Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MC II > Final exam > Flashcards

Final exam Flashcards

1
Q

secondary factors from marrow infiltration and decreased marrow production

A

anemia, thrombocytopenia, leukopenia/neutropenia, bone or joint pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

factors secondary to extramedullary infiltration

A

hepatosplenomegaly, lymphadenopathy, stridor and orthopnea, cranial nerve palsies, retinal exudates, testicular enlargement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

common laboratory findings at diagnosis

A

low hemoglobin
low platelet count
abnormal WBC- some very high, some lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

treatment stages for leukemia

A

induction- puts into remission- 4 weeks
consolidation- treatment to spine 4-8 weeks
interim maintenance- rest phase 6-8 weeks
delayed intensification: reduces hiding cells- 8 weeks
maintenance: 2 yrs females 3 males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

common side effects w/ chemotherapy

A

bone pain, muscle weakness, avascular necrosis, peripheral neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

differential diagnosis for lymphadenopathy

A

infection
cyst
systemic disease- rheumatic
tumor- benign/malgnant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

when to biopsy lymph node

A

supraclavicular node, increasing size over 2-4 weeks, constitutional symptoms, asymptomatic enlarged node-not decreasing in size over 6 weeks or not normal after 8-12 seeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

important factor to remember w/ non-hodgkinds lymphoma

A

can present w/ spinal cord compression and weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

wilms tumor

A

peak age 2-3 years
spreads to contralateral kidney, lungs
asymptomatic abdominal mass
increased risk w/ african americans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

overgrowth syndromes

A

beckwith-wiedemann syndrome
perlman
simpson-golabibehmel
sporadic hemihypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

neuroblastoma

A

tumor of sympathetic nervous tissue majority in adrenal or paraspinal or cervical
median age- 22 months
therapy: chemo, stem cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

when to be concerned about bone pain

A

persistent pain
progressive pain
occurs at night
associated w/ swelling/mass/limitation of mvmt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

osteosarcoma

A

peak incidence in 2nd decade of life
occurs ealier in females- associated w/ growth spurt
occur in metaphyseal portion of long bones
pain, mass
most occur in distal femur, proximal tibia, proximal humerus while in swings, there is even split between extremities dn axial skeleton

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

ewings sarcoma

A 
most common in 2nd decade, also young children
equally in extremities and central
more constitutional symptoms
no associations
onion peel on xray
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

therapy os and es

A

OS0 chemo, no radiation, surgical resection

ES- chemo and/or radiation, surgical resection if not axial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

most common pediatric brain tumor

A

supratentorial astrocytoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

clinical features brain tumors

A 
increased ICP
irritability, lethargy
early morning HA which improves
vomiting- usually in AM
unexplained changes in personality/behavior
papilledema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

functions of renal system

A 
filters waste
regulates ion levels in plasma
regulates blood pH
conserves valuable nutrients
regulates blood volume
regulates RBC production
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

functions of nephron

A

filtration
tubular reabsorption
tubular secretion
urinary excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

causes of acute renal failure

A

pre-renal: conditions that decrease renal blood flow (HF, sepsis, shock)
post-renal: conditions that obstruct urine output (kidney stones, prostatic hypertrophy, cancers of the bladder)
intra-renal: injury and/or inflammation within kidneys (interstitial nephritis, acute glomerulonephritis, ischemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

oliguria

A

daily urine output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

anuria

A

no urine production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

pyelonephritis

A

when a UTI progresses to involve the upper urinary system

s/s: back pain, flank pain, fever/chills, feeling sick, n/v, confusion, changes in urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

urinary tract calculi (stones)

A

increased concentration of salts in good, UTI,

treatment: manage pain, hydration, cytoscope, lithotripsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

rhabdomyolysis

A

breakdown of muscle fibers, specifically of the sarcolemma of skeletal muscle, resulting in release of myoglobin
released myoglobin may cause acute kidney injury
shift of extracellular fluid into injured muscles resulting in undwrperfusion of kidneys and risk for compartment syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

causes of rhabdomyolysis

A

traumatic/compression
nontraumatic exertional
nontraumatic nonexertional (alcohol/drugs/infection)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

triad s/s for rhabdomyolysis

A

muscle pain, weakness, dark urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

laboratory findings in rhabdo

A

creatine kinase >5x upper limit of normal

higher the CK, greater the risk of AKI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

causes of chronic renal failure

A 
diabetic nephropathy
hypertension
glomerulonephritis
polycycstic kidney disease
kidney infections, obstructions, renal vascular disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

normal creatinine levels

A

.8-1.2 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

normal BUN levels

A

10-20 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

common laboratory measurements in renal dysfunction

A

hyperkalemia- muscle weakness, paralysis
hypercalcemia- stones, bones (pain), groans (abdominal pain), thrones (polyuria) and psychiatric overtones
bicarbonate- metablolic acidosis (low bicarb)- lethargy, fatigue, muscle weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

