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pathophys > Midterm-professors points > Flashcards

Midterm-professors points Flashcards

1
Q

What to expect at level of spinal fracture

A

Damange along their dermatomes (more)

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2
Q

ABG

A

Draw it out-
U-uremia, can be detected with high BUN, acidotic pH,
K/Na/Cl all norm
bicarb low=acidotic

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3
Q

Asthma

A

IgE
type 1 hypersensitivity

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4
Q

What would be the physical effects of hyper vs hypocalcemia? What
would you see in a patient in hypo vs hyperkalemia?

A

Blood transfusions are common cause
Citrate solution

Seizures
Tetany
Involuntary contraction of muscles that leads to painful muscle cramps, spasms, and overactive neurological reflexes
Psychiatric manifestations
Anxiety, depression, emotional lability

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5
Q

Intracellular vs Extracellular volume (dehydration)

A

Dehydration is the focus on how to apply data. Pt travels to Mexico and gets diarrhea. Is it ICV or ECV loss?
ECV

If not an ion changed then it’s not intracellular.

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6
Q

Endoplasmic reticulum

A

Cell membrane

Place that proteins are synthesized, all secretions that cells excrete
are packaged.

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7
Q

Hypomagnesemia also causes what other electrolyte finding?

A

When you have Mag loss, you ALSO have calcium loss.

also K

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8
Q

Why is there a difference in ion composition between intracellular and extracellular compartments?

A

Potassium levels inside the cell

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9
Q

Physical features:
Turner’s syndrom

A

Short stature
Female only
Neck abnorms
low hair line at back of neck, low-set ears, high/narrow roof of mouth, small lower jaw, drooping eye lids
broad chest/wide spaced nipples
above avg #moles
undeveloped ovaries

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10
Q

Physical features
Down’s Syndrome

A

Trisomy 21
Low nasal bridge, epicanthal folds, protruding tongue, flat low-set ears

Increased risk of congenital heart disease, respiratory infections, leukemia

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11
Q

Physical features- Klienfelters

A

smaller testes/penis
gynecomastia
min body hair,
long limbs
taller
low energy
decr sexual interest
1:1000 male births

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12
Q

Fragile X syndrome
2 questions

A

Physical features
Large ears, long face, prominent jaw and forehead, flat feet
many learning disabilities. social/behavioral problems

Second MC cause of intellectual disability
1:7000 males 1:11000 females

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13
Q

Praeder-Willi syndrome

A

constantly hungry = obesity

Inherited from father

Short, obese, hypogonadism

caused by a genetic abnormality that occurs due to the deletion or dysfunction of gene 4Mb on chromosome 15q;

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14
Q

Expressivity

A

How does a ds show differently in 1 sibling vs the other sibling

Von Recklinghausen disease, also known as Neurofibromatosis Type 1 (NF1)
growth of tumors on nerves throughout the body. It is one of the most common inherited disorders, affecting about 1 in 3,000 people

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15
Q

Incidence rate-define

A

number of new cases of a disease that are reported (typically over one year course)

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16
Q

Colorectal cancer

A

Somatic mutations
High-fat, low-fiber diet, red meat, processed meat

just beat lung cancer in the US, doesn’t cluster in the family.

Does have APC gene mutation
■ It is NOW the first leading cause of death

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17
Q

Sickle Cell Anemia

A

autosomal recessive

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17
Q

Punnett square example

A

See the same quiz punnett square again! Think of hetero male and
female. What is the chance the child has a sickle cell in the 1:4 ratio?
25%

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18
Q

Autosomal dominant disorders versus Autosomal recessive disorders - what similarity do they have?

A

both types can be inherited from parents who are carriers;

pattern of inheritance differs; dom (50%) ; recess (25%)

both types of disorders result from genes on autosomes

(non-sex)

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18
Q

Methylation = ? 

A

The process that turns the genes off! Low methyl then expresses or exhibits features

DNA less likely to transcribe into mRNA
Key component of x-inactivation

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19
Q

Breast Cancer

A

Affects 12% of american women
If first degree relative with breast cancer, risk doubles
Recurrence risk increases if the age of onset in the affected relative is early and is the cancer is bilateral
Autosomal dominant 5-10%
Linked to chromosomes 13 and 17
Increases risk for ovarian cancer

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20
Q

Immunoglobulins: E,M,G

A

They are ANTIBODIES

E: type 1, asthma
Type 1-> Remember immediate, vasoactive, anaphylactic, IgE
mediated, caused by allergen/antigen/ urticaria, allergies,
anaphylaxis, asthma, allergic-type response of Type 1.

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20
Q

Bipolar and schizo

A

How do we know if it’s passed down in family lines? Hard to know the
rate because of environmental factors.

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21
Q

Staphylococcus -why is it common in wounds? What is it?

