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PAS 753 (Molecular Pathophysiology) > Final > Flashcards

Final Flashcards

1
Q

T/F “all that wheezes is not asthma, and all asthma does not wheeze”

A

true

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2
Q

asthma incidence has been increasing for 30 years

two theories why

A

air pollution

increased sensitivity to allergens due to hygiene hypothesis

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3
Q

describe the effect of H pylori on cancer

A

increaesd risk of gastric cancer, decreased risk of esophageal cancer

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4
Q

five chronic complications of DM

A

CAD

PVD

nephropathy

neuropathy

retinopathy

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5
Q

three Ps of diabetes

A

polyuria

polydipsia

polyphagia

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6
Q

resistant TB treatment

A

up to 20 months of 2nd or 3rd line agents

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7
Q

US findings of ectopic pregnancy

A

No IUP “empty uterus”

adnexal mass

free fluid in the cul de sac

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8
Q

what is necessary for the evaluation of first trimester pain and bleeding

A

ultrasound is mandatory to catch ectopic pregnancy brefore rupture

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9
Q

diagnosis of melaoma

A

biopsy

ABCDE

ugly duckling

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10
Q

fatal complication of diabetes

A

diabetic ketoacidosis

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11
Q

four non-joint manifestations of RA

is there an effect on lifespan

A

anemia, pleura, eye, skin

life span is shortened, mechanism unknown

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12
Q

T/F multiple myeloma bones are prone to fracture

A

true

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13
Q

OA symptoms

A

pain on use that is worse with activity and improved with rest

<15 of stiffness each morning

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14
Q

what is the presentation of ectopic pregnancy

A

vaginal bleeding

pelvic pain

usually starts in the firs ttrimester

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15
Q

what percent of people have asthma

how many office visits are asthmas related

A

7-10%

1-3%

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16
Q

define diabete mellitus

A

a disorder characterized by chronic hyperglycemia due to relative or absolute deficiency of insulin, or resistance to insulin

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17
Q

signs of appendicitis

A

abdominal pain

nauseaa

low fever, leukocytosis

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18
Q

treatment for gastric cancer

A

gastrectomy (only possible for 30% of patients)

chemo

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19
Q

what is the most common type of hyperthyroidism (60-80%)

A

graves disease

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20
Q

how do H2 inbitors block acid production

A

block the binding f histamine in to receptors, stopping the production of cMAP from adenylate cyclase and reducting proton pump action

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21
Q

what medication is used to treat gout by reducing inflammation

A

colchicine

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22
Q

two photo treatments of psoriaisis

A

UVB, PUVA

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23
Q

which thyroid hormone is most readily available

why is this effect in treatment

A

T4

because T4 is converted to T3 in tissues

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24
Q

when will most diabetic have complications

A

after 20 years

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25
Q

psoriasis

A

chronic, relapsing skin disorder that causes itching, joint inflammation, and depression

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26
Q

what is the function of beta-2 agonists in asthma treatment

side effects are caused by beta 1 cross reactivity

what are the side efects

A

bronchodilation

tachycardia, hyperglycemia, HTN

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27
Q

describe multiple myeloma in three bullets

A

most common form of bone cancer

comes from a single plasma cell

produces large amounts of antibodies

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28
Q

four pathologies of appedicitis

A

obstruction form feces, foreign body, inflammation, neoplasm

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29
Q

tests and exams to confirm cushings

A

elevated cortisol

cortisol suppression test

Low ACTH levels

imaging

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30
Q

what is the process of a bone marrow transplant

A

destroy bone marrow with radiation and chem

transplant hematogenous stem cells

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31
Q

What is responsible for GERD

A

a disorder of the lower esophageal sphincter that allow acid to come up

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32
Q

risk factors for GERD

A

obesity

hiatal hernia

increased acid production

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33
Q

5 general categories of hormones

A

amino acid

neuropeptides

proteins/glycoproteins

Steroids

Vitamin deriviatives

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34
Q

what is required to pass TB onto someone else

what is the efficiency of transition

A

fair close prolonged contact

23%

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35
Q

what is the preferred method of treatment to definatively cure hyperthyroid

what makes it good

A

ablation wth radioactive iodine

because it spares the parathyroid

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36
Q

symptomatic treatment of cirrhosis

A

paracentesis of ascities

shunts to reduce portal hypertension

correction of coagulopathy and hypoalbumemia

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37
Q

treatment for fibromyalgia

A

antidepressants

lifestyle adjustment (stress reduction, exercise, normal sleep)

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38
Q

how does the IBD increase the risk of colon cancer based on duration

A

after 10 yrs 2%

after 20 8%

after 30 18%

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39
Q

what is the treatment for a cure in esophageal cancer

A

surgery, radiation, chemo

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40
Q

5 protein/glycoprotein hormones

A

FSH

LH

TSH

HCG

Insulin

PTH

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41
Q

target cell

A

the end-target of a hormone that produces a response within the cell

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42
Q

what is the hallmark of type II DM

A

insulin resistance

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43
Q

what is the most common cause of cholecystitis

A

distal occulsion of the bile duct by a gallstone

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44
Q

gram negative sources of HAP

A

klebsiella, pseudomonas

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45
Q

why can radioactive iodine be used to ablate the thyroid

A

because the thyroid is the only place where iodine is stored in the bdoy

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46
Q

psoriasis is associated with increased risk for what diseases

A

inflammatory bowel disease

skin cancer

upper GI cancer

lung cancer

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47
Q

which is more relevant, long or short feedback loops?

why?

A

long, because they work on the hypothalamus and the pitutiary

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48
Q

what medications can be used to reduce inflammation of asthma

A

glucocorticoids or other anti-inflammatories

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49
Q

trigger of RA

A

unknow, suspected infectious agent or smoking

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50
Q

what diagnoses for cushings have a good prognosis?

poor?

A

good: cushings disease and iatrogenic cushings
bad: adrenal carcinoma and small cell lung cancer

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51
Q

how is COPD related to asthma

A

smoking damages epithelium, leading to infection, inflammtion and asthma like reactive airways

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52
Q

typical cause of lobar pneumonia

A

strep

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53
Q

dermatological manifestation of insufficient oxygenation

A

clubbing and cyanosis

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54
Q

T/F its common to have severe symptoms in the early stages of pancreatic cancer

A

false, it is commonly asymptomatic

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55
Q

what changed in peptic ulcer treatment after 1981

A

helicobacter pyloria was linked to PUD

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56
Q

what is common when ovarian cancer starts to spread in the abdomen

A

obstruction, malabsorption

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57
Q

special hazard of PR

A

connection with giant cell arteritis in 1/3 of patients what can cause sudden blindness due to occluding the opthalmic arteries

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58
Q

what is the main method of TB spread

where else can it come from

A

airborne in aerosol mucus

infected cow milk

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59
Q

what is the effect of Hep D and B infection

A

a significantly more severe disease than Hep B alone

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60
Q

what is the age and gender bias for esophageal cancer

A

50-70

3x more common in men to women

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61
Q

explain why endocrine systems are homeostatic

A

they respond to outside challenges to maintain homeostasis

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62
Q

what is the result of build up of nodular and fibrotic tissue from cirrhosis

A

obstruction of the biliary channels and portal hypertension

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63
Q

two types of auto immunte arthritis

A

rheumatoid arthritis

lupus

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64
Q

when does obstetrical dating start

A

the first day of the LMP

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65
Q

what is the hallmark symptom of RA

A

early morning stiffness lasting more than one hour

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66
Q

renal involvement of gout

A

urate crystals can deposit in the glomeruli and cause renal failure

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67
Q

risk factors for esophageal cancer

A

tobacco (specifically for squamous cell)

obesity

GERD/Barrett’s esophagus

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68
Q

two types of myalgia for our test

A

fibromyalgia

polymyalgia rheumatica

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69
Q

three orgin sites for ovarian cancer

which is the most common

A

epithelial

germ cell

stromal/sex cord

epithelial

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70
Q

differentiating factor between RA and OA

A

OA effects the hips and spine, RA doesn’t, though it can effect many joints

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71
Q

three types of peptic acid disorders

A

benign peptic ulcers

GERD

zollinger-ellison syndrome (gastrinoma)

