Midterm Flashcards
What information is contained within the nucleolus?
RNA, DNA, binding proteins (Histones)
The function of proteins?
Act as receptors, transport channels, drive active pumps, cell surface markers, cell adhesion markers (CAMs), catalysts of chemical reactions, role in ATP
Why are water-soluble molecules unable to center cells?
Phospholipid bilayer
Refractory period?
No stimulus can evoke another response at that time?
when normal columnar ciliated epithelial cells of the bronchial lining are replaced by stratified squamous epithelial cells due to chronic irritation
Metaplasia
During pregnancy, mammary glands enlarge. What type of hormonal process causes this?
Hyperplasia - increase in cell amount, does not affect shape/size of cells
A consequence of multiple blood transfusions for the patient.
Hemosiderosis - excess iron stored as hemosiderin in tissues/organs
What is the physiological effect of hypernatremia?
High Na in blood vessels pulls H2O out of cells (ex brain) and into the blood vessels causing cells to shrink.
What condition consists of an absent homologous X chromosome with a single X chromosome and physical features of the following: Short stature, widely spaced nipples, webbed neck?
Turners syndrome
which blood type is that of a heterozygous having A & B alleles as a codominant?
Blood type AB
Of the genetic processes, which can cause asthma in only one pair of identical twins
epigenetic modifications
Which cell is the primary defense against parasites
Eosinophils
Why do complement and chemotaxis deficiencies occur in neonates?
Transient depressed inflammatory response - born in sterile environment, neutrophils/monocytes not yet capable of effective chemotaxis making them prone to infection
Why are some vaccines administered orally vs injected?
Each route stimulates a different lymphocyte containing tissues resulting in a different type of cellular and humoral immunity
If a patient is having an IgE-mediated hypersensitivity reaction, what is the best intervention?
Antihistamines
Mechanisms of type II hypersensitivity reaction
- Tissue-specific
- Antibodies (IgG/IgM) coat mast cells by binding to receptors that signal its degranulation, followed by a discharge of preformed mediators
Rh- Mom delivers a Rh+ baby, what would you tell mom about RHO(D) immunoglobulin
prevents alloimmunity and hemolytic anemia of the newborns
Neutrophils attack, engulf, and destroy which microorganism using phagocytosis?
Bacteria
What are exotoxins
Released by bacteria during bacterial growth and affect surround tissues
Immunity decreases during stress. The helper T cell response to stress is suppressed by which hormone makes them prone to infection?
Cortisol
Which neurotransmitter causes a patient that is severely stressed to develop cold clammy skin.
Norepinephrine - causes vasoconstriction
What percentage of intravascular volume needs to be decreased before hypovolemic shock occurs?
15%
what is the hallmark of neurogenic shock due to overstimulation of the parasympathetic nervous system?
Vasodilation d/t low SVR
Which of the following shock states has the highest priority to treat?
a. septic
b. hypovolemia
c. anaphylactic
d. neurogenic
Anaphylactic - concern for airway
During septic shock which clinical finding confirms the elevation of the immune response?
Leukocytosis - Increased WBCs
periorbital edema and hepatomegaly occur in pediatric cardiogenic shock due to?
Increased systemic venous congestion from high SVR
true or false: Capillary refill greater than 4 seconds is normal in a child
False - sign of shock
The primary goal of shock in a child?
Maximize O2 delivery, decrease demand.
Limited glycogen storage of a child that has been seriously burned results in what outcome?
Increased morbidity - limited glycogen makes it hard to meet the increased energy demands of the burn leading to metabolic dysfunction and loss of lean body mass
Which of these behaviors would be observed in a newborn suffering shock? SATA:
a. Decreased heart variability
b. hyperalertness
c. hypoglycemia
d. temperature instability
e. increased muscle tone
A. decreased heart variability
C. hypoglycemia
D. temperature instability
How does a child physiologically compensate for cardiogenic shock?
- splanchnic arteries are constricted to divert blood from the skin, kidneys, and gut to the heart and brain
- Peripheral blood vessels are constricted to raise blood pressure
- Adrenergic responses produce tachycardia to increase CO
- The RAAS system is stimulated when renal function decreases
what tissue does carcinoma originate?