continuous renal replacement therapy

A

use of an extracorporeal blood circuit through a small-volume low-resistance filter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

peritoneal dialysis

A

uses peritoneum as semipermeable membrane and the diasylate is infused directly into the abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

important PT takeaways w/ dialysis

A

no bp measurements on same arm as fistula
protect arm from injury
control obvious hemorrhage
a thrill is normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

examination of the renal patient

A

skin: pallor, yellow-gray
face/extremities: peripheral edema
abdomen: observe abdominal contour for midline mass in lower abdomen
weight: weight gain 2nd to edema, weight loss and muscle wasting in chronic renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

murphys percussion

A

costovertebral angle at rib 12

palm over angle and strike w/ other hand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

functions of the GI tract

A

digestion: physical/chemical breakdown
absorption
excretion
host defense

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

4 layers of go tract

A

mucosea- epithelium
submucosa- regulates secretion
muscularis- regulates motility
serosa- connective tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

achalasia

A

impaired esophageal persistalsis w/ failure of lower esophageal sphincter to relax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

diverticulum

A

out pouching of wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

GERD

A

tussue damage due to reflux of gastric contents
barrett’s esophogus- transformation of the normal esophageal squamous epithelium to columnar epithelium- increase risk for cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

esophageal varices

A

dilated veins- lower 1/3 of esophagus, beneath mucosa, collateral veins develop, increased risk of rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

4 regions of stomach

A

cardia, fundus, body, antrum (pyloric sphincter)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

gastritis

A

inflammation of the inner lining of the stomach

can be acute (NSAIDS/aspirin) or stress-induced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

peptic ulcer disease

A

increased acid secretions and digestive enzymes erodee gastric mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

role of small intestine

A

absorb digested foodstuffs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

large intestine function

A

re-absorption of water along with ions and some vitamins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

crohns disease

A

progressive inflammation primarily of the distal ilium and colon but may include entire GI tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

ulcerative colitis

A

recurrent chronic inflammation of colon and rectum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

s/s of crowns and UC

A

abdominal pain, cramping or swelling, GI bleeding, anemia, urgent bowel movements, fever, joint pain malabsorption, weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

hernia

A

protrusion of organ through the wall of the cavity that normally contains it

53
Q

hemorrhoids

A

swelling and stretching of veins around the anal canal; varicose veins of hemorrhoidal venous plexus

54
Q

red flags of GI bleeding

A

syncope, hypotension, pallor, diaphoresis, tachycardia
drop in Hct and Hgb
vomiting of blood; coffee ground emesis

55
Q

adhesions

A

fibrous bands that form between tissues and organs- complication following GI surgery

56
Q

side to stand on for abdominal palpation

A

right

57
Q

difference between acute inflammation and chronic

A

acute- nonspecific response of living tissue

chronic- destruction > repair

58
Q

types of leukocytes

A 
neutrophils
eusinophils
basophils
lymphocytes
monocytes
59
Q

immune system lines of defense

A 
*Nonspecific
first line: skin, mucous membranes
second line: phonetic white blood cells, antimicrobial proteins
*Specific
third line: lymphocytes, antibodies
60
Q

innate immunity

A

comprises the cells and mechanisms that defend against other organisms in a non-specific manner

61
Q

acquired/adaptive immunity

A

derives from the formation of antibodies and sensitized lymphocytes as specific humoral or cellular response

62
Q

4 major types of autoimmune disorders and hypersensitivity reactions

A

type I hypersensitivity: allergies
type II: reactions to self antigens
type III: immune complex formation
IV: cell-mediated

63
Q

Type I allergic response

A

occurs within minutes of exposure to antigen- IgE binds to mast cells and basophils, causes release of histamine, prostaglandins, and leukotrienes.
skin: flushing, hives, rash, itching lungs: SOB, wheeze, CV: coronary artery spasm, MI

64
Q

Type II (cytotoxic) reactions

A

involves antibodies bindin to antigens on the ell surface: antigen may be intrinsic OR extrinsic (self or absorbed)
transfusion reactions, graves disease

65
Q

Type III reaction

A

reactions against soluble antigens circulating in serum- usually involves IgG and IgM antibodies
result= prolonged inflammation w/ resultant damage

66
Q

Connective tissue disease

A

Ex: lupus, RA, ankylosing spondylitis, ehlers danlos, marfans
diverse group of diseases in which connective tissues extracellular matrix proteins are damaged

67
Q

systemic lupus erythematosus

A

multisystem autoimmune disease

diffuse inflammation involving skin, joints, brain, kidneys, heart, lungs, serous membranes

68
Q

aneurysm vs dissection

A

aneurysm: ballooning/weakening of vessel wall
dissection: tear in the intimal layer

69
Q

clinical presentation of AAA

A

abdominal or back pain
hypotension
pulsatile mass
other common: groin/flank pain, hematuria, abdominal bruit

70
Q

what seems to be more beneficial between open and endovascular aneurysm repair?