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72
Q

what treatment that works on gout won’t be very helpful in other cases of arthritis

A

colchicine will reduce pain only in gout, not OA and RA

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73
Q

where are other ACTH secreting cells located beside the pituitary

A

small cell lung cancers

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74
Q

methods to stimulate cartiliage repair in OA

A

glucosamine/chondroitin, chondroctye transplantation

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75
Q

diagnostic process of lung cancer

A

direct visualization with biopsy

diagnostic imaging

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76
Q

what happens histologically with smoking

A

the loss of respiratory cilia

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77
Q

what is the gender bias of cholelithaisis

A

women over men, 8.6% to 5.5%

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78
Q

how common is Hep A

how is it spread

what is the mortality rate

A

30% of americans are serologically positive for Hep A

fecal oral transmission from sanitation, shellfish

usualyl low, the disease does not lead to chronic infection or liver damage

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79
Q

what was the mean survival of a diabetic patient before 1922

after

what changed?

A

5 year <5%

increaed to 30-40 years

insulin was discovered

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80
Q

PE findings for appedicitis

A

RLQ, pain, guarding, rebound, positive psoas or obturator

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81
Q

treatment for melanoma

A

excision

chemo

immunotherapy

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82
Q

prognosis of active TB

A

100% cure rate with compliance and non-drug resistance

withotut treatment 35% will die in 1 year, another 35% in five years

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83
Q

is Hep C commonly spread to babies through breast feeding

A

not commonly

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84
Q

what is the process of Hep A

A

incubation for 30 days

prodrome for several days

icteric phase for 2-3 weeks with worsening symptoms

convalescence

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85
Q

why is it imporant to know the amount of a hormone that is bound vs free

A

a bound hormone can’t do anything

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86
Q

how long does an acute gout flare last

do they recur?

when wil gout cause joint deformity

A

several days to weeks

yes, in months or years later

only in early onset or untreated goiut

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87
Q

paracrine

A

chemical signalling to nearby cells

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88
Q

5 adverse effects of cortisol

A

weight gain

striae

moon facies

HTN

peptic ulcers

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89
Q

three facts about steroid hormones

A

insoluble

requires transport molecules

causes DNA transcription and translation

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90
Q

four less common symptoms of pneumonia

A

pleurisy, chest pain, hemoptysis, anorexia

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91
Q

what is the fucntion of C peptide after it is removed from proinsulin

what would high levels of c peptide indicate?

low?

A

nothing

high levels = type 2 DM

low = type 1 DM

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92
Q

what is the most common type of osteoporosis

A

involutional

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93
Q

what is the gender ratio of patients with graves disease

A

female 8:1

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94
Q

three bacteria agents that will cause septic arthritis

A

gonorrhea, staph, strep, TB

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95
Q

three subtypes of osteosarcoma

A

osteoblastic

fibroblastic

chondroblastic

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96
Q

polymyalgia rheumatica

also has…

A

pain and stiffness of the shoulder and pelvic muscles causing difficulty combing hair or rising from a chair due to pain, not weakness

also has a low grade fever, weight loss, and malaise

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97
Q

two types of COPD

what is the difference

A

chronic bronchitis and emphysema

chronic bronchitis is has more obstruction from sputum and inflammation

emphysema has more destruction of alveoli

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98
Q

what percent of people will develop episodic biliary pain related to gallstones

what are the symptoms

A

10-25%

RUQ pain, often at night

pain related to a high fat meal

lasts from 30 minute to hours

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99
Q

screening procedures for colorectal cancer

A

fecal occult blood testing

fecal immunochemistry screening

colonoscopy

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100
Q

three ways to limt joint trauma in OA

A

reduce joint loading, change types of exercise, strengthen muscles

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101
Q

risks of osteoporosis treatment

A

estrogens: heart disease and breast cancer
bisphosphonates: jaw osteonecrosis

SERMs: hot flashes

Ca supps: renal caliculi

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102
Q

two variants of endometriosis

A

benign and aggressive

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103
Q

what is the effect of glucocorticoids on asthma treatment

typical oral treatment

one example of inhaled glucocorticoids

A

strong anti inflammatory effect

prednisone for 5-10 days

flunisolide

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104
Q

what joint is most commonly effected by gout

A

the big toe

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105
Q

T/F tuberculosis only effects the lungs

A

false, late stages can effect every organ

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106
Q

describe pelvic pain associated with ectopic pregnancy

A

usually mild, starts at 6-8 weeks in

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107
Q

what are the physical exam findings present with cholecystitis

A

murphy’s sign

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108
Q

diagnossis of esophageal cancer

A

endoscopy, biopsy, Ct for stagin

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109
Q

T/F gallstones are usually symptomatic

A

false

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110
Q

three mediations that cause cause asthma

A

beta blockers

anaphylaxis to medication

aspirin

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111
Q

why would you check for hyperthyroidism in new onset a fib

A

because hyperthyroid can trigger arrhytmias

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112
Q

symptoms of lung cancer

A

weight loss (50-90%)

cough (60%)

hemoptysis (10-30%)

some have cest pain (20-40%)

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113
Q

tophus

A

a nodular deposit of urate monohydrate crystals that cuases a foreign body reaction

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114
Q

what is the risk of breast cancer in females without estrogen

what about men with estrogen

A

male level risk

increased risk because of estrogen

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115
Q

what joints are most commonly affected by RA

A

MP, PIP, knees

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116
Q

thyroid storm

A

acute high levels of T3 and T4 that can cause hypotension and fever

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117
Q

two stratgies to reduce insulin resistance

A

weight loss

medication (biguanides and thiaxolidinediones)

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118
Q

what are the protective effects of gastric prostaglandins

A

suppression of acid production

stimulates mucin production

increase HCO3

increase muscosal blood flow

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119
Q

four types of arthritis

A

auto immune

osteo

gout

septic/infectious

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120
Q

PUD treatment

A

eradicate H pylori

reduced acid secretion

neutralize acid

enhance mucosal defense

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121
Q

what is the pathophysiology of asthma

A

reduction in airway diameter brough about by a contraction of smooth muscle, vascular congestion, edema, and tenacious sputum

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122
Q

diagnostic process for asthma

A

improvement of symptoms with bronchodilators

sensitivity to stimuli

sputum elevated IgE

high blood eosinophil counts

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123
Q

what are three less common presentations of breast cancer

A

nipple erosion or discharge

skin dimpling

inflammatory breast carcinoma

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124
Q

describe pelvic pain associatd with ectopic pregnancy

A

usually starts at weeks 7-9

can vary from cramping to sharp pain

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125
Q

how has PUD disease changed

A

H pylori

nsaid and sterioids effect

increase acid production (smoking and stress)

inadequate mucosal effect (smoking)

