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(Duluth) HRM Final Review > (Journal) HRM - Final Exam Review > Flashcards

(Journal) HRM - Final Exam Review Flashcards

1
Q
A

Granuloma w/ multinucleated giant cells

Trying to “wall-off” an infection

Caseous necrosis = caused by infection

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2
Q

Diagnosis?

A

Sertoli - only syndrome

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3
Q

A ____ mass is a palpable breast mass that is 3-dimensional, distinct from surrounding tissues, and asymmetrical relative to the other breast

Persists through menstrual cycle

A

Dominant mass

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4
Q

An ____ mass is often described as an area of vague or indiscrete nodularity or thickening that differs from the surrounding tissue and the finding is not matched in a mirror-image location in the opposite breast.

A

Indeterminate

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5
Q

When should breast cancer screening exams ideally be performed?

(what week)

A

The week after menses

(when breast tissue is engorged)

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6
Q

What type of breast cancer is often silent on mammogram?

A

Infiltrative lobular

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7
Q

Do HER2/neu (+) tumors need oncotype testing? Why?

A

NO

(because they are already high-grade by definition)

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8
Q

Which breast cancer do you NOT use chemotherapy in?

A

DCIS

(ductal carcinoma in situ)

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9
Q

Where do direct inguinal hernias go through?

A

Direct = through weakness in the floor of inguinal canal

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10
Q

Where do indirect inguinal hernias go through?

A

Indirect = through inguinal ring

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11
Q

Ethics:

What 2 topics can youth make decisions on?

A

Pregnancy and STD’s

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12
Q

Ethics:

Pregnant mother can make decisions independent of ____ and implications for health of fetus/child

A

Independent of father

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13
Q

Ethics:

If pregnant woman is under <18 and is a dependent, what is required to happen before obtaining an abortion?

What are 3 exeptions to this?

A

Parental notification

(unless there is sexual abuse, physical abuse, or neglect)

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14
Q

With assisted reproduction, when is sex selection appropriate?

A

Only to avoid sex-linked inheritable diseases

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15
Q

Ethics:

Pre-implantation genetic diagnosis/testing to select for disability is ____ (acceptable, prohibited)

What is an example of this?

A

Morally unacceptable but not prohibited

Deaf parents commonly want to have deaf kids since they do not see it as a disability

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16
Q

Ethics:

Surrogate mothers (to host baby)

What are the 3 requirements in MN for a woman to become a pregnancy surrogate for another woman?

A

Surrogate pregnancy requirements:

  • Age > 21
  • Mental competence
  • Prior pregnancy of their own (b/c surrogacy can lead to infertility)
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17
Q

What is the most common male cancer?

A

Prostate cancer

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18
Q

What is the 5-year survival rate for prostate cancer if it is local at the time of diagnosis?

A

100%

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19
Q

What race is more common to have prostate cancer?

A

African americans

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20
Q

Men with a ____ (relative) or ___ (relative) who has prostate cancer are 2.4x as likely to develop prostate cancer themselves

A

Father or brother

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21
Q

Male relatives of patients with ____ (other cancer) have a higher incidence of prostate cancer

Why?

A

Breast cancer

Increased if BRCA1 and BRCA2 carrier

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22
Q

What tumor suppressor gene associated with breast cancer, prostate cancer, and endometrial cancer?

What chromosome?

A

PTEN (on chromosome 10)

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23
Q

~ 70% of men with prostate cancer have lost one copy of what gene at diagnosis?

A

PTEN (on chromosome 10)

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24
Q

sufficient dietary ____ is protective against prostate cancer

A

folate

25
Q

Men with high plasma levels of what hormone are at increased risk for prostate cancer?

A

Testosterone

(low testosterone may have a protective effect)

26
Q

When prescribing testosterone replacement, what cancer must you increase the screening for?

A

Prostate cancer

27
Q

What is the primary intra-prostatic androgen for cell growth?

Where is it made?

A

DHT

testosterone is converted by 5-alpha reductase to DHT in the prostate

28
Q

___ (agent orange) exposure is associated with an increased risk for prostate cancer

A

Dioxin

29
Q

In the SELECT study, how does Selenium and Vitamin E affect risk of prostate cancer?

A

NO CHANGE in risk

30
Q

What is selenium used as a cofactor for?

A

Glutathione peroxidase

31
Q

What 2 drugs can reduce the risk of prostate cancer?

A

Finasteride

Dutasteride

(5a-reductase inhibitors)

32
Q

What are 4 things that can cause an increase in PSA (protein sensitive antigen)?