A

Endovascular. Open has higher ST mortality, longer IC stay, longer time to activity

71
Q

Type IV delayed reaction

A

cell mediated
involve reactions by memory cells- subsequent contacts elicit a reaction
reactions are delayed by one or more days
tuberculosis, poison ivy, latex

72
Q

exocrine function of pancrease

A

releases enzymes as a zymogen- activation occurs at the brush border of the small intestine.

73
Q

Molecules that regulate pancreatic secretion

A

ACh= released before eating begins and stimulates acinar cells to secrete enzymes
Cholecystokinin- stimulates acinar cells to secrete enzymes
secretin- stimulates aqueous bicarbonate secretion

74
Q

two major causes accounting for ~90% of pancreatitis cases

A

alcohol abuse and gallstones

75
Q

pancreatic insufficiency

A

inability to secrete bicarbonate and water which limits the amount of enzymes released into the intestinal lumen
iability to break down nutritional content

76
Q

2 distinct sources that supply blood to liver

A

oxygenate blood flows in from the hepatic artery

nutrient rich blood flows in from the portal vein

77
Q

sign that liver is enlarged

A

> 2-3 cm below costal margin may indicate enlargement

78
Q

functions of the liver

A

synthetic: production of plasma proteins and coagulation factors
excretory: production of bile
metabolism: synthesizes fats and carbs, storage of glycogen, protein catabolism
detoxification- of noxious compounds found in chemicals/drugs

79
Q

3 blood tests for liver function

A

bilirubin (transaminases)
INR
creatinine

80
Q

transjugular intrahepatic portosystemic shunt

A

percutaneous formation of tract between hepatic vein and intrahepatic segment of portal vein- blood flows from high pressure portal vein to lower pressure hepatic vein

81
Q

asterixis

A

liver flap=sign of hepatic encephalopathy

alternating flexion-extension of hands

82
Q

hepatic encephalopathy

A

reversible decrease in neurologic function due to shunting of blood away from the portal circulation
associate w/ hepatic failure
extrapyramidal symptoms include: tremor, bradykinesia, cog-wheel rigidity, and shuffling gait

83
Q

most common waste product to accumulate in the systemic circulation secondary

A

NH3

hepatocytes incapable of metabolizing waste products

84
Q

what can the accumulation of ammonia (NH3) lead to?

A

it crosses the blood brain barrier and is absorbed and metabolized by the astrocytes and use it when synthesizing glutamine. Glutamine increases osmotic pressure in the astrocytes which then become swollen and lead to cerebral edema

85
Q

clinical stages of hepatic encephalopathy

A

0- subclinical, 4 coma/dilated pupils/oculocephalic reflexes, decerebrate posturing

86
Q

hepatic disorders cv complications

A 
cirrhotic cardiomyopathy
hyperdynamic syndrome (elevated HR and CO, decreased BP)
chronotropic incompetence
dysthythmias
peripheral edema
87
Q

hepatic disorders pulmonary complications

A

ascites can impair diaphragm

hepatopulmonary syndrome

88
Q

fibromyalgia

A

chronic, non-inflammatory, non-autoimmune diffuse central pain processing syndrome
widespread pain and tenderness, depression, fatigue, poor sleep

89
Q

what molecule is found in higher amounts in pts w/ fibro?

A

substance P

90
Q

treatment for fibro

A 
not just meds
start low, go slow
change one med at a time
avoid opioids
NSAIDS don't work
target central neurologic mechanism
91
Q

Treatment of fatigue and depression

A

difficult

fluoxetine, bupoprion, modafinil, SNRI’s(better for pain than fatigue)

92
Q

treatment for pain and sleep

A

tricyclic antidepressants

snri’s pregabalin, gabapenting, avoid opiods and NSAIDS

93
Q

what unique factor shows increased activation and increased pain?

A

pain catastrophizing

94
Q

PT treatment for fibro

A

aerobic training, resistance, flexibility (less so, but effective), group exercise, pool based exercises , neurodynamic mobilization, balance program

95
Q

RA definition

A

chronic, systemic, inflammatory autoimmune disease of unknown etiology
chronic, symmetric, erosive synovitis

96
Q

phases of RA

A

1: genetic risk- HLA DR, PTPN22
2: preclinical autoimmunity: RA related autoantibodies (RF, anti CCP_
Phase 3: clinical disease- RA related auto antibodies, clinical signs and symptoms, radiographic changes

97
Q

etiology of RA

A

combination of unknown antigen in genetically susceptible host (HLA-DR1 or DR4)