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126
Q

autocrine

A

chemical signaling of cells among the same type

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127
Q

what two effects of cortisol are considerd to improve resistance to stress

A

increased glucose availibility

increased blood pressure

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128
Q

three signs of clotting abnormalities in the skin

A

petechiae

purpura

easy bruising

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129
Q

prognosis of osteosarcoma

A

good with treatment, greater than 10 years at 60-80%
without, death in months

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130
Q

where are T3 receptors found

A

in alll most all human tissue

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131
Q

what percent of patients with lung cancer are symptomatic on diagnosis

A

75-90%

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132
Q

who should be screened for colorectal cancer

A

low risk patients every 10 years at 50

high risk earlier and more often

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133
Q

what is the goal of psoriasis treatment

A

slow the turnover rate of the epidermis

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134
Q

what makes Hep C more problematic

A

chronic infection is a comon complication and is the leading cause of cirrhosis

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135
Q

how is IBD diagnosed

A

diagnostic imaging

endoscopy

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136
Q

what has changed recently in RA treatment

A

DMARDs have allowed for early intervention with aggressive treatment, if patients can afford them

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137
Q

what causes tuberculosis

describe the pathogens

A

infection by mycobaterium tuberculosis

slow growing acid fast aerobe

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138
Q

five symptoms of acute cholecystitis

A

biliary pain

nausea/vomiting

fever

leukocytosis

jaudice

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139
Q

dermatological manifestation of heart failure

A

pitting edema

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140
Q

cushing syndrome

A

a cluster of symptoms caused by excess cortisol

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141
Q

OA treatment types

A

anti-inflammatory/analgesia

cartilage repair

surgical

reduce joint loading

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142
Q

what is the presentation of ruptured ectopic pregnancy

A

massive intrabdominal blood loss

severe pain

syncope

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143
Q

what cells in the pancreatic islets that secrete insulin

glucagon

A

beta cells

alpha cells

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144
Q

what are the main risks for chronic pancreatitis

A

alcoholism, smoking, biliary tract disease

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145
Q

three areas of cancer of the reproductive system

A

breast cancer

ovarian

uterine

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146
Q

two ways to improve COPD symptoms

A

stop smoking and control infections

improve airways with asthma medicaiton (bronchodilators, glucocorticoids, reduction in airway mucus

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147
Q

what triggers beta cell loss in type I DM

A

can be a virus or toxin such as mumps or coxsackie, as well as a genetic predispostion

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148
Q

what is the second most common primary bone cancer

is it common overall?

when does it most commonly strike

A

osteosarcoma

no

60% in the first two decades

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149
Q

two types of vitamin derived hormones

A

retinoids (vitamin A)

vitamin D

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150
Q

three types of steroid hormones

A

estrogens

androgens

progestins

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151
Q

should patients with hep C us protection

A

its not necessary

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152
Q

three disease that can be triggered by hyperthyroid

A

acute chest pain (MI)

CHF

Arrhythmia

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153
Q

two considerations to account for with surgical excision of melanoma

A

wide surgical margins with lymph node sampling

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154
Q

what is the 5 year survivable prognosis for esophageal cancer

A

less than 20%

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155
Q

secondary hyperthyroid

A

failure of the pituitary to release TSH

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156
Q

two actions of insulin

A

inhibit catabolism

promotes anabolism

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157
Q

what is the etiology of PR

A

autoimmune disorder with elevated ESR

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158
Q

in what countries are breast cancers most commonly found

why

A

developed countries

related to fat content

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159
Q

what is the main cause of cervical cancer

what are two synergistic factors

A

HPV

smoking, immunosuppression

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160
Q

common treatment of PR

A

predinsone should produce recovery in 72 hrs or its something else

conitinue low does steroids for 6-12 montsh

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161
Q

two main types of hyperthyroidism

A

graves disease

toxic nodular goiter

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162
Q

gout treatment strategies

A

reduce acid production through diet

reduce inflammation

enhaance excretion

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163
Q

what is the common cause of squamous cell carcinoma

when would it be considered deadly

A

UV light

when it is in the oral cavities or mucus membranes

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164
Q

what is insulin

what compound is it derived from

how does this happen

A

a small protein

conversion of proinsulin into insulin

removal of connecting C peptide

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165
Q

downsides of glucocorticoid treatment of asthma

A

can cause calcium deficiency, HTN, hyperglycemia

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166
Q

where do lung mets spread

A

liver, spine, and brain

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167
Q

2/3 of RA patients will present with what

A

fatigue, malise, generalized weakness, vague joint complaints

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168
Q

define pneumonia

A

inflammation of the lungs caused by bacteria, viruses, fungus

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169
Q

what is the radiographic hallmark of multiple myeloma

A

punch out lesions

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170
Q

what is the treatment for multiple myeloma

A

aggressive chemo, possibly bone marrow transplant

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171
Q

in what hyperthyroid condition does exopthalmos not occur

A

goiter

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172
Q

what is the cause of goiters

is there a gender bias

what may be a contributing factor

A

unknown

no, 1:1

low iodine may contribute

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173
Q

what differentiates allergic from idiosyncratic asthma

A

idiosyncratic has no Hx, negative allergy skin tests, normal serum IgE

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174
Q

what are the three primary surgical treatments of breast cancer

A

lumpectomy

mastectomy

axillary node dissection

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175
Q

three imaging studies for lung cancer and their utlitiy

A

CXR

CT (for CT biopsy)

PET (useful in looking for distant mets)

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176
Q

how to prevent Hep A

A

sanitation

hep A vaccine

antiobodies for post exposure treatment

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177
Q

what is the method of imaging a gall stone

A

ultrasound

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178
Q

two methods to reduce acid production related to PUD

A

H2 receptor antagonist

PPI

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179
Q

what is the first line treatment for hypothyroid

A

daily thyroxine

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180
Q

what is the purpose of screening procedures for colorectal cancer

A

the identification and removal of adenimoatous polyps

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181
Q

four types of primary bone cancer

A

multiple myeloma

osteosarcoma

chondrosarcoma

ewing sarcoma

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182
Q

three pathophysiology hallmarks of COPD

A

airflow obstruction

alveolar dialtion and destruction

chronic and acute airway infection

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183
Q

what is the connection between ethanol and breast cancer

A

slight increase in ris

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184
Q

long feedback look

A

a feedback loop where the end hormone produce by trophic stimulation will inhibit production at the hypothalamus and pituitary

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185
Q

what causes DKA

A

hyperglycemia >300mg/dl causes keto acids to accumulate

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186
Q

what is the treatment of an ectopic pregnancy

A

removal of affected tube

blood transfusion

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187
Q

treatment for HAP

A

ABx for resistant pathogens

supportive care

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188
Q

how common are peptic ulcers

how has the epidemiiology changed

A

very common (500,000 new cases yearly)

increasing numbers of gastric ulcers vs duodenal

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189
Q

what typpe of diabetics are most likely to have DKA

A

type one

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190
Q

treatment of unruptured ectopics

A

methotrexate with follow up

laproscopy with preservation (little) or removal (big) of the tube

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191
Q

what is the effect of smoking cessation on CVD

A

decreased risk to normal within 3-5 years

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192
Q

what demographic has the highest instance of IBD

A

ashkenazi jews

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193
Q

major endocrine glands (10)

A
  1. pineal gland
  2. parathyroid
  3. thyroid
  4. hypothalamus
  5. pituitary
  6. thymus
  7. kidney
  8. adrenal
  9. pancreas
  10. ovary/testes
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194
Q

three goals of COPD treatment

A

prevent, improve, support

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195
Q

what type of bacteria is helicobacter pylori

where is it common

if H pylori is not erradicated what is the risk

A

gram negative spirochet that causes gastritis

most common in places with poor santitation

85% of ulcers will recur

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196
Q

treatment of H pylori

A

2 week course of abx with bismuth or PPI

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197
Q

short feed back loop

A

a feedback loop where a trophic hormone from the pituitary inhibits production of stimulating factors from the hypothalamus

