develops
what is the rationale for annual eye exams for those with DM
retinal ischemia and RBC aggregation occur
common s/s of hypothyroidism
(SATA)
constipation
bradycardia
lethargy
obese individuals are at higher risk of hypertension d/t increased production of…?
antiotensinogen
pt is unable to sense the touch of a sharp pin or distinguish a hot object from cold… which are of the brain is damaged?
Pons
which part of the brain is responsible for involuntary muscle control and balance/posture?
cerebellum
pt only able to smile on one side of the face indicates dysfunction of which cranial nerve?
VII (facial nerve)
pt with COPD w/ elevated PVR has increased chance of developing which HF?
Right sided HF
VSD is a common congenital heart defect in which pt population?
trisomy 21 (down syndrome)
which physical and clinical findings would you expect to find on an infant with ASD?
typically asymptomatic
- crescendo-decrescendo systolic ejection murmur
- wide fixed spitting of the second heart sound
describe process of conjugation of bilirubin in the liver?
unconjugated (fat soluble) bilirubin converts to conjugated (water soluble) bilirubin
projectile vomiting w/o N&V could indicate what?
Neurologic lesion, Increased ICP, tumor, aneurysm
Need CT scan
what type of diarrhea occurs in lactase deficiency?
Osmotic Diarrhea
Frank brigh red/ burgundy blood?
Hematochezia
EARLY sign of small intestinal obstruction?
Distention
what is NOT a contributing factor to duodenal ulcer
-gastric emptying is slowed, causing greater exposure of the mucosa to acid
Alcoholic cirrhosis has an accumulation of
hepatic fat accumulation
EARLY s/s hepatitis?
Fatigue
Vomiting
hyperalgia
what structures are not completely fused in cleft lip?
nasomedial and intermaxiallary process
Mild conjugated (indirect-reacting) hyperbilirubinemia causes what condition in a newborn?
Jaundice?
how does varicose bronchiectasis deform the bronchi?
varicose bronchiectasis exists when both constrictions and dilations deform the bronchi
pt with transudative pleural effusion, what intervention would you do/ what does it indicate?
check protein levels
result of decreased capillary oncotic pressure
which condition would you most likely find the diagnosis of ARDS
PNA
pt diagnosed w/ primary emphysema w/o hx of smoking…
facilitate genetic testing
definition of pleural effusion?
Fluid in the pleural space
clinical findings of pulmonary hypertension
dyspnea on exertion
peripheral edema
JVD
nasal congestions is a serious threat to young infants b/c?
they are obligatory nose breathers for first 2-3 months
which 2 substances are inhibited with the release of natriuretic peptides?
Renin & Aldosterone
best lab to eval renal function?
GFR
What measures can be done to decrease colon cancer risk
exercise
what causes renal failure in children after electrical burns?
myoglobin that is relseased from damaged muscles
pressure from a pitutiary tumor on the optic chiasm can cause what?
visual distrubances
what are effects of age related anorexia cause (SATA)
decreases in saliva and the sense of taste are contributing factors
age related loss of appetite common
social stimulation at meals may promote better eating habits
how does surfactant facilitate alveolar distention and ventilation ?
Decreases surface tension in the alveoli
what are expected changes in a UA for an elderly pt?
Lower specific gravity (1.003)
what are expected changes in a UA for an elderly pt?
Lower specific gravity (1.003)
what is the role of pyrophosphate, potassium citrate, and magnesium in the formation of kidney stones?
inhibit crystal growth
how to differentiate between pyelonphritis or cystitis
UA confirmation of white blood cell casts
pt with hematuria, RBC casts, proteinuria exceeding 3-5g/day, with albumin as the major protein. What diagnostic test or treatment regime would be the next intervention?
renal biopsy
a child with acute poststreptococcal glomerulonephritis is voiding smoky, brown colored urine. what does this indicate?
presence of RBCs
In IgG nephropathies such as glomerulonephritis, IgG is deposited in ___ of the kidney
glomerulus basement membrane
what causes vesicoureteral reflux in children
short ureter making anti-reflux mech inefficient
term used to identify a functional urinary tract obstruction caused by an interruption of the nerve supply to bladder
neurogenic bladder
articular cartilage
insensitive to pain and regenerates slowly and minimally after injury
what is transporting glycoprotein between bone cells for essential elements such as hormones, ions, and other metabolites?
bone albumin
what is the function of osteocytes
maintain bone matrix
what is a pathologic fracture
a fracture that happens at the site of an abnormality already in that bone
when a patient injuries the upper motor neuron, the damage is expected to be ___paralysis, with gradual ____ recovery later
inital, partial
what separates the brains cerebellum
tentorium cerebelli
defect of the arachnoid villi causes
too little absorption of CSF
executive attention functions is mediated from which area of the brain?
prefrontal
10 sec tom -cant keep attention
complex focal seizure
loss of consciousness
dreamlike state
vasogenic cerebral edema
increased permeability of the capillary endothelium of the brain after injury to the vascular structure
inability to identify an object when ones eyes are closed
tactile agnosia
which type of injury is expected to cause more pain based on the process of nocieptors?
