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NR 615 TEST 1 Flashcards

1
Q

Metabolic syndrome aka syndrome X includes….

A

Increased waist circumference (w35,m40)
Triglycerides >150
HDL <50
Fasting glucose>100
HTN>180/85

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2
Q

Release of IGE in early asthmatic response results in…

A

H1 receptor activation which causes the smooth muscles to bronchoconstrict and spasm

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3
Q

What is the karotype for Klinefelter syndrome?

A

XXY

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4
Q

Deficiency in what chemical could result in hypothyroidism

A

Iodine

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5
Q

Best measure for cardiac preload is

A

Left Ventricle Enddiastolic Pressure (LVDEP)

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6
Q

Risk factors for DVT aka Virchows triad

A

Endothelial injury
Venous Stasis
Hypercoagulation

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7
Q

TNM systems to classify cancer:
T

A

T1 is <3cm, T2 >3cm, t3 >3cm and close to airways/chest, T4 in heart muscle or esophagus

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8
Q

TNM systems to classify cancer
N

A

N0- no node involvement
N1- ipsilateral close node involvement
N2- ipsilateral distant node
N3-contralateral node

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9
Q

TNM system to classify cancer
M

A

M0- no Mets
M1-Mets

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10
Q

Stage 1 cancer is…

A

Contained to one organ

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11
Q

Stage 2 cancer is

A

Locally invasive

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12
Q

Stage 3 cancer has…

A

Lymph involvement

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13
Q

Stage 4 cancer has

A

+ Mets

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14
Q

What is a saccular aneurysm and how do you treat it

A

One with a “sac” protrusion…tx is Usually clipping or coiling

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15
Q

What is a fusiform aneurysm and how do you treat it

A

An anureysm that is fat all around. Tx is usually stent

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16
Q

What is a dissecting aneurysm and how do you treat it

A

False lumen to medial wall, arterial wall splits and bleeds. Tx is grafting the tear and betablockers

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17
Q

What is a false aneurysm and how do you treat it

A

A hematoma that looks like an aneurysm. Tx is supportive care

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18
Q

In HTN, pressure- natriuresis causes what?

A

Decrease in NA+ in urine

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19
Q

Angiotensin II usually has what SYSTEMIC type of effects in CHF?

A

Activation of RAAS which causes vasoconstriction and fluid retention. Decreased vasoresistence and an increased in preload and afterload. This causes toxicity to the myocardium which results in decreased contractility and myocardium remodeling. Overall, this leaders to HYPERtrophy of the myocardium

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20
Q

Angiotensin II usually has what local effects in CHF?

A

Promotes catecholamine release

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21
Q

Complex consetallyion of systolic congestive failure

A

Systolic HF -> issue to systole d/t contraction= decrease in cardiac output= RAAS activation to increase CO= increase preload and afterload = remodeling and toxicity to myocardium

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22
Q

stages of atherosclerosis

A

Begins with injury to endothelial cells that make up the arterial walls.
Stage 1 can be seen as early as 8 months when macrophages become lipid foam cells.
Stage 2 seen in puberty, increase in these lipid macrophages
Stages 3/4 fatty streaks become visible.
Stage 5 is in the 30s, when fibrous tissue occurs.

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23
Q

Pathology of atherosclerosis

A

Macrophages fill with LDL and penetrate inner material wall. This results in fat streaks. The fat streak produces more inflammation and toxicity resulting in vessel wall damage.