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198
Q

how are hormones sent through out the body

A

dissolved in blood or bound to carriers

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199
Q

5 risk factors for pancreatitis

A

alcohol abuse

smoking

female gender

biliary disease

medicaion

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200
Q

what type of peptic ulcer is most common

what age

what age of gastric

A

duodenal 4:1

35-55

55-70

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201
Q

how is bone density measured

A

DEXA

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202
Q

what are the conventional screens for HPV

A

pap smear

liquid based medium

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203
Q

HLA-DR4 is associated with what

is this correlated to incidence

A

RA

no, only 10-15 percent of twins with HLA-DR4 will have concordant RA

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204
Q

what are the diagnostic considerations for endometriosis

A

laparoscopy

open surgery

US

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205
Q

what is the relationship of leukotrines to asthma treatment

what is one side effect of increased leukotrienes

A

modulation of inflammation

LTD4 is a powerful bronchoconstrictor

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206
Q

how is hep b spread

A

transfusion

exchange of bodily fluids

vertical transmission (mother to off spring)

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207
Q

treatment of osteoporosis

A

Ca supplements

estrogen

selective estrogen modulators (SERMs)

bisphosphates

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208
Q

symptoms of UC

A

diarrhea, cramping, rectal bleeding, passage of mucus

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209
Q

hallmarks of allergic asthma

A

personal or family Hx of allergies

early onset

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210
Q

what type of feedback loop primarily regulates the endocrine system

how is regulation accomplished

A

negative

secretion of inhibiting or enhancing factors

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211
Q

smoking cessation is only effective 15-20% of the time

why?

what can be done to help the odds

A

nicotine is highly addictive

multi-faceted programs (education, support groups, meds)

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212
Q

treatment for endometrial cancer

A

radiation

surgery

hormones

chemo

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213
Q

three types of emergency asthma treatment

A

epinephrine subcutaneous injection

beta 2 inhalers

glucocorticoids

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214
Q

risk factors for pancreatic cancer

A

smoking

chronic pancreatitis

obestity

long term diabetes

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215
Q

three examples of antiinflammtory/analgesic treatment of OA

A

NSAID, joint injections, heat therapy

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216
Q

what causes osteosarcoma in older patients

A

radiation or transformation from pagets disease

217
Q

five effects of cortisol

A

increases glucose production

raises blood pressure

raises blood sugar

lowers lymphcyte and monocyte levesl

218
Q

two main types of IBD

A

Ulcerative colitis or crohns

219
Q

what percept of prenancies are ectopic

what percent of those are in the fallopian tube

A

0.5%

95% in the fallopian tube

220
Q

T/F complete control of glucose is bad

A

true, it decreases longevity

221
Q

what are the treatments for psoriasis ranked by toxicity

what is the relationship between toxicity and effectiveness

A

topical, photo, systemic

increasingly effective treatment is increasingly toxic

222
Q

what are the laboratory signs of cholecystitis

A

leukocytosis, elevated bilirubin, elevated liver enzymes

223
Q

what kind of diet will lower the risk of galll stones

A

low carb high fiber

224
Q

what can cause CAP pneumonia

what is the most common

A

bacteria, virus, fungi

strepococcus pneumoniae (65-70%)

225
Q

symptoms of crohns

A

recurrent episodes of RLQ pain

malabsorption

steatorrhea

bowel obstruction

226
Q

where is GERD most common

A

develop countries 10-20%

227
Q

why can FSH, LH, TSH, and HCG cross react with each other

A

they have receptors in the same family

228
Q

from a clinical perspective, what are the two types of lung cancer

A

small cell and non small cell

229
Q

three consequences of bone marrow failure found in multiple myeloma

A

anemia

bacterial infection

increased bleeding

230
Q

T/F periodic swelling of joints, with rednesss and pain are common with RA

A

true

231
Q

what is the current mortality for hospital pneumonia patients

A

10%

232
Q

what is the only behavioral risk factor of RA

A

smoking

233
Q

what type of hormones will dissolve in blood

what type of hormones will need a carrier

A

water soluable

lipid soluble

234
Q

what is the risk factor for breast cancer associated with familial linkage

but…

A

risk is increased 3-4x if a mother or sister has breast cancer

75% of patients have no history

235
Q

what joints can be affected by RA

A

almost any joint except those of the thorax but including the neck

236
Q

benign variant endometriosis characteristics

A

later onset

superficial lesions

slow progression

237
Q

what age is most common for polymyalgia rheumatica

A

always after age 50, mean 72

238
Q

two regulators of thyroid function

A

thyrotropin-releasing hormone (TRH)

thyrotropin (TSH)

239
Q

FLD causes and management

A

chronic alcohol use

obestiy

metabolic disease

drug toxicity

240
Q

primary hyperthyroid

A

the 99% of hypothyroidism that is caused by failure of the thyroid galdn

241
Q

what is the relationship between keloids and skin pigmentation

A

increasing pigmentation increases risk

242
Q

how common is hashimotos

is there a gender bias

A

1-4/1000

females 1:4

243
Q

three results of airway inflammation

A

bronchial hyperreactivity and bronchospasm

increased secretion and viscosity

bronchial remodeling

244
Q

what percent of TB are resistant to first line drugs

how does mortality from multi-resistant TB compare to untreated active TB

A

10-15% of all strains

they are similar

245
Q

how is fatty liver detected

A

liver function test

US

CT

246
Q

what often causes chest pain assocaited with lung cancer

A

mets to bone

247
Q

when is direct inoculation a common cause of septic arthritis

A

complication of joint injection or post surgical

248
Q

why is inhalation therapy common

A

maximizes airway dose, minimizes systemic dose to decrease side effects

249
Q

at what age does mammography have a proven value

A

between ages 50-70, no value under age 40

250
Q

symptoms and infectiousness of an active (progressive) TB infection

A

systemic symptoms (fever, weight loss, cough, hemoptysis, fatigue)

TB bacilli in expired air

251
Q

what is the treatment plan of hyperthyroid

A

control symptoms

prevent thyrid storm

plan long term control

252
Q

what is the main task of the thyroid

A

to produce T3 ad T4

253
Q

where does osteosarcoma start

what is the msot common complaint

what is the risk of untreated cancer

A

in a long bone

bone pain with pathologic fracture

mets to other bones or the lungs

254
Q

what is the most common cause of hypothyroid

A

hashimotos thyroiditis

255
Q

what is the key pathologic feature of TB

why does it form

A

caseous granuloma

because the immune system cannot eliminate TB

256
Q

T/F most chronic conditions are no effected by cortisol

A

false, many (such as DM and HTN) can be exacerbated by cortisol

257
Q

what is the most common bone disorder in the US

what is the gender bias

A

involutional osteoporosis

258
Q

two treatment options for basal or squamous cell carcinoma

A

outpatient excision or thermal ablation

259
Q

osteoporosis

A

loss of calcium from overactive osteoclasts that results in a demineralization of bone with a normal bone matrix

260
Q

ABCDE for melanoma

A

assymetry

border

color

diameter

evolution

261
Q

who is Hep E most dangerous in

A

pregnany women and immunosuppressed patients

262
Q

how is fibromyalgia diagnosed

A

physical exam with trigger points

widespread pain for longer than 3 montsh

263
Q

prodromal symptoms of Hep A

A

malaise, anorexia, fatigue, myalgia, RUQ tenderness

264
Q

what is the risk of a ruptured ectopic pregnancy

A

death

265
Q

contrast the course of illness between Hep A and B

A

they have similar symptoms and rarely fatal, BUT chronic infection is possible that increases risk of cirrhosis and hepatoma

266
Q

how does early diagnosis effect prognosis of ovarian cancer

but…

A

early detection increases prognosis

but only 20% of cases are detected earyl

267
Q

three factors that increase risk for endometrial cancer

two factors that decrease risk

A

estrogen exposure, insufficient progesteron, genetics

oral contraceptives, progestin use

268
Q

two benign forms of skin cancer

one maglignant type

A

basal cell and squamous cell carcinoma

melanoma

269
Q

three lower GI disorders

A

acute appendicitis

colorectal cancer

IBS

270
Q

hypertrophic scars

A

raised or expanded scars that often form in reaction to suboptimal healing

271
Q

four risk factors for osteoporosis

A

genetics

smoking

low calcium intake

early menopause

272
Q

Which is more common, Hep A or B

A

hep A 5-6% positive

273
Q

what is the most common age group to form keloids

A

10-20

274
Q

three options for GERD treatment

A

gastric acid suppression

lifestyle modification

surgery

275
Q

when would a septicemia cause arthritis

A

a systemic infection, comonly in immuno suppressed patients or IV drug usres

276
Q

isoniazid and rifampin

A

first line TB drugs

277
Q

how effective is gardasil against cervical cancer

what about genital warts

A

prevents 70-90% of cervical cancer

only some protection

278
Q

medications used in treatent of RA

A

NSAIDs

physical therapy

glucocorticoids

DMARDs

279
Q

what is the main risk factor for melanoma

why is the incidence increasing but the mortality decreasing

A

sun exposure

sun worship - early detection, better treatment

280
Q

what is the mortality for acute pancreatitis

A

5-25% depending on severity

281
Q

three ways to use hormone suppression to treat endometriosis

A

contraceptives

Pituitary down regulation

mild androgens

282
Q

what are the laboratory tests that will confirm hyperthyroid

A

very low or absent TSH

very high T4

sometimes autoimmune tests are positive

283
Q

gram positive sources of HAP pneumonia

A

strep and staph

284
Q

how many joints does gout usually effect

A

one

285
Q

what is the main complication of osteoporosi

A

increased risk of fracture

286
Q

treatment for endometriosis

A

NSAIDs for dysmenorrhea

ovarian suppresssion

surgery

287
Q

why is follow up in TB treatment so important

A

monitor compliance, clinical response, and drug toxicity

288
Q

dscribe the abdominal pain associated with appendicitis

A

periumbilical and epigastric, migrating to the right lowe quadrand

289
Q

differing pain in gastric ulcers

A

intermittent heartburn type vs chronic boring pain with deep ulcers

290
Q

two parts of the adrenal gland

A

medulla

cortex

291
Q

symptoms of gastric cancer

A

none, in the early stages

upper abdominal pain

anorexia/weight loss

blood loss anemia

292
Q

diagnosis of gastric cancer

A

double contrast upper GI xray

esophagogastroduodenoscopy (EGD)

293
Q

what percent of patients will develop latent TB

what about progressive TB

A

90-95%

5-10%

294
Q

what is the prognosis of small cells lung cancer with and without treatment

A

with 10-16 months

without 6-17 weeks

295
Q

diagnostic factors of pancreatitis

A

elevation of pancreatic enzymes

fever and leukocytosis

Ct imaging

296
Q

what is the function of the adrenal medulla

A

secretes epi/norepinephrine

297
Q

what will the response to T3 be

A

increased…

energy utilization

protein synthesis

sensitivity to other hormones

298
Q

what is the prognosis of lung cancer 1 and 5 year

A

1 year, 40%

5 year, 15%

299
Q

three goals of asthma treatment

A

reduce inflammation

dilate terminal airways

improve airway secretions

300
Q

three risk factors for gastric cancer

A

chronic H pylori

smoking

diet high in nitrates but low in vitamin c

301
Q

symptoms of pancreatic cancer

A

gnawing visceral midabdominal pain

weight loss

jaundice from biliary obstruction

302
Q

5 common locations of distant endometriosis

A

umbilicus

intestine

upper abdomen

lung

brain

303
Q

what is the prognosis of RA

what percent untreated people will have disability

what percent will have a work disability

A

it depends, there is a fluctuation of disease

80% will have disability within 12 years

50% will have work disability within 10 years

304
Q

how common is psoriasis

what is the typical age of onset

what is the gender bias

A

very common (1-3%)

15-25 yrs

none

305
Q

five ways to treat breast cancer

A

surgery

radiation

chemo

anti estrogen driugs

antibodies against growth factors

306
Q

why are men at less risk of involutional osteoporosis

A

men start with a higher bone density

307
Q

describe the use of glucocorticoid as an emergency asthma therapy

A

oral is as effective as paenteral

takes 6-12 hours

reduces hospitalization

308
Q

what is the definitive surgical treatment for endometriosis

A

hysterectomy and oophorectomy

309
Q

5 locations in the body with especially high numbers of T3 receptors

A

brain

heart

muscle

kidneys

gonads

310
Q

common etiology prior to 1981

A

stress

enviromment (smoking, spicy food)

alchool

glucocortioids and NSAIDs

311
Q

treatment of pancreatic cancer

A

surgical resection

chemo

radation

312
Q

what is more common, secondary or primary bone cancer

A

secondary

313
Q

treatment strategy for RA

A

relieive pain with NSAIDs and physical therapy

prevent joint damage with disease modifying drugs

possibly repair damage

314
Q

five non-insulin treatments of DM

A

reduce insulin resistance

stimulate secretion fo endogeneous insulin

reduce glucagoon

reduce glucose absorption

enhance urinary secretion

315
Q

what is injected into a joint for OA

A

local anesthetic, glucocortcoids, hyaluronic acid

316
Q

what is the strategy for decreasing bronchial secretions in asthma treatment

A

application of anticholinergic/antimuscarinic agents to improve air way diamter

317
Q

what pattern is lost with cushing syndrome

A

the diurnal pattern which causes higher cortisol in the morning and lower at night

318
Q

three symptoms of GERD

A

esophageal pain

nausea

coughing

319
Q

two types of beta 2 agonists and one example of each

A

short acting (albuterol)

long acting (salmetrol)

320
Q

what causes graves disease

A

auto-antibodies that bind and active TSH receptors

321
Q

what is the prognosis of cirrhosis

A

severe cirrhosis 6 month survival at 50%

moderate 5-10 yrs

322
Q

potential complications of chronic pancreatitis

A

opiod addiction

DM

malabsorption from enzyme deficiencies

pancreatic cancer

323
Q

treatment of septic arthritis

A

intravenous abx

removal of hardware

324
Q

two types of lupus

A

systemic

discoid (only skin)

325
Q

serous and mucinous cystadenocarcinoma are examples of what type of ovarian cancer origin

A

epthelial

326
Q

three risk factors for OA

A

age, joint loading/repetitive stress, obestity

327
Q

what is the advantage of SERM treatment in osteoporosis

A

selectively effects estrogen receptors in bone

328
Q

preventing Hep B

A

screening to protect blood supply

Hep B vaccine for children

HBIG for exposure

prevention of transmission at bith

329
Q

diagnostic process for TB

A

HP

sputum culture with acid fast stain

skin test

lab test

chest xray

330
Q

three facts about peptide/protein/glycoprotein hormones

A

water soluble

interact with cell membrane

work through second messanger

331
Q

what is the paradox of osteoporosis treatment

A

there are approved drugs to improve bone density and reduce fractures

BUT

there are significant risks

332
Q

explain the saying “female, forty, fat, and fertile”

A

delineates the risk factors for gall stones

333
Q

what is the risk of untreated cholecystitis

A

ischemia leading to perforation/rupture, followed by abcess, peritonitis, and death