Epithelial
When a cell loses cellular differentiation, it is referred to as?
Anaplasia - hallmark of CA
A pts in your office with a known diagnosis of CA and their labs show hgb of 7.9. what factors will you assess for? SATA:
a. chronic bleeding
b. malabsorption of iron
c. malnutrition
d. recent blood transfusion
e. current infection
a. chronic bleeding
b. malabsorption of iron
c. malnutiriton
You are tasked with developing a series of community discussions related to CA prevention strategies. Which of these topics do you choose? SATA:
a. healthy eating
b. tobacco avoidance
c. importance of early diagnosis
d. impact of obesity on one’s health
e. age-appropriate exercise
a. healthy eating
b. tobacco avoidance
d. impact of obesity on health
e. age appropriate exercise
Which form of CA is linked to congenital malformation syndrome?
Wilms tumor (nephroblastoma)
a child that is diagnosed with aids, has an increased risk of developing …?
Non-Hodgkin’s lymphoma
which cells can destroy some types of tumor cells and some viruses infected cells without having been exposed to them before?
Natural killer cells
why do lymph nodes enlarge and become tender during an infection?
Increased antigens cause the proliferation of more B-lymphocytes which causes lymph nodes to become swollen and tender.
What condition would cause hepatomegaly, cardiac dysfunction and bronze skin?
Hereditary hemochromatosis
Tx: therapeutic phlebotomy
What is the cause of neurological symptoms in a polycythemia pt?
Viscous blood
Which of the following pts would be a priority to assess for DIC?
a. heat stroke
b. pancreatitis
c. term delivery
d. HELLP
e. snake bite
a. heat stroke
b. pancreatitis
d. HELLP
e. snake bite
What is the role of collagen in the clotting process?
Activates platelets
How would you describe acute lymphoblastic anemia (ALL) to a pt?
progressive neoplasm defined by the presence of greater than 30% lymphoblasts in the bone marrow or blood
Burkitt’s lymphoma in African children associated with which virus?
Epstein barr virus
early symptoms of acute leukemia include: SATA:
a. dizziness
b. paresthesia
c. anorexia
d. bruising
e. bone pain
c. anorexia
d. bruising
e. bone pain
common causes of erythropoiesis in children
Iron deficiency
G6PD deficiency is what form of inherited disorder
X-linked recessive disorder
a potential cure for microcytic hypochromic anemia?
cord blood transplant
Which disease is autosomal dominant inherited hemorrhagic disease?
Von Willebrand disease
Pediatric pt presents with the following: pallor, fatigue, fever, petechiae, and purpura. What tests would you order? SATA:
a. CBC
b. renal function studies
c. bone marrow biopsy
d. CXR
e. joint fluid sampling
a. cbc
b. renal function studies
c. bone marrow biopsy
d. CXR
is cortisol a lipid or water-soluble hormone?
Lipid
Thyroid-stimulating hormone is released to stimulate thyroid hormones and is inhibited when plasma levels of TH are adequate. what type of feedback is this?
Negative feedback
If a diabetic pt did not take their insulin in days, and no is in the ED w/ high blood glucose, which electrolyte is a priority
K+
target tissue for prolactin-releasing factor
Anterior pituitary
growth hormone is inhibited by which hormone?
Somatostatin
The adrenal medulla excretes which hormone?
Epinephrine
if a pt is diagnosed w/ SIADH, which lab values would you expect to see?
hyponatremia (120)
hypoosmolality (260)
when a pt is suffering from DI, which form will result in the target cells for ADH in the renal collecting tubules demonstrating insensitivity?
Nephrogenic
What are the signs of thyrotoxic crisis?
Tachycardia, hyperthermia
“speed up mode”
what is the pathophysiology of a pt with the following labs: ph 7.20, glucose 500, positive urine glucose, serum K 2.0, Na 130?
Decreased glucose causes fatty acid use (ketogenesis) resulting in metabolic acidosis & metabolic alkalosis
What is the action of calcitonin?
Decreases serum Calcium
In an acromegaly pt, what lifestyle patterns would you want to assess?
Sleep patterns
Type 1 DM has episodes of hunger, lightheadedness, tachycardia, pallor, headache, and confusion. What causes these symptoms?
Hypoglycemia caused by increased exercise
what is the Somogyi effect?
Hypoglycemia with rebound hyperglycemia
your diabetic pt has a routine UA, which demonstrates proteinuria. Which therapy would you prescribe?
a. ACE inhibitor
b. Frequent BG monitor
c. repeat UA
ACE inhibitor - protects kidneys and keeps them from spilling out proteins?
Chronic microvascular complications for diabetes: SATA: a. eyes, b. peripheral, c. vascular, d. nerves, e. renal
a. eyes
d. nerves
e. renal
which complication is a result of a reduction in parathyroid hormone? SATA:
a. asphyxiation
b. tonic clinic seizures
c. muscle spasms
d. laryngeal spasms
e. hyporeflexia
a. asphyxiation
b. tonic-clonic seizures
c. muscle spasms
d. laryngeal spasms
A pt with abnormally severe tooth decay and erosion, what should a health care professional assess for?
Bulimia
A health care professional speaking to a weight loss support group encourages participants for regular screening for medical conditions related to obesity: SATA:
a. cancer
b. cardiovascular disease
c. cirrhosis
d. diabetes
e. dementia
a. cancer
b. cardiovascular
d. diabetes
Head injury and pt can sense heat/cold or dull/pain comes from what part of the brain?
Pons
Microinfarcts resulting in pure motor or pure sensory deficit result from which stroke?
Lacunar Stroke
Pt with spinal cord damage to UPPER motor neurons what assessment finding would the healthcare provider associate with this injury
Initial paralysis, gradual partial recovery later
Where is CSF produced
Choroid plexus
Pt who sustained cervical spinal cord injury 2 days ago develops a sudden headache and blurred vision. What should be done?
Take BP/ pulse for hyperreflexia?
Cognitive operations cannot occur w/o effective functioning of what part of the brain?
Reticular activating system
Which midbrain dysfunction causes pinpoint pupils fixed in position?
pontine dysfuction
The event most likely to occur when a person experiences a closed head injury
Brief instability of ones vital signs
Pt w/ spinal cord injury C4, what should health care professional assess as a priority
Breathing. “C5 stay alive, C4 breathe no more”
The neural group closes dorsally during which week of gestational life
4th week
Health care professional advises pregnant women to add which supplement to prevent birth defects?
Folic acid
Result of Arnold-Chiari type 2 malformation associated with myelomeningocele?
Downward displacement of cerebellum, brainstem, and 4th ventricle
Pt cleaning litter box with HIV/AIDS develops fever, clumsy, trouble speaking. what medicine to give
pyrimethamine (pt has toxoplasmosis)
Type of vascular malformation that most often results in hemorrhage
Arterial venous malformation
Which cerebral vascular hemorrhage causes photophobia, positive kernig’s & brudzinskis, & meningeal irritation?
Sub arachnoid hemorrhage (SAH)
Vascular malformation is characterized by arteries that feed directly into veins through a vascular tangle of abnormal vessels?
AVM - arterial venous malformation
Which neurotransmitter is reduced in schizophrenia?
GABA
Hypothalamic pituitary-adrenal system abnormalities are present in which psychiatric disorder
Depression
antipsychotic drugs causes tardive dyskinesia, which mimics the effects of an increase of which neurotransmitter?
Dopamine
What is the link between depression and cortisol secretion?
Persistently increased cortisol increases depression risk
Decrease in receptor binding for which neurotransmitter is found in depression
serotonin
Which electrolyte imbalance is associated with lithium toxicity?
Hyponatremia
Nerve fiber that transmits pain impuse?
A-delta fibers
endogenous opioid located in the hypothalamus and pituitary and is a strong receptor agonist?
Endorphins
A pregnant pt with severe depression has been taking venlafaxine (Effexor) and asks the health care professional what options are available. what would be recommended?
ECT - elctroconvulsion therapy