A

Prostate cancer

BPH

Prostatitis

Digital rectal exam (DRE)

33
Q

Which is better at detecting prostate cancer: PSA or DRE?

(Protein-Sensitive Antigen or Digital Rectal Exam)

A

PSA is better

(although it’s possible that PSA could miss a prostate cancer that a DRE would have picked up)

34
Q

What is a normal PSA level?

A

< 4

35
Q

A lower % of free PSA increases what risk?

A

A lower % of free PSA = INCREASED cancer risk

36
Q

What part of the prostate does cancer arise?

A

Peripheral zone

“Peripheral prostate cancer”

37
Q

What are 2 drugs for hormonal therapy of prostate cancer?

MOA’s?

A

Leuprolide

(GnRH analog) - admistered continously

(downregulates ↓ GnRH receptor →↓ FSH + LH)

Flutamide

(androgen receptor antagonist)

38
Q

What best reflects a patient’s hormone status?

(Free T4 vs total T4)

A

Free T4

39
Q

In post-partum thyroiditis, what occurs first?

(thyrotoxicosis or hypothyroidism)

A

Thyrotoxicosis

40
Q

What are risk factors for osteoporosis?

A
  • Female gender
  • petite body frame
  • White or Asian
  • Smoking
  • Alcohol
  • Sedentary
  • Nulliparity
  • Old age
  • High caffeine intake
  • Renal disease
  • Postmenopausal status
41
Q

What age is bone mineral density (BMD) testing recommended in women? Men?

What if their is concern given their risk factors?

A

Women = 65+

Men = 70+

If has risk factors = 50+

42
Q

When to start osteoporosis Tx if there is a hip or vertebral fracture?

A

Always start right away

43
Q

Which bone mineral density scan score is compared to young adult?

What levels indicate osteopenia?

What levels indicated osteoporosis?

A

T-score

“young adul-T”

Between -1 and -2.5 = osteopenia

Less than 2.5 = osteoporosis

44
Q

Which bone mineral density scan score is compared to someone of same age/sex/race?

A

Z-score

“Z = zame age”

45
Q

Which synthetic glucocorticoid also ha very strong mineralocorticoid effects?

A

Fludrocortisone

46
Q

_____ inhibits CYP450scc, used to tx Cushing syndrome (Cushing disease and ectopic ACTH-secreting tumors)

A

Ketoconazole

47
Q

What is the treatment for Cushing syndrome?

A

Ketoconazole

48
Q

What are renin levels in primary hyperaldosteronism?

How do the adrenal glands change?

A

High aldosterone (duh)

Low renin

Bilateral adrenal hyperplasia

49
Q

What syndrome cause a unilaterally enlarged adrenal gland + high aldosterone + low renin?

A

Conn Syndrome

(adrenal adenoma)

type of primary hyperaldosteronism

50
Q

What type of acute adrenal insufficiency has hemorrhagic necrosis of the adrenal glands stemming from infection with Neisseria Meningitidis

A

Waterhouse-Friderichsen syndrome

51
Q

What type of hyaline change is a sign of Cushing disease?

A

Crook hyaline change

52
Q

What syndrome has mutation of AIRE gene + IL-17 antibodies?

A

Autoimmune polyendocrine syndrome 1

53
Q

What is the posterior pituitary derived from?

(embryologically)

A

Neural crest (ectoderm)

54
Q

What is the adrenal medulla derived from?

(embryologically)

A

Neural crest (ectoderm)

55
Q

What is the adrenal cortex derived from?

(embryologically)

A

Mesoderm

(like the rest of the GI tract)

56
Q

Child w/ VMA + HVA in urine + Homer-Wright rosettes + small blue cell tumor

Diagnosis?

A

Neuroblastoma

57
Q

What are the 3 P’s of MEN-1?

A
  • Pituitary tumors
  • Parathyroid adenomas
  • Pancreas endocrine tumors
58
Q

What are the components of MEN-2A and MEN2B?

What mutation is associated with these?

A
  • MEN-2A: (RET mutation) = MPP
    • Medullary thyroid carcinoma (parafollicular C cell proliferation – secrete calcitonin)
    • Pheochromocytoma
    • Parathyroid adenomas
  • MEN-2B: (RET mutation) = MPG
    • Medullary thyroid carcinoma
    • Pheochromocytoma
    • Gangliomas of the oral mucosa
59
Q
A

(Duluth) HRM Final Review (22 decks)

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