334
Q

treating viral hepatitis

A

infereron

antivirals to reduce the risk of liver failure

there is a cure

335
Q

direct treatment of cirrhosis

A

anti viral drugs for hepatitis

anti-inflammatory and immunosuppresive drugs in the case of an autoimmune disorder

liver transplant

336
Q

what does tight management of DM entail

A

diet

frequent blood assays

medication 3-4 times daily

flexible dosing

337
Q

what happens in hashimotos

A

the thyroid is infiltrated with T and B cells

338
Q

exophthalmos

cause

A

protrusion of the eyes found in 20-40% of Graves patients

caused by lymphcytic infilitration of the eyes

339
Q

four types of receptor hormone interactions

A

agonists (stimulate receptors)

antagonists (block receptors)

down regulation

change receptor affinity

340
Q

what is the usual presentation of breast cancer

A

a painless lump found by the patient

341
Q

four common of osteoporosis

A

cushings

hyperparathyroidism

chronic renal disease

involutional

342
Q

what percent of people with ecoptic pregnancy will have at least one risk factor

A

50%

343
Q

three atmospheric triggers of asthma

A

pollution

cold air

abrupt weather changes

344
Q

what can happen if a homone is present in high enough concentrations

A

the hormone can interact with receptors of the same family

345
Q

T/F what percent of all humans have been infected with TB

A

30-40 percent

346
Q

four facts regardings breast cancer and age

increasing risk

rare before…

mean age

diagnosis time

A

risk increases with age

rare before 40

mean age of diagnosis 60-61

time from origin to diagnosis 2-8 years

347
Q

when pursuing surgical treatment of ovarian cancer, what needs to be removed

A

uterus, ovaries, fallopian tubes, omentum

348
Q

how long does it take for a breast cancer tumor to double in size

A

20-100 days

349
Q

what nervous system are many of the symptoms of hyperthyroidism related to

A

sympathetic nervous system

  1. restlessness
  2. insomnia
  3. tremor
  4. weight loss
  5. heat intolerance
350
Q

endometriosis

A

endometrial glands and stroma outside the uterus

351
Q

two types of esophageal cancer

A

squamous cell (most common)

adenocarcinoma

352
Q

three conditons associated with GERD

A

Barrett’s esophagus

Esophageal carcinoma

esophageal stricture

353
Q

what links receptors of the same “family)

A

they have a similar structure

354
Q

what factors decrease risk for ovarian cancer

A

pregnancy

oral contraceptive use

tubal ligation

355
Q

how much does liver failure incrase the risk of liver cancer

A

3-5% per year

356
Q

how does cortisol exacebate HTN?

DM

A

HTN: increase salt intake

DM: increase blood sugar

357
Q

what is the benefit of antacids

but?

A

the provide rapid pain relief but the effect is short lived and there is no indication that they promote healin

358
Q

what is the intial pathophysiology of OA

how does that progress

A

thickening followed by atrophy and damage to cartiliage which causes loss of cartilage and inflammation

the entire joint wil become involved and cause bone erosion

359
Q

what is the percent break down of gallstone composition

A

choleterol (80-85%)

calcium bilirubinate (<20%)

360
Q

what is the cause of gout

A

a disorder which causes an accumulation of uric acid from gout and protein metabolism

361
Q

diagnostic factors for pancreatitis

A

PE findings

CT

US

362
Q

what demographic is more likley yo hae endometriosis

A

infertile women 25-35%

363
Q

four ways to reduce risk of colorectal cancer

A

screening

low dose aspirin

high fiber, low fat diets

hormone replacement in women

364
Q

what is the most common medication for type II DM

A

metformin (glucophage)

365
Q

treatment of UC

A

aminosalicylates

glucocorticoids

surgery

366
Q

what types of substances are synthesized in the liver

A

clotting factors

albumin

CHO

bile

367
Q

what is the surgical treatment for acute cholecystitis

A

laproscopy after the swelling has gone down unless there is sign of peritonitis

368
Q

what is the treatment for appendicitis

non surgical

A

laparoscopy/laparotomy

Ice, iv, transport

369
Q

how is endometrial cancer diagnosed

A

post menopausal bleeding

endometrial biopsy/d & c

ultrasound

MRI for staging

370
Q

what is the prognosis of septic arthritis

A

usually good unless there are major ortho complication like after joint replacement

371
Q

what produces leukotrienes

three types

A

the action of 5-lipoxygenase on arachadonic acid

LTC4, LTD4, LTE4

372
Q

three non-asthmatic causes of wheezing

A

heart disease

COPD

inhaled foreign body

373
Q

four causes related to asthma that reduce airway diameter

A

bronchospasm

vascular congestion

edema

thick sputum

374
Q

three sites of distant metastases in ovarian cancer

A

liver

lung

bone

375
Q

treatment for sensitive TB

A

first line drugs based on sensitivity for 2-3 months

two to three drugs for additonal 4-7 months

376
Q

what lab tests confirm hypothyroid

A

Low T4

very high TSh

377
Q

treatment of mild pancreatitis

A

bed rest with NPO

analgesia

Iv fluids

378
Q

clinical manifestations of asthma

A

chronic dry cough

wheezing

SOB

sleep disturbances

poor exercise tolerance

chest tightness

379
Q

risks for ectopic pregnancy

A

salpingitis

prior ectopic pregnancy

prior tubal surgery

cigerette smoking

380
Q

symptoms of the chronic vs acute bleeding

A

black tarry stools vs hematemesis

381
Q

what are the risk factors for gall stones

A

gender

old age

obesity

child bearing

diet

382
Q

three common symptoms of pneumonia

A

productive cough

fever/chills

dyspnea

383
Q

treatment of severe pancreatitis

A

intensive care

aggressive fluid and electrolyte replacement

possibly antibiotic use

384
Q

when wil acute synovitis occur in RA

what is the delay between onset of RA and diagnosis

A

weeks to months after diagnosis

9 months

385
Q

central sensization theory of fibromyalgia

A

genetic defect in CNS pain signalling the involves cytokines and neurotransmitters (glutamate, dopamine)

386
Q

common treatment of osteosarcoma

A

amputation or excision of the tumor

chemo

387
Q

five main functions of the liver

A

bilirubin elimination

blood filtering

synthesis of important substances

drug detoxificaiton

mineral and vitamin storage

388
Q

diagnosis of pancreatic cancer

A

CT/Pet scan

laparotomy with biopsy or resection

389
Q

why is there a clincial distinciton between small cell lung cancer and others

A

because it is very aggressive and usually not able to be excised

390
Q

symptoms of endometriosis

A

dysmenorrhea

dysparenunia

constant deep seated pelvic or rectal pain

infertility

391
Q

two breast cancer mutations that increase risk

what type of genes are mutated

what is the life time risk with the mutation

A

BRCA 1 and 2

tumor suppressor mutations

50-85%

392
Q

sources of organisms that typically cause pneumonia

A

community acquired (CAP)

hospital acquired (HAP)

393
Q

what is the median survival time for multiple myeloma

three causes of death

A

4-6 up from 3 years

renal failure, infection, complications from chemo

394
Q

because of the risk of giant cell arteries, what should all new onset myalgia patients get

A

sed rate (ESR)

395
Q

symptoms and infectiousness of latent TB

A

usually none with a positive skin test

no expired TB

396
Q

keloid scars

A

idiopathic benign neoplastic extension of scars

397
Q

what demographic is most likely to have asthmai

A

inner city population

398
Q

three examples of topical psoriasis treatment

A

corticosteroids

anthralin

coal tar

399
Q

five hypothyroid symptoms

A
  1. cold intolerance
  2. hair loss
  3. weight gain
  4. weakness
  5. dry skin
400
Q

pancreatitis

A

acute or chronic inflammation of exocrine pancreas

401
Q

fatty liver disease

A

steatosis (fatty deposits) in the liver common in obese adult that distorts the normal structure of the liver

402
Q

suportive strategy for COPD

A

airway support

supplemental oxygen

403
Q

dyspareunia

A

painful intercourse

404
Q

treatment for CAP

A

antibiotics, hospitalization for 25%, supportive care

405
Q

treatment of crohns

A

symptomatic

diet

antibiotics

corticosteroids

resecetion of the terminal ileum or other segments

406
Q

what is the main cause of lung cancer

A

smoking (13x higher) or exposure to smoke (1.5-2x)

407
Q

what is the effect of smoking cessation on lung cancer risk and prognosis

A

risk of lung cancer declines but more slowly than CVD

even with cancer the prognosis is better for those who quit

408
Q

five symptoms of DKA

A

tachycardia

dehydration

SOB

lethargy

coma

409
Q

what is the full name of T3

T4

which is the main functional hormone of the thyroid

A

triodothyroinine

tetraiodothyroinine

T3

410
Q

dietary factors associated with colorectal cancer

A

high fat and meat, low fiber

411
Q

how is mutiple myeloma diagnosed

A

Xray

anemia

high IgG or Ig components

bone marrow biopsy with plasma cell prolifferation

412
Q

though the exact pathogenesis of pancreatitis is unknow, what are two suspected causes

A

edema/obstruction of the ampulla of vater

direct injury to secretory cells

413
Q

define arthritis

A

a group of conditions characterized by inflammatoy changes to varous joints of the bodyh

414
Q

primary adrenal hyperplasia causes

A

idiopathic

neoplasm

congenital

415
Q

T/f all gout will havy hypernuricema

A

true, but not all hyperuricemia will have gout

416
Q

main symptoms of emphysema

chronic bronchitis

A

SOB with exertion and SOB at rest

chronic productive caugh with mucopurulent sputum

417
Q

what is the function of TRH

A

stimulates the production of TSH and prolattin

418
Q

T/F both chronic bronchitis and emphysema have alveolar loss and obstrution

A

true

419
Q

what is the function of the adrenal cortex

A

secretes glucocorticoids, androgens, mineralocorticoids

420
Q

what is the most common symptom of multiple myeloma

A

bone pain in the back or ribs that is worse with movement and beter at rest

421
Q

types of leukotriene blocking drugs

A

leukotriene receptor antagonists

5-lipoxygenase inhibitor

422
Q

diet management of gout

A

decrease protein

stop chemo

allopurinol

423
Q

what are the most common viral causes of cirrhosis

A

hep A, B, and C

424
Q

three causes of Cushings

A

iatrogenic

secondary adrenal hyperplasia

primary adrenal hyperplasia

425
Q

describe the etiology of type II DM

A

a very slow loss of beta cells causd by genetic or obestity

426
Q

three causes of contact dermatitis

A

allergic reaction similar to poison ivy/oak/sumac

427
Q

conservative treatment of cholecystitis

A

NPO w/ IV fluids

analgesics

IV antibiotics

428
Q

what wil happen if the thyroid gland is dysfunctional

what can also happen?

A

TRH and TSH will be produced in high amounts

prolactin can also be produced

429
Q

what is the long term complication of asthma

A

airway remodeling in response to chronic inflammation that can lead to decline in pulmonary function

430
Q

what is the mean age of diagnosis of Gastric cancer

what is the gender bias

A

63, men 2:1

431
Q

what is the prognosis of gastric cancer based on stage

A

1 60%

2 44%

3 20%

4 3%

432
Q

ulnar deviation is typical of what type of arthritis

A

RA

433
Q

what levels of lipase and amylase wuld indicate pancratitis

A

3x the normal limit

434
Q

what other cancers are associated with BRCA 1 and 2

A

ovarian

pancreatic

fallopian

prostate

435
Q

preventing Hep C

A

screening to protect blood supply

no HCIG

no vaccine

436
Q

what causes cushings disease

what is the distinction between this and secondary adrenal hyperplasia

A

an ACTH secreting tumor on the pituitary

there isn;t one

437
Q

three possible treatment plans for cushings

A

stop glucocorticoids

surgery

antiglucocorticoid medication

438
Q

treatment for small cell lung cancer

A

combination chem with radiation

439
Q

what do beta blockers do in treating hyperthyroid

four results of treatment

A

block sympathetic pathways

rapid reduction in anxiety, restlessness, tremor, palpitations

440
Q

two common drugs that cause osteoporosis

A

glucocorticoids or heparin

441
Q

three types of liver failure

A

alcoholic

biliary

infectious (post necrotic)

442
Q

what is the leading cause of hospitalization among children and teens

A

asthma

443
Q

what are two methods of lowering T3 and T4 in hyperthyroidism

A

prevent hormone release

stop T3 and T4 production

444
Q

how common is fibromyalgia

what is the gender/age bias

A

common, 3-10%

usually women ages 20-50

445
Q

four types of lung cancer

most commin in bold

A

squamous 30%

small cell 15%

large cell 10%

adenocarcinoma 35%

446
Q

what is the prognosis of pneumonia

A

stabilization in 3-5 days

full recovery in 4-12 weeks dependant on age

447
Q

describe tie etiology of Type I DM

A

an autoimmune disorder that causes rapid loss of beta cells

448
Q

two main types of asthma

which is most common

A

allergic and idiosyncratic

allergic

449
Q

three upper GI disorders

A

peptic acid disorders

gastric cancer

esophageal cancer

450
Q

treatment of non-small cells carcinoma

A

surgery and chemo

451
Q

two treatment options for ovarian cancer

A

surgery

chemo

452
Q

what is the most common abdominal surgical emergency

A

appendicitis

453
Q

causes of endometriosis

A

retrograde mensturation that allows viable endometrial cells to implant on pelvis structures or travel in lymph that the immune system fails to elimante

454
Q

what causes septic arthritits

A

bacteria infection of a joint from bloood or direct joint inoculation

455
Q

signs of pancreatitis

A

acute epigastric pain

N/V

fever

abdominal tenderness and distention

456
Q

asthma defintion

A

chronic episodic airway disease with effective treatment but no known cure

457
Q

incidence and prognosis of pancreatic cancer

A

>30,000 increasing over the last 2 decades

overall very poor

458
Q

does removing or blocking fallopian tubes increase to decrease risk of ovarian cancer

A

decrease

459
Q

miliary TB is most common in what patients

is this more or less lethal than other

A

infants, elderly, immunocompromisd adults

very lethal

460
Q

symptoms of cirrhosis

A

chronic RUQ pain

jaundice

edema

portal hypertension

reduced coagulation

reduced drug metabolism

461
Q

surgical repair of OA

A

joint replacement

462
Q

when are antacids contraindicated

tablets or liquid more effective

A

renal failure

liquid better than tablets

463
Q

clinical features of osteoporosis

A

wrist, hip, or vertebrae fracture

loss of height due to fracture

chronic back pain

464
Q

two ways that hormone-receptor complexes elicit effects in target cells

A

2nd messanger

DNA transcription leading to protein production

465
Q

methods to manage FLD

A

stop using alcohol

lose weight with bariatric surgery if necessary

466
Q

four liver and biliary tract disorders

A

heptaitis

fatty liver

cirrhosis

gallbladder disorder

467
Q

what will induce a conversion of latent to active TB

A

immunosuppresion through HIV infection, glucocorticoids, chemo, poverty

468
Q

three forms of immunotherapy against melanoma

A

interferon

tumor vaccines

lymphocyte training

469
Q

complications of appendectomy

A

perforation leading to peritonitis or pelvic abcess

death from septicemia

470
Q

three typical causes of COPD

how does it rank as common cause of death

A

smoking (99%)

other debris (coal dust/silica)

genetics (cystic fibrosis)

471
Q

three types of coagulopathies

A

low platelet counts

clotting factor deficiencies

excessive anticoagulation

472
Q

common antibiotics for CAP

A

cell wall inhibitors (amoxicillin/ampicillin)

protein inhibitors (macrolides)

fluoroquinolones (nucleic acid inhibitors)

473
Q

what drugs stop the production of T3 and T4

when are they most effective

A

thioamides

when combined with beta blockers and potassium iodine

474
Q

clinical findings of fibromyalgia

A

chronic diffuse pain

fatigue, sleep disorders, headache

increased pain sensation

475
Q

pannus formation

A

inflammatory response to inflammation from RA causes destruction of cartilage and erosion of bone

476
Q

what is the screening test for lung cancer

what are the pros and cons

A

yearly low dose CT for 3 yeras in patients 55 or older with a 30 yr pack history

pro: provides a modest increase in survival
cons: costly, high false positive

477
Q

what is the effect of birth control on the risk for the following cancers

breast

ovarian

cervical

endometrial

A

possible increased risk

decreased risk

no impact

decreased

478
Q

four types of breast cancer screenings

A

monthly self exam

annual breast exam

mammography

blood test for tumor markers

479
Q

what is the most common form of skin cancer

what is the common cause

what is the risk if left untreated

A

basal cell carcinoma

UV light

local destruction, rarely metastasis

480
Q

treatment of colorectal cancer

A

surgical resection for all patients

chemo

immunotherapy

481
Q

where does the majority of chronic Hep B fall in the population

A

90% in neonates and infants

1-5% in normal adults

482
Q

two characteristics of acute epigastric pain associated with pancreatitis

A

abrupt onset of severe, boring pain that often radiates to the lower bac

483
Q

risk factors for pneumonia

A

smoking, alcoholism, comorbid disease, immunosuppression

484
Q

three systemic treatments of psoriaisis

A

cyclosprin

methotrextate

retinoids

485
Q

aggressive variant endometriosis characteristics

A

early onset

invasive lesions

rapid progression

486
Q

what is the effect of thyrotropin (TSH)

A

increased T3 and T4

487
Q

three amino acid hormones

A

dopamine

thyroxine

catecholamines

488
Q

two possible pathophysiolgies of IBD

A

abnormailites of intestinal microflora

possible auto immune mechanisms

489
Q

risk fastors for colorectal cancer

A

dietarty fcators

HPV

IBS (crohns or UC

490
Q

how does insulin promote anabolism

A

increase glycogen production and storage

promotes triglyceride synthesis in fat cells

incrases protein synthesis in muscle

491
Q

what is the treatment for gallstones

A

laproscopy

stone dissolution with bile salts

492
Q

define hepatitis

A

acute inflammation of the liver that disrupts normal function and causes scarring

493
Q

three environmental changes that can cause an endocrine response

A

nutritional

thermal

existential

494
Q

what is the etiology of psoriasis

A

it is a T cell mediated immune disease which also involves TNF and interleukins

495
Q

five treatment options for keloids

A

corticosteroid injections

cryotherapy

radiation

surgical excision

laser reduction

496
Q

what is one medication that increases the risk of gall stones

one that decreases

A

cephalosporin

aspirin

497
Q

which are more prominent, alpha or beta cells?

A

alpha (75% to 20%)

498
Q

Cirrhosis

A

irreversible inflamatory disease that disrupts the liver function and structure

499
Q

what is the pathophysiology of psoriasis

A

excessively rapid turnover of the epidermis (3-5 days instead of 21-30 days)

500
Q

two types of pancreatic disorders

A

pancreatitis

pancreatic cancer

501
Q

three potential complications of pneumonia

A

pleural empyema

lung abcess

pleural effusion

502
Q

how does insulin inhibit catabolism

A

inhibits glycogen break down

inhibits amino acid and fatty acid break down

503
Q

three types of uterine cancer

A

cervical cancer

endometrial cancer

leiomyosarcoma

504
Q

pathophy of RA

A

autoimmune response causes inflammation of the synovial membranes of multiple joints

505
Q

four conditions that are most commonly caused by DM

A

chronic renal failure

neuropathic pain

blindness

gangrene caused limb amputation

506
Q

three types of secondary bone cancer

A

mets from lung, breaks, prostate

507
Q

four complications of peptic ulcers

A

pain 100% of the time

bleeding 10%

perforation 3-5%

gastric outlet obstruction 2%

508
Q

what drug will cause hypothyroid

A

amiodirone

509
Q

what is the average length of pregnancy

A

266 days from conception

280 days from LMP

510
Q

what types of HPV are associted with warts

what are associated with cervical cancer

A

6, 11, 42, 43

16, 18, 33, 35, 45

511
Q

what drug can stop the relase of T3 and T4

A

potassium iodine

512
Q

describe the negative feedback loop that regulates adrenal function

A

pituitary secretes ACTH

adrenal cortex secretes cortisol

cortsol inhibits ACTH secretion

513
Q

what is the risk of cirrhosis with chronic Hep B

A

40%

514
Q

two main types of peptic ulcers

A

duodenal and gastric

515
Q

four small neurpeptide hormones

A

GnRH

TRH

vasopressin

somatostatin

516
Q

what is the familial genetic influence with psoriasis

A

1/3 of people will have a positive FHx

70% chance that twins will have this together

517
Q

which type of arthritis is more common (and the most common cause of disability in the US)

A

Osteoarthritis

518
Q

medication used to decrease glucagon secretion

A

glucagon like peptide 1

519
Q

what is the treatment for type I DM

type II

A

type I = insulin

type II = insulin plus other stuff

520
Q

specific radiograhpic findings on xray

A

sunburt or codmans triangle

lesion tthat needs to be surgically or needle biopsy

521
Q

causes of hepatitis

A

medication, chemicals, parastites, viruses

522
Q

four theories for the cuase of fibromyaligia

A

virus, depression, sleep disorders, central sensitiization

523
Q

what is a common iatrogenic cause of cushings

A

prednisone

524
Q

three treatments of cervical cancer

A

radial hysterectomy and lymph node dissection

radiation

chemo

525
Q

two long term control options for hyperthyroid

A

thyroid excision or destruction

continued antithyroid drugs

526
Q

IUP

A

intrauterine pregnancy

527
Q

four causes of hypothyroid

A

post thyroidectomy/ablation

hashimotos thyroiditis

Drug induced

dietary iodine deficiency

528
Q

describe the incidence of psoriasis from the follow ethnicities

caucasians

african americans

native americans

A

most common

uncommon

very rare

529
Q

where does glucagon like peptide naturally come from

what does it do

A

L cells in the intestine

opposes insulin

530
Q

T/F horomes are secreted continuously

A

false they are usually in pulses

531
Q

what percent of the population has RA

what is the gender ratio

when do most people get RA

A

1%

female 3:1

80% between 35-64

532
Q

dermatological manifestation of vascular insufficiency

A

venous stasis ulcers

533
Q

signs and symptoms of acute cholecysitis

A

RUQ, nausea, fever

534
Q

common triggers of allergic ashtma

A

allergies

psychological

medications

infections

habits

atmospheric

535
Q

main symptoms of esophageal cancer

A

dysphagia

weight loss

pain

536
Q

what is the most common type of primary bone cancer

A

multiple myeloma

537
Q

two other symptoms of diabetes that aren’t the 3 Ps

A

weight loss despite increased appetite

fatigue

538
Q

diagnostic process of pneumonia

A

symptoms plus

CXR

Labs

point of care tests

PAS 753 (Molecular Pathophysiology) (17 decks)

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