A

Normal flora, opportunistic with impaired dx: wounds, immunocompromised

High occurrence of staph infections of patient with diabetes, cancer,
vascular disorders

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22
Q

Benefits of a fever

A

Aids in killing microorganisms
■ vasodilation-> increased lymphatic motility
● Moves through immunity responses/markers to be able to kill microorganisms
■ Deprive bacteria from food

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23
Q

Innate immune response

A

Think of categories so you understand big ideas

● Adaptive vs humoral
○ Adaptive- not involving antigens
○ Innate- natural. The response is the same basic
response to fight anything, despite it’s the same
stimulant. Generalized, nonspecific. Faster because it’s
the first response that triggered

○ Humoral- slide 7 in ch 8!!!!!! Doesnt kill,target, or stimulate other leukocytes. B cells.
Directly inactivates microorganisms

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24
Q

Primary lymphoid tissue example

A

Thymus that helps with secreting factors that affect the immunity of patients

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25
Q

Inflammation - describe definition

A

Nonspecific, happens for a variety of reasons not just infection or
wounds

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26
Q

Acute inflammation
(true/false-are these the steps?)

A

Elevated neutrophils
Fever that is produced by hypothalamus
Endogenous pyrogens

  1. acute reaction phase
  2. subacute proliferation stage
  3. proliferative stage
  4. strengthening phase
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27
Q

Endotoxins & Exotoxins

A

Endo- contained inside the cell wall, usually associated with gram-negative bacteria
■ Exo- released during bacterial growth, can cause inflammation in responses.

How bacteria will invade and how the immune system
knows something is there that we need to attack

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28
Q

Alloimmunity example

A

blood transfusion

28
Q

Acute bacterial meningitis - lab findings?

A

CSF fluid
WBC=high
Protein=high
glucose= LOW

29
Q

MHC’s facts
major histocompatibility complex

A

Do not display antibodies or present them
● They DO present antigens!!
● Anaphylactic vs allergic response
● Type 1 vs Type 2

29
Q

SLE

A

A classic example is the butterfly rash appearance. Goes across the bridge of the nose and expands on the cheeks.
Example question:
On my differential->
lupus. You would order an ANA to determine if SLE rules in/out.

30
Q

Innate Immune system: (PAMP’s) and DAMP’s 

A

(PAMPs) are molecular structures commonly found on pathogens such as bacteria, viruses, and fungi;

structures are recognized by pattern recognition receptors (PRRs) expressed by cells of the innate immune system;

examples of PAMPs include lipopolysaccharide (LPS) on the outer membrane of Gram-negative bacteria and lipoteichoic acid (LTA) on Gram-positive bacteria

Pathogen associated molecular patterns (PAMP’s)

31
Q

Innate Immune system: PAMP’s and (DAMP’s) 

A

(DAMPs) are endogenous molecules that can be released from damaged or dying cells;

DAMPs are recognized by PRRs and can activate innate immune responses similar to PAMPs;

can include various molecules such as ATP, DNA, RNA, heat shock proteins, and extracellular matrix components

Danger-associated molecular patterns (DAMP’s)

32
Q

Dysfunctional wound healing during the inflammatory response

A

Wound Healing
Phase I: Inflammation
* Coagulation and infiltration
* Platelets, neutrophils, macrophages
* Fibrin mesh of blood clot acts as scaffold
* Platelets release growth factors.
* Neutrophils and macrophages clean the wound.
* Debridement occurs.
* Blood vessels and lymph drain away debris.
* Vascular dilation and permeability reverse.

Phase II: Reconstruction
* Wound begins to heal.
* Healing begins 3–4 days after the injury and continues
for 2 weeks.
* Fibroblast proliferation occurs.
* Collagen synthesis by fibroblasts.
* Epithelialization—cells from healthy tissue grow into
wound.
* Wound contracts through the actions of myofibroblasts.
* Cellular differentiation occurs

33
Q

Basic definitions- tumor, neoplasia, dysplasia

A

dysplasia: Abnormal cell growth. We don’t know if cancerous

34
Q

Metastasis features
What causes cancers to actually spread? 3 stages

A

they detach from the primary tumor and invade the surrounding tissue, eventually entering the bloodstream or lymphatic system (invasion/migration); cancer cells in the bloodstream or lymphatic system can travel to distant organs or tissues (circulation);

Once cancer cells reach a distant site, they must establish a new tumor in that location;

involves survival in a foreign environment, evasion of the immune system, and the ability to stimulate the growth of blood vessels to support tumor growth (colonization)

35
Q

Reasons for cancerous growth

A

High rates of oncogenes. Not a lot of deletion or inactivation of oncogenes

36
Q

Malignant tumors facts

A

Not encapsulated
Disorganized
leak/metastasize
travel in lymph sys
RAPID growth
INVASIVE

36
Q

Carcinoma in Situ

A

Associated with

preinvasive epithelial malignant
tumor from glands or squamous origin

37
Q

Human carcinogenesis - key genetic mechanisms

A

Lots of mutations, oncogenes activated, not a large immune response—evades

This is the process of how cancers really grow and move

38
Q

Where does hematopoiesis occur?

A

Bone marrow

39
Q

HallMarks of Cancer

A

Genomic instability,
evasive of cell death (oncogenes cannot be
deleted),
self-sufficient growth signals (make own signals to infer
own growth),
replicate limitlessly indefinitely

40
Q

HIV = patients are more at risk for what?

