Path 2 Exam 2 Flashcards
1
Q
What are the most common pituitary tumors?
A
1 Prolactinoma (PRL)*, 2 Corticotropinoma (ACTH), 3 Somatotropinoma (GH)
2
Q
What are the causes of Hyperparathyroidism? How do you treat?
A
Neck radiation for thyroid Adenoma Carcinoma (rare) Hypocalcemia (secondary). Tx with surgery
3
Q
Type 1 diabetes is ___% of diabetes
A
5-10%
4
Q
Atrophy and loss of ____cells is the cause of type 1 diabetes. It is ____-mediated. T1D develops in…
A
Beta cells of the pancreas. Immune mediated. Develops in childhood or early adulthood
5
Q
What are the major signs and symptoms of Hyperthyroidism?
A
Heat intolerance Increased GI motility Weight loss Tachycardia Goiter (but more common in hypothyroidism)
6
Q
What are the signs and symptoms of hydrocephalus? How do you treat it?
A
Large head size, Seizures, Headache, Nausea/Vomiting, Blurred/Double Vision, Balance/Gait problem, Incontinence. Treat it with a shunt
7
Q
Name disease S&S Asymptomatic until late Increased abdominal girth Weight loss Abdominal pain Dysuria or urinary frequency Constipation
A
Ovarian cancer
8
Q
What hormones are found in the posterior pituitary?
A
Oxytocin, ADH
9
Q
What is Polycystic Ovary syndrome? S&S? Risk factors?
A
It’s when a woman has a huge, many ovary cysts.
S&S:
Hirsutism, Androgen excess, Infertility, Obesity, Acne, DRY EYE
RF: obesity, young age
10
Q
What is the ice-pack test?
A
Icepack decreases Ach-esterase, relieving symptoms of Myasthenia Gravis. This can help diagnose MG
11
Q
What is the first onset of bleeding (period) in females
A
Menarche
12
Q
What are the RF for cervical cancer?
A
High parity (multiple childbirths) (4X)
Smoking (3X)
Oral contraceptive use (4X)
Unprotected sex
13
Q
How often does Bell’s palsy happen?
A
Usually only once
14
Q
Delivery, bed rest, and HTN management is tx for what?
A
Eclampsia
15
Q
Where does prostate cancer typically metastasizes?
A
Bone, lymph node, lung, liver, & brain metastases more likely
16
Q
What is the most common cause of proptosis and diplopia in adults?
A
The thyroid eye disease in Graves disease.
17
Q
Name disease: RF High parity (multiple childbirths) Smoking Oral contraceptive use Unprotected sex
A
cervical cancer
18
Q
What is the pathogenesis of thyroid eye disease?
A
Lymphocytic infiltration of the orbital soft tissue
Edema and mucopolysaccharide deposition by fibroblasts
Enlargement of EOMs
19
Q
What are the signs and symptoms of Hyperparathyroidism?
A
Asymptomatic (50%) *Osteoporosis *Subperiosteal absorption (bone indentation) Polyuria and polydipsia Constipation Weakness and fatigue Myalgias Cognitive impairment
20
Q
What is the most common form of Non-cutaneous cancer?
A
Breast cancer
21
Q
What is Hashimoto’s Thyroiditis? What are the signs and symptoms?
A
-Autoimmune response causing thyroid damage
-Most common cause of hypothyroidism*
Middle aged individuals
Females:Males 10:1
Signs and symptoms
-Low serum T4
-Elevated TSH levels
-Myxedema
-Goiter
22
Q
What can cause non-arteritic ischemic optic neuropathy?
A
PDE-5 inhibitors can cause this “stroke” in the eye in the posterior ciliary arteries, causing permanent vision loss (usually in the superior retina).
however, this can be confounded with heart disease (HTN, atherosclerosis), diabetes, smoking, small C/D
23
Q
___% of cancers are primary brain tumors. are metastatic.
A
1.4% of cancers are primary brain tumors. Majority are metastatic….like from lung
24
Q
Who is at greatest risk for pelvic inflammatory disease?
A
Sexually active women under 25
25
What is the main purpose of the thyroid gland?
It regulates the basal metabolic rate.
26
Menstrual cycle days 14-28
Luteal phase
27
What hormones change during pregnancy?