crushed fingers
gate control theory
balance of impulses conducted from the spinal cord to the higher centers in the central nervous system modulates the transmission of pain
nerve fiber that transmits pain impulses
a-delta fibers
primary-order transmitting neuron in the spinal cord
dorsal root ganglia
endogenous opioid located in the hypothalamus and pituitary gland
endorphins
major depressive patients have an abnormality in the
hypothalamic pituitary adrenal system (HPA)
decrease in receptor binding for which neurotransmitter found in depression
serotonin
electrolyte abnormaility associated with lithium toxicity
hyponatremia
complication of panic disorder
agoraphobia
correlation between major depression and cortisol secretion
persistently elevated plasma cortisol levels can result in inflammation that is believed to trigger depression
Which of these statments are correct regarding the pericardium?
a. its a double walled membranous sac that encloses the heart
b. made up of connective tissue and a surface layer of squamous cells
c. protects the heart against infection and inflammation
d. contains pain and mechanoreceptors that can elicit reflex changes in blood pressure and heart rate
ACD
function of papillary muscles
prevent backward expulsion of the AV valves
electrolyte imbalance of the phase 0 cardiac cycle
hyponatremia
explain raynaud disease to a new student
vasospastic disorder of the small arteries and arterioles of the fingers and less commonly of the toes
age related bone loss in older women is associated with
increased oxidative stress and increased intracellular reactive oxygen species
for a pt found down on the ground after a fall, what lab to order?
serum creatine kinase
paget disease explanation
problem with bone resorption and formation
what does sequestrum mean regarding osteomyelitis?
area of devascularized and devitalized bone
what is ankylosing spondylitis
chronic inflammatory diseae with stiffening and fusion of the spine
subluxated hip?
maintains contact with the acetabulum but is not well seated within the joint
allergic contact and stasis dermatitis have in common
erythemia and pruritus
demarcated lesions on the elbow and knees that are thick, silver, scaly, and erythemaous describe…
plaque psoriasis
collection of infected hair follicles on the back of the neck
carbuncles
highly contagious infection
impetigo
tinea corporis (ringworm) can be described as
circular lesions with erythema and scaling pathces
facts regarding kaposi sarcoma (quick)
AIDS
drug induced
African American
Lower legs
onychomycosis location
finernail
malignancy lesion of face/neck with depressed centers with rolled borders
basal cell carcinoma
pelvic inflammatory disease caused by inflammation that results in permanent changes to ____of the ____
ciliated epithelium, fallopian tubes
benign uterine tumors that develop from smooth muscle cells
leiomyomas
cervical carcinoma in situ defined as
full epithelial thickness of the cervis
gene mutation associated with breast/ovarian cancer
BRACA1
clinical findings of superficial breast cyts
squishy feeling and eaily palpated
what do you want to assess in balanitis
check blood glucose
frim nontender testicular mass can indicate
testicular cancer
a man reports that he had sudden onset of malaise, low back pain, and perineal pain with high fever and chills, dyuria, nocturia, and urinary retention. what is the next most steps?
urine sample
clinical findings of prostate cancer (SATA)
a. ranks 2nd to lung cancer as being most common among American men.
b. >65 yrs of age increases risk
c. Dietary habits increases risk
d. African American men have increased risk
BCD
condition in which the foreskin cannot be attracted back over the glans
phimosis
newborn with gonococcal STI will have
bilateral corneal ulceration
stage of syphilis would the following be found: destructive skin, bone and soft tissue lesion, aneurysms, HF, neurosyphils
tertiary
what is reposible for the development of syphilis
Treponema Pallidum
how to treat strawberry spots on vagina and cervix
metronidazole
which two STI frequently coexist?
Chlamydia & Gonorrhea
woman with severe preeclampsia. What clincial findings could be present (SATA)
a. edema of hands and face
b. clonus
c. fetal heart rate accelerations
d. right upper quadrant pain
e. headache
A.B.D.E
A woman who is G3 T2 P2 A0 L2is admitted to the obstetric unit at 30 weeks gestation with a sudden onset of vaginal bleeding that is bright red in color. Upon exam, her uterus is soft and she pain reports no pain. The fetal heart rate is 140 beats/minute. The healthcare provider correctly identifies these assessment findings are related to which of the following problems?
no pain is clue—-
Placenta Previa
A 45 y/o woman with a history of pelvic inflammatory disease (PID) presents to the primary care clinic with a report of dizziness, sharp abdominal pain, and scant dark red vaginal discharge. She has missed two menstrual periods and is concerned about being pregnant. A pregnancy test confirms her pregnancy. These assessment findings indicate the woman is experiencing which of the following problems?
ruptured ectopic pregnancy — SHARP Pain
during amniocentesis to look for neural tube defect
alpha feto protein
which pt would you want to check to see if they have an elevated ADH level?
small cell carcinoma of the stomach
pt with closed head injury and significant urine output, hypotension
Give desmopressin to decrease urine output and increase BP