A

Opportunistic infection they HIV are predisposed to
■ AIDs/HIV susceptible to odd organisms, really rare

● Meningitis, pt has high immune deficiencies
● Toxoplasma organisms

41
Q

Macrocytic normochromic anemias are caused by

A

folic acid deficiency

42
Q

Non-Hodgkin’s lymphoma

A

Basic hallmark- PAINLESS axillary/cervical lymph nodes.

Pt comes they have palpable or you find it on the physical exam

43
Q

Viruses linked to cancer

A

HPV,
EBV, nasopharynx,/stomach, HODkins
Kaposi sarcoma, (herpes 8)
HepB/HepC

44
Q

TNM staging

A

The M is a 0, NO metastasis
■ T is high, large number or large cell

45
Q

Anemia of Chronic Disease

A

Most common of anemias

also known as anemia of inflammation or ACD, is a

type of anemia that occurs in individuals with conditions that cause inflammation;

some of the conditions that can lead to anemia of chronic disease include

infections,

autoimmune diseases,

cancer, and

chronic kidney disease

46
Q

Sign of splenic sequestration after sickle cell crisis

A

YOU won’t find
vomiting or fever

Abd P
Pallor
tachycardia

47
Q

Iron deficiency anemia: lab findings

A

MC anemia

low iron
low feretin
low MCV
HIGH TiBC

47
Q

Monocytes become what?

A

Transform when they invade into MACROPHAGES

48
Q

How do cancer cells use the enzyme telomerase?

A

maintain the length of their telomeres, which are the protective caps at the ends of chromosomes;

by activating telomerase, cancer cells can prevent the progressive shortening of telomeres and maintain their ability to divide and proliferate indefinitely

49
Q

ITP vs. TTP labs scenarios

A

idopathic vs thrombotic

ITP: low platelet (thrombocytopenia)
Incr coag-**smear to lab*

If smear neg = ITP
if smear +=TTP

50
Q

Glandular Epithelial Malignancy example

A

adenocarcinomas

51
Q

Most common type of stroke?

A

Ischemic MCA

52
Q

Schwan cells vs oligodendrocytes-
which is which?

A

schwann: glial cells that myelinate neurons in the PNS,
oligodendrocytes-myelinate the neurons in CNS

52
Q

focal vs global cerebral ischemia-scenarios

A

global-
hypoperfused, low BP over time, blood loss, or trauma

Focal: specific artery, by thrombus /embolus

53
Q

Types of headaches
primary vs secondary

A

primary: tension, migraine and cluster
secondary: TBI, vascular disorders

54
Q

Cranial nerve functions 3-8

A

: cn3 - eye movement + pupil size,
cn4 - eye movement down and in,
cn6 - eye movement out,
cn7- facial expression/movement,
cn8 - hearing and balance

55
Q

Depression NT’s
2+ questions, T/F

A

all NT’s are low
serotonin
norepinepherine
dopamine

56
Q

Anxiety d/o and dx:

A

Prev: 10-30%, MC mental health disorder in US
C: idiop. genetic factors, stress, chem/phys alt.,
ex: hypothyroid

Panic-psychosomatic manif.
diaphor, incr HR, HEAT, N, disassociation

GAD- excessive worry, continuous; norepinephrine/serotonin abnormal;
acute stress d/o
agora-, social-, specific phobias
OCD
PTSD

TX:
80% respond to CBT
hypnosis
expertise
antidepressants (SSRI’s)
Benzo if not responsive

57
Q

Vision acuity

A

Diplopia
nystagmus
Cataract
Retinal detachment

58
Q

Calcium ion causes what in the presynaptic membrane?

A

neurotransmitter release, allowing transmission of signals

59
Q

Acute Otitis Media vs. otitis externa
2 questions: scenario

A

ear pain, drng, fever, decr hearing

externa: swimmers ear

60
Q

Parkinsons (scenerio)

A

shuffling gait, eyes, vision changes
tremor, bradykinesia,

61
Q

Pain perception and sensation

A

Neuropathic (shooting/burning)
Visceral (internal organs)

where do they come from in the brain??
nociceptors,

the ascending pathway (spinal cord, thalamus, and cortical areas), and the descending pathways

emotional aspect of pain in the amygdala and prefrontal cortex

62
Q

Older adult temperature management changes in physiology

A
  • Blood circulation and vasoconstriction/vasodilation or responses are slowed.
  • Metabolic rate is decreased.
  • Shivering is decreased and ineffective.
  • Sweating and the perceptions of heat and cold are decreased
63
Q

Efferent pathways carry ____________

A

Efferent paths carry sensory info AWAY from the CNS

64
Q

depression dx

A

most occurrence is white females
- 10-15% attempt suicide
- Neurotransmitter changes – all depressed of serotonin, norepinephrine, and dopamine

65
Q

Paranoid delusion vs delusion
(Scenerio)

A

Anosognosia is ignorance or denial of the existence of disease.

66
Q

Broca’s aphasia - which artery is most likely involved?

A

Left MCA

67
Q

Cholinergic NT = ?

A

ACETYLCHOLINE*

pathophys (14 decks)

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