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24
Q

What is the most common type of childhood cancer up to 14 y.o

A

ALL
2nd is brain tumors

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25
Clinical manifestations of R sided heart failure
JVD, hepatospleenomegaly, peripheral edema,fluid retention.
26
Definition of anaplasia
Loss of cell differentiation aka pleomorphism. Irregularities in the size and shape of cell nucleuses, no normal tissue structure.
27
Clinical manifestations of Cushing disease
Truncal obesity, moon face, bronze pigmentation, purple striae, acne, thin extremities, bruising
28
Hgb A1c levels are…
Normal: 4.5-5.6%, Pre:5.7-6.4% Diabetic: 6.5%+
29
The clinical manifestations of congenital hypothyroidism are…
Cretinism. Macro gloss is, hypotonia, cognitive delay
30
Aging does what thyroid gland
Atrophy, fibrosis, nodularity, increased inflammation, decreased TSH production
31
Aging does what to the pancreas?
Impaired glucose production, cells are replaced with fat, decreased insulin secretion, increased insulin resistance
32
Aging does what to growth hormones?
Declines (soma to pause), decrease in bone/muscle/fat mass, changes to reproductive and cognitive function
33
Aging does what to parathyroid hormone
Decrease in parathyroid hormone secretions which lead to alterations in calcium
34
Aging does what to adrenal gland?
Cortisol clearance decreases. Related to decline in liver/kidney function, adrenopause (plasma levels decrease)
35
Aging does what to antidirectic
Hyponatremia/ SIADH
36
Dysfunction of RAAS and hypertension results in
Vasoconstriction=Renal salt and water retention=increase in peripheral resistance= increase in blood volume
37
What is the hematological spread of cancer Mets?
Cancer cells break away and travel through bloodstream and go to different parts of the body
38
What BP is prehypertension
120-129/<80
39
What BP is stage 1 HTN?
130-139/80-89
40
What BP is stage 2 HTN?
140 or >140/90 or >90
41
What BP is HTN crises?
>180/>120
42
What are local s/s of inflammation?
Increases redness, warmth, and swelling and pain
43
Systemic s/s of inflammation?
Fever, +leukocytes, increased plasm proteins
44
What is the underlying cause of dilated cardiomyopathy?
Ischemic heart disease, valve disease, drug toxicity, hyperthyroidism, renal failure. Will have impaired systolic function.
45
Active- acquired immunity is…
Direct exposure aka vaccines or natural exposure
46
Passive immunity is…
Transferred, temp/short ex IVIG
47
Common allergic responses are mediated through what class of antibodies?
IgE antibodies
48
What IGG do?
Protective against infections
49
IgM is…
The largest and first produced during immune response
50
IgA is…
Found in body secretions that defend against pathogens on body surfaces
51
IgD is….
Present in plasma and easily broken down, predominant in early B cells
52
B cells are…
Responsible for immunoglobulin mediated immunity originated in bone marrow
53
T cells are…
Killer, helper cells, or suppressor
54
Complications of micro vascular DM?
Nephropathy, Neuropathy, and Retinopathy. Result from capillary basement membranes thickening and endothelial cell hyperplasia.
55
Complications of macro DM
CAD, PVD, Stroke
56
Risk factors for endocarditis are…
IV drug use, indwelling catheterization, heart valve disease, blood borne pathogen.
57
What is the most common pathogen for infective endocarditis?
Staph Aureus
58
Hyperparathyroidism is associated with
Increase in ca+ and decrease in phos. Painful bones, renal stones,GI upset, depression/memory loss/psychosis
59
Symptoms of hyperthyroidism include…
Tachycardia, palpations, weight loss, increase appetite, goiter
60
What is the pathophysiology of valvular regurgitation?
Valve does not fully close which lease to back flow of blood from ventricle to atrium
61
What is seen in primary hypothyroidism that is not seen in secondary hypothyroidism?
Hyperpigmentation
62
What are the risk factors for peripheral artery disease?
Obesity, HTN, HLD, male, tobacco use, over 40 y.o
63
What are the ways to diagnose DM?
Elevated hgA1C Fasting plasma glucose Random glucose test 2 hour glucose tolerance test
64
What is the difference between hypoglycemic hyperosmolar nonketotic syndrome vs DKA?
HHNS: SEVERE fluid deficiency, profound hypoglycemia (greater than 600), higher mortality, no ketones, less insulin deficiency than DKA, occurs over time DKA: insulin deficiency, +ketones, +kussmaul, occurs rapidly, dehydration (not as much as hhns).
65
What is cushings disease?
Caused by pituitary Adenoma which leads to increase ACTH
66
What is Cushing’s syndrome?
Chronic excessive cortisol level aka lack of circadian patterns
67
What causes tachycardia?
SNS causes fast heart rate
68
Right sided heart failure vs left sided
R- JVD, peripheral edema, retention of fluid. Increased pulmonary HTN L- Dyspnea, SOB, Cough, frothy sputum, impaired gas exchange, Think blood keeps emptying back to R side of heart and back flowing to lungs.
69
What is the risk of myocardial infarction when referring to LDL and HDL ?
LDL: high levels cause toxicity and remodeling of smooth muscles in heart. HDL: HDL converts cholesterol to steroids or bile. Low HDL means increased coronary risk.
70
Which cancer can H. Pylori cause?
Stomach
71
What cancer can HPV cause?
Cervical
72
What cancer can hep b and c cause
Liver
73
What cancer can hiv cause??
Kaposi sarcoma, nonhodgkins, squamous cell carcinoma
74
What cancer can EBV cause?
Lymphomas, nasopharyngeal
75
What cancer can HTLV1
T cellLeukemia/lymphoma
76
Where are Mets of pancreatic cancer common?
Liver, lungs, abdomen
77
Where are Mets of lung cancer common?
Colorectal, gastric, pancreatic, breast, prostate, bladder, renal, skin. Brain
78
Where are Mets of brain cancer common?
Lung, breast, skin, renal, colorectal
79
Where are Mets of bone cancer common?
Breast, prostate, lung, skin, renal, thyroid
80
Where are Mets of prostate cancer common?
Bone
81
Understand the blood flow of TOF
Blood is shunted from R to L over the VSD. Results in oxygen poor blood from r ventricle flowing right into aorta and increased flow to pulm artery and lungs.
82
How does blood flow with a VSD?
Left ventricle to right ventricle, extra blood going to lungs.
83
What are the effects of calcitonin
Decreases calcium by inhibiting bone reabsorption. Increases phos.
84
What are the effects of insulin on the body.
Helps control blood glucose by signaling liver, muscle, and fat. Secretion is promoted by glucose livers.
85
Know about the adrenal gland
Adrenal gland is stimulated by ACTH. Produces hormones that regulate metabolism, immune system. Response to stress.
86
Know about corticosteroids
AKA CORTISOL. Increase blood glucose, regulate metabolism, anti inflammatoru, decreases immune responses, stimulates gastric secretion.
87
What is a pheochromocytoma and what does it do
Tunor on the adrenal medulla. Causes HTN, palpations, glucose intolerance, sweating, constipation.
88
Clinical manifestations of hypothyroidism
Cold intolerance, lethargy, tiredness, diastolic HTN, weight gain, depression, puffy face and eyelids, goiter, edema,
89
Clinical manifestations of Addison disease
Bronze skin, hypoglycemia, weakness, vitiligo, hypotension
90
What are the symptoms of adrenal adenoma
Overproduces ACTH and causes cushings disease. Benign tumor. Hirtuism, deep voice.
91
What are the the symptoms of primary hyperaldosteronism
Excessive secretion by adrenal cortex. HTN, Hypokalemia, hypervolemia d/t increased sodium reabsortion, metabolic alkalosis
92
Autoimmune disorders occurs when
Misdirected response against the hosts own cells. Ex. Lupus
93
Consequences of aortic stenosis is
Diminished blood from LV to aorta. Heart failure, MI, dysrhythmias.
94
Graves’ disease is cause by…
Hyper function of the thyroid gland. Bulging eyes, tremor, irregular heartbeat, sweating, weight loss, emotional instability.
95
What is transposition of great arteries?
Pulmonary artery and aorta are swapped. Incompatible with life unless pda/VSD/asd exists to mix oxygenated blood and deoxygenated blood.
96
Parental obesity is associated with …
Childhood obesity, increasing risk of HTN
97
A child’s BP will go down if….
Both systolic and diastolic BP will decrease with moderate weight loss
98
Sensitivity of target cells will Dow regulate when…
High concentrations of hormones decrease the number of receptors.
99
What is the pathophysiology of Cushing’s syndrome
ACTH stimulated adrenal gland. Adrenal gland secrets cortisol. Excessive cortisol causes lack of circadian rhythms
100
What are the major contributors to insulin resistance and diabetes type 2?
Obesity is major contributor because it increases insulin resistance. DM type 2- Positive family history and obesity

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