Human chorionic gonadotropin, estrogen, progesterone. adrenocortical
HCG changes thyroxine 15% higher,
28
Name condition: Usually asymptomatic, Pain, Urinary retention, Menstrual irregularity
ovarian cysts
29
What is Endometriosis? Signs and symptoms? Risk factors? Effects? Tx?
Ectopic endometrial tissue, meaning tissue that normally lines the uterus grows outside the uterus.
SYMPTOMS
Dysmenorrhea, Excessive menstrual bleeding, Pain, Dyspareunia, Pain with defecation
RISK FACTORS
childless and over 30-40 years
EFFECTS
Periodic hemorrhage of ectopic tissue, Peritoneal irritation, Adhesion formation
TX: analgesia, hormone, surgery.
30
What is Duchenne muscular dystrophy?
x-linked early onset (3-5 years). Absence of dystrophin. Pseudohypertrophy (muscle replaced with fat). Death by early 30s
31
Generalized absence seizures symptoms
Staring spell, brief, immediate recovery
32
What is non-spastic cerebral palsy?
Damage outside of pyramidal tracts. 20% of cases. Hypotensicity and ataxia.
33
What is Pheochromocytoma?
Tumor of the adrenal medulla that causes secretion of excess catecholamines (NE)
90% benign /10% malignant.
34
DBM =≥ __mg/dL after 2 hour glucose bolus
200
35
Pheochromocytoma is from…
Excessive production and release of catecholamines
36
Pregnancy can cause (inc/dec) tear production
Decreased
37
DMB= ≥___ mg/dL for random reading of Blood glucose
200
38
Snowflake cataracts are more commonly found in _____
Type 1 diabetics
39
What is metabolic syndrome?
a cluster of biochemical and physiological abnormalities associated with the development of cardiovascular disease and type 2 diabetes.
40
What is tx of prostate cancer?
Watchful waiting (see if there is progression if pt is older)
Surgery
93% 15-year survival rate
41
Which prostatitis is the most common?
Chronic prostatitis, the non-bacterial version
42
What can rotational injury or acceleration/deceleration injury cause?
diffuse axonal injury
43
What's the tx of pituitary adenoma?
Surgery or medication (to reduce hormone level in blood)
44
What can cause white dots in palpebral conj?
Conjunctival concretions of hyperparathyroidism
45
How do you diagnose Hashimoto's Thyroiditis? Tx? Untreated complications?
```
Dx: Anti-TPO (thyroperoxidase ) antibody titers, Serum TSH high, low T3, low T4.
Tx: Levothyroxine (Synthroid)
Complications:
Cardiomegaly
Heart failure
Pleural effusion
```
46
Name condition: RF: obesity, young age
Polycystic Ovary syndrome
47
When should you call 911 for a seizure?
When it lasts for more than 10 minutes
48
TRH in the hypothalamus stimulates the ______ to make ___ which stimulates thyroid to make T4 and T3
the pituitary gland to make TSH
49
Pineal gland produces ____
Melatonin
50
What is Ophthalmia neonatorum? S&S? tx? Prevent?
```
Baby is born and gets infected with Neisseria gonorrhoeae or Chlamydia trachomatis.
S&S:
Bilateral
Edema
Chemosis
Mucopurulent discharge
TX: IV or IM abx
Prevent: topical silver nitrate or erythromycin ointment
```
51
1st and 2nd leading cause of death from cancer in children?
1st Leukemia, 2nd is brain tumors.
52
What does parathyroid hormone do?
Increases osteoclast activity
Increases Ca reabsorption by kidneys
Increase Ca uptake by intestines
53
What does LH trigger?
It triggers ovulation and conversion of follicle to corpus luteum
54
What is Chronic Traumatic Encephalopathy?
Progressive degenerative disease of the brain from Accumulation of tau protein in neurons. From repeated brain injury.
55
What is the order of thyroid tests? (detail)
```
1 *Thyroid Panel: TSH, free T4, free T3
2 *Thyroid Stimulating Immunoglobulin
aka: TSH-Receptor AB
(+) in Grave’s Disease (90+%)
3 Thyroglobulin antibodies
(+) in Hashimoto’s Disease
(+) in Grave’s Disease
4 TPO (thyroperoxidase) antibodies
(+) in Hashimoto’s Disease (95%)
(+) in Grave’s Disease (50-75%)
```
56
What is the tx for Cushing's syndrome?
Discontinue steroids
Surgery
Radiation
Medication
57
Name disease:
Muscle Spasms, Poor balance
Frequent falls, Inability to walk, Drooping eyelids, Scoliosis, Joint contractures, Restrictions of mobility, Respiratory difficulty*, Arrhythmias, Cardiomyopathy
Muscular Dystrophy
58
Name disease: weakness that worsens with activity?
Myasthenia Gravis
59
Absence of monthly flow is…
Amenorrhea
60
```
Bladder incontinence
Impotence
Diarrhea
Perspiration
can indicate what?
```
Autonomic neuropathy (Diabetic)
61
What are sunset eyes?
Parinaud’s Syndrome/Dorsal Midbrain Syndrome.
| The eyes bulge in pediatric hydrocephalus, causing white of eye to be shown in upper eye.
62
What are the adrenal disorders?
Cushing’s Syndrome, Addison’s Disease, Conn’s Disease, Pheochromocytoma
63
What are most common causes of head injuries?
Car accidents, falls, assaults
64
Causes of viral meningitis?
Enteroviruses, HSV 2, Varicella zoster, Mumps, Influenza, HIV
65
What causes Alzheimer's disease?
Buildup of amyloid plaques and neurofibrillary tangles
66
Diabetic neuropathy affects ____% of diabetics
60-70%
67
What results indicate diabetes?
If you have one of the 4:
higher than 125 mg/dL FBG
Higher than 200 mg/dL after 2 hour glucose bolus
higher than 200 mg/dL for random reading of Blood glucose
Higher than 6.5% HbA1c level
68
What med can cause issues during surgery?
Alpha blockers (you get poor dilation during surgery)
69
What are the risk factors of brain tumors?
Ionizing radiation, Immunosuppression, Hereditary syndromes
70
Too heavy menstrual flow is
Menorrhagia
71
What is the most common cause of hypothyroidism in the US? In the world?
Hashimoto's thyroiditis. Iodine deficiency
72
Name disease: Headache, Confusion, Lightheadedness, Dizziness, Blurred vision or tired eyes, Ringing in the ears, Bad taste in the mouth, Fatigue or lethargy, A change in sleep patterns, Behavioral or mood changes: Memory, concentration, or attention problems
Mild TBI
73
What is the goal of HBA1c levels for diabetic patients?
Get them below 6.5%
74
Acromegaly vs gigantism? Acromegaly symptoms? How do you diagnose and treat acromegaly?
Acromegaly is excess growth hormone after bones have fused, affects cartilaginous growth. Symptoms: Increased ring or shoe size, Enlarged facial features and skin tags, Increased size of internal organs, Deepening of the voice. Dx via MRI and GH suppression test. Tx medication or surgery
75
What are ovarian cysts? Signs and symptoms? Treatment?
They large follicles that haven't ruptured and are in almost all women of childbearing age. 95% are benign.
S&S: Usually asymptomatic, Pain, Urinary retention, Menstrual irregularity
Tx: hormonal contraceptives, analgesics, surgery when 5 cm or larger. Resolve on own by next menstrual cycle, usually
76
What is the most common form of breast cancer? What %?
74-80% are Ductal carcinoma.
77
What can cause hypertensive crisis?
Pheochromocytoma
78
Why is increased protein kinase C in diabetes bad? It causes….
Vasoconstriction of smooth muscle
Vascular permeability
Basement membrane thickening
Abnormal angiogenesis (enhances VEGF)
79
Papilledema can indicate what?
Early sign of increased cranial pressure, Brain tumors
80
Qualitative diagnoses for metabolic syndrome:
High blood glucose, high TG, Low HDL, HTN, large waistline, large waistline and apple shape
81
What leads reproductive cancer deaths?
Ovarian cancer
82
Chronic red eye that can cause foreign body sensation can be….
Adult inclusion conjunctivitis
83
What are RF for T1D?
-Illness in early infancy
-Family history of Type 1 Diabetes (P>M)
-Maternal age at birth (older mothers)
-Maternal preeclampsia during pregnancy
-Other autoimmune disorder
Graves disease
Hashimoto's thyroiditis
Addison's disease
Multiple sclerosis (MS)
Pernicious anemia
84
Chlamydia trachomatis, then Neisseria gonorrhoeae. Pelvic surgery, IUD, Abortion procedures, Infection with pregnancy CAN CAUSE
Pelvic Inflammatory Disease
85
What is hirsutism associated with?
Abnormal hair growth in Polycystic Ovary Syndrome
86