98
Q

pathophysiology of RA

A

synovial based
antigen injures synovial endothelial cells
synovial inflammation and release of inflammatory cytokines
stystemic symptoms- cytokines induce fibroblasts and chrondrocytes to produce PGE, collagenase and proteinases
—cartilage and bone destruction

99
Q

factors making it most likely for criteria for RA

A

> 10 joints with at least 1 small joint involved
High positive RF or high positive ACPA
abnormal CRP or abnormal ESR
symptoms >6 weeks

100
Q

screening tool for RA

A

significant discomfort w/ squeezing the MCP and MTP joints
presence of 3 or more swollen joints
more than 1 hour of morning stiffness

101
Q

most specific antibodies detected for diagnosing RA

A

RF AND anti-CCP

102
Q

poor prognostic indicators of RA

A

earlier onset, female sex, polyarticular synovitis, elevated ESR or CRP level, cartilage loss on x-ray, HLA DR4, poor functional status

103
Q

important consideration of cervical spine in RA

A

AAsubluxation due to laxity/ rupture of transverse ligament or
*thoracic, lumbar and sacral spine usually spared in RA

104
Q

shoulder manifestations of RA

A

GH and AC joint
subacromial bursitis
rotator cuff
bicipital tendintis/rupture

105
Q

elbow joint manifestations

A

loss of lateral stability, entrapment of ulnar nerve or radial nerve from synovitis
olecranon bursitis,

106
Q

hand and wrist joint manifestations

A 
MCP/PIP/wrist synovitis (DIP's spared)
ulnar drift
palmar subluxation of MCP
swan-neck deformity
boutonniere deformity
tenosynovitis
107
Q

swan-neck deformity

A

rupture of extensor hood mechanism- flexion DIP, hyperextension PIP, flexion MCP
boutounniere- opposite

108
Q

common hip joint manifestations of RA

A

half w/ evidence of hip disease, protrusion acetabuli, bursitis, avascular necrosis

109
Q

knee joint RA

A

synovial thickening, quad atrophy, loss of full extension, baker’s cyst

110
Q

ankle/foot joints in RA

A

MTP synovitis, ankle synovitis in severe disease
MTP subluxation w/ deformities
pes planus, post. tib tendon rupture
valgus deformity of ankle
achilles tendon: tendinitis, nodules, rupture
tarsal tunnel syndrome

111
Q

initial treatment of RA

A 
NSAIDS- reduce swelling
multidisiplinary care
glucocorticoids- local injection or oral
DMARD's
modalities
joint protection
ROM
112
Q

best anchor drug for RA

A

methotrexate

113
Q

spondyloarthropathies definition

A

cluster of interrelated chronic inflammatory diseases including ankylosing spondylitis, reactive arthritis, psoriatic arthritis, inflammatory bowel disease

114
Q

enthesis

A

insertion site

115
Q

gene w/ high correlation in ankylosing spondylitis

A

HLA B-27

116
Q

classification criteria for axial spondy

A

sacroiliitis on imaging plus >/=1 spA feature
OR
HLA B27 plus >/=2 other SpA features

117
Q

cardinal s/s AS

A

age 3 months
morning >60 min and nitetime stiffness
improves w/ activity
no neurologic symptoms

118
Q

AS physical exam items

A 
global loss ROM
schobers maneuver 10 cm to 15 cm
occiput to wall 
chest expansion 4 cm
patrick test- fabere test
119
Q

extraarticular manifestations of AS

A 
eyes- acute anterior uveilitis
heart= aortic insufficiency, heart block
glut- IBD, crohns
cauda equina
kidneys-amyloidosis
lungs restrictive lung disease
osteoporosis
120
Q

AS treatment

A

PT exercise (aerobic, strength flexibilit) and smoking cessation
Indocin (NSAID)
sulfasalazine and methotrexate for peripheral arthritis
anti-TNF

121
Q

-mabs

A

TNF antagonist structures

122
Q

poor prognostic factors AS

A

hip disease, onset

123
Q

reactive arthritis

A

starts w/ GI infection, Salmonella, GU infection, chlaymdia
followed by urethritis, conjunctivitis, arthritis
formerly Reiters disease
LE joints- asymmetrical
SI asymmetrical
sausage digits
rash

124
Q

treatment reactive arthritis

A

PT, intraarticular steroids, NSAIDS, slufasalazine, MTX, anti-TNF

125
Q

key difference between psoriasis arthritis and RA in diff diagnosis?

A

DIP involvement of psoriatic arthritis

126
Q

asymmetric oligoarthritis

A

most common presenting pattern of PsA- swelling of one knee

127
Q

psoriatic arthritis mutilans

A

rare form of PsA- end stage condition of small joints of hands and feet

128
Q

extraarticular manifestations

A 
A- synovitis
A- acne
P- pustulosis
H- hyperostos
O- osteitis

MC II (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions