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AA. Patho 2 > FINAL: diabetes/male and female repro disorders/renal disorders > Flashcards

FINAL: diabetes/male and female repro disorders/renal disorders Flashcards

0
Q

Which cells of the pancreas secrete glucagon?

A

∂ cells of the Islets of Langerhans

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1
Q

Which cells of the pancreas secrete insulin?

A

ß cells of the Islets of Langerhans

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2
Q

What is the function of insulin?

A

anabolic hormone that promotes insulin inside of the cell. Lowers the glucose level of the bloodstream by pulling glucose into the cells (and therefore tissues) to be metabolized.

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3
Q

What is the function of Glucagon?

A

catabolic hormone that converts stored glycogen in the cells of (and therefore tissues of) the LV to glucose and raises the amount of glucose in the bloodstream. Opposite of Insulin.

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4
Q

When would the body need Glucagon to break down glycogen into Glucose?

A

Periods of strenuous labor or exercise or when the blood sugar level gets too low.

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5
Q

What is a normal Fasting Glucose Level?

A

70-100mg/dL

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6
Q

What level of glucose in blood is considered Glucose Intolerance or “pre-diabetes”?

A

140-199mg/dL

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7
Q

What level of glucose in blood is considered Diabetes?

A

above 200mg/dL

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8
Q

Which type of diabetes is autoimmune?

A

diabetes mellitus Type 1

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9
Q

Which type of diabetes is environmental?

A

diabetes mellitus Type 2

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10
Q

This type of diabetes is characterized by a loss of insulin producing ß-cells leading to a deficiency of insulin:

A

diabetes mellitus type 1 - usually a T-cell mediated autoimmune attack.

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11
Q

This type of diabetes is due to an insulin resistance or reduced insulin sensitivity:

A

diabetes mellitus type 2 - eventually this leads to a loss of insulin secretion

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12
Q

Which type of diabetes is caused by either a deficiency of ADH or an insensitivity (by receptors in the distal convoluted tubules of the KD) to ADH?

A

diabetes insipidus also called Neurogenic Diabetes Insipidus if the pituitary gland is not producing ADH and Nephrogenic Diabetes Insipidus if there is increased intolerance to ADH by the receptors in the distal convoluted tubules - this one is related to the hypothalamus.

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13
Q

All untreated types of diabetes can present with polyuria, polydipsia and polyphagia. What symptom differentiates diabetes insipidus from diabetes mellitus?

A

diabetes insipidus will have diluted urine with LOW SPECIFIC GRAVITY. Diabetes mellitus will have a HIGH SPECIFIC GRAVITY. Diabetes mellitus also leads to neuropathies and nephropathy, retinopathy and vascular deficiencies (DI will not)

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14
Q

What is measured in a diabetes patient to control and monitor progress?

A

A1C Test - to measure the glycosylated hemoglobin. 6-6.5% is considered normal.

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15
Q

What is gestational diabetes?

A

A glucose intolerance initially detected during pregnancy due to the effects of human the chorionic gonadotropic hormones (estrogen, testosterone) causing a resistance to insulin by the receptors. A diabetogenic state - but not exactly diabetes.

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16
Q

What does Aldosterone do?

A

released from the adrenal glands, it functions to retain sodium in the blood.

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17
Q

What does cortisol do?

A

released by the adrenal glands to regain homoeostasis following stress or sleep. We wake up in the morning because of high levels of cortisol that constrict our blood vessels to return more blood to the heart. Cortisol also regulates the release of epinephrine and norepinephrine

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18
Q

What is the relationship between cortisol and insulin?

A

cortisol counters insulin by encouraging more glucose in the blood by stimulating gluconeogenesis.

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19
Q

What is the function of the leydig cells?

A

located in the seminiferous tubules - important function to secrete testosterone.

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20
Q

What is the function of the sertoli cells?

A

located in the seminiferous tubules - important function to create the blood-testes barrier.

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21
Q

What occurs in the seminal vesicles?

A

provides liquid that mixes with the semen and the fluid from the epididymis to form seminol fluid. The fluid is mostly sugar and provides nutrition for the sperm>

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22
Q

Where do sperm mature?

A

final maturation occurs in the epididymis

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23
Q

What are the three parts of the urethra?

A

prostatic, membranous and spongy

Prostatic urethra: The prostatic urethra is that part of the urethra that passes through the prostate.

Membranous urethra: The membranous urethra is the shortest part of the urethra that connects the prostatic to the spongy urethra.

Spongy or penile urethra: The spongy urethra is the last part of the urethra that carries urine outside the body.

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24
Q

What is the major function of the prostate gland?

A

activation of testosterone to dihydrotestosterone (DHT - the active form of T)

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25
Q

Why is the occurrence of cryptorchidism important?

A

predisposes to testicular cancer

26
Q

What is varicocele and how is it diagnosed?

A

dilation of the pampiniform venous plexus and the internal spermatic vein causing the stagnation of blood within the scrotum. Can cause male infertility by interfering with testicular thermoregulation.

27
Q

Who is most predisposed to testicular cancer?

A

young males, 15-34

28
Q

What are red flags for referral in regards to testicular health?

A

(not sure what she is looking for here…back pain? worse at night for prostate cancer? redness, lumps, swelling, pain…?

I know she said a few times that any mass should be considered cancer unless ruled out…so definitely lumps and masses! (M)

29
Q

What are the risk factors for priapism?

A

ischemia is most common risk, atherosclerosis, thrombosis, sickle cell anemia, diabetes mellitus, drugs for ED. Not from sexual arousal.

30
Q

What does a high level of Prostate Specific Antigen indicate?

A

non-specific growth of the prostate tissue - not necessarily cancerous.

31
Q

What increases a woman’s risk for female reproductive cancers?

A

early onset of menses and late menopause.

32
Q

A postmenopausal woman with vaginal bleeding is a red flag for what?

A

uterine cancer or endometriosis

33
Q

Penile cancer and Cervical cancer are due primarily to what and are considered what?

A

HPV, STDs

34
Q

A 50+ yo female who was an athlete and perhaps used steroids presenting with recent abdominal bloating, indigestions, heavy discomfort in the abdomen and lower back. Red flag for what?

A

ovarian cancer

35
Q

When is the clinical diagnosis for primary amenorrhea made?

A

when a female does not establish menarche by age 16 or by 14 if no secondary sexual characteristics.

36
Q

When is the clinical diagnosis for secondary amenorrhea made?

A

when a regularly menstruating female does not get a period for 3 months. If the period was irregular - then for 9 months.

37
Q

What are the three hallmarks of the clinical presentation of endometriosis?

A

dysmenorrhea, infertility, dyspareunia (painful intercourse)

38
Q

What does endometrial tissue found within the myometrium signify?

A

Adenomyosis

39
Q

What does endometrial tissue found ectopically throughout the body signify?

A

Endometriosis

40
Q

Where is a common place within the peritoneal cavity to find ectopic endometrial tissue?

A

within the Pouch of Douglas aka Posterior Sac, which is located between the uterus and rectum.

41
Q

What is the most common endocrine disease of the female reproductive system?

A

PCOS

42
Q

How does PCOS affect the hormones FSH and LH?

A

PCOS results in a lower FSH and a higher LH which rarely spikes and as a result there is no ovulation and no period.

43
Q

What is the major cause of ectopic pregnancy?

A

imperfections within the fallopian tubes, usually a result of Pelvic Inflammatory Disease

44
Q

What are the risks associated with urinary tract infections and pregnancy?

A

in pregnancy the ureters are dilated, making it easier for the ascent of bacteria up to the KD which could lead to pyelonephritis and miscarriage.

45
Q

How are the elderly treated for asymptomatic UTI?

A

they are not treated because it might decrease resistance to antimicrobial medication

46
Q

When does the NIH recommend the first PAP smear occur?

A

At age 21 - no longer dictated by sexual activity

47
Q

What reflex controls thermoregulation of the testicles? Which nerve produces this reflex?

A

cremasteric reflex is produced by the genitofemoral nerve.

48
Q

The first ~14 days of the menstrual cycle are called what and dictated by which hormones?

A

Proliferative Stage in reference to the endometrium building during this stage. It is dictated mostly by Estradiol - active form of estrogen which is released by the developing follicles, so it is also referred to as the Follicular Phase.

49
Q

Which hormone’s surge initiates the release of the ovum? aka Ovulation.

A

Luteinizing Hormone - LH

50
Q

The ~14-28 days of the menstrual cycle are called what and dictated by which hormone?

A

The Secretory Phase in reference to the endometrium secreting a gluey substance to help the fertilized egg adhere to the pinopodes and achieve implantation. It is dictated by an increase in the Progesterone level which is being emitted by the Corpus Luteum. It is also called the Luteal Phase in reference to the Luteal Body or the Corpus Luteum. The disintegration of the Corpus Luteum and subsequent drop of progesterone will signal the start of the endometrial shedding.

51
Q

A drop in which hormone level signals the shedding of the endometrial layer?

A

progesterone

52
Q

What are the three types of Calculi (stones) found in the renal system?

A

Calcium Oxalate (most common). Calcium Phosphate, and rarely Struvite (magnesium-ammonium-phosphate). People with metabolic abnormalities may produce Uric Acid Stones or Cystine Stones.

53
Q

How are Struvite stones produced?

A

by urea splitting bacteria in people with urinary tract infections

54
Q

Which stones are opaque? Which are translucent?

A

Uric Acid and Cystine stones are radiolucent. Calcium Oxalate, Calcium Phosphate and Struvite stones are radiopaque.

55
Q

Which stones are due to bacterial infections?

A

Struvite (magnesium ammonium phosphate) stones are usually seen in the setting of infection with urease producing bacteria, resulting in hydrolysis of urea into ammonium and increase in the urinary pH.

56
Q

What conditions predispose to calculi?

A

hypercalcemia, hypercalciuria, excessive oxalate and vit C consumption, malignancies of the bone and blood, hyperparathyroidism and hyperthyroidism.

57
Q

Renal colic presentation?

A

“loin to groin’ pain - worst pain ever experienced”; hematuria (blood); pyuria (pus); dysuria (pain); oliguria (reduced volume from obstruction); abdominal distention; nausea/vomiting; fever/chills; hydronephrosis (water in KD); increase in frequency of urination but no increase in total output of urine; loss of appetite; loss of weight.

58
Q

post streptococcal Glomerulonephritis causes damage to what?

A

immunoglobulins designed to kill bacteria target glomerular membranes (fenestration and basement membranes) causing leakage into the bloodstream

59
Q

damage of the fenestration membranes of the glomeruli, hematuria, HTN, slight proteinuria, periorbital edema, petechial skin hemorrhages, fever, flank pain, and malaise indicate what?

A

Nephritic Syndrome

60
Q

Damage to both fenestration and basement membranes of the glomeruli, generalized edema, hyperlipidemia, loss of albumins in blood indicate what?

A

Nephrotic Syndrome

61
Q

Having calculi in the KD or in the urinary tract is called?

A

nephrolithiasis or urolithiasis

62
Q

A UTI that ascends to infect the UB is called? ascends to the KD is called?

A

Cystitis (UB) and Pyelonephritis (KD - all except the Nephron)

AA. Patho 2 (8 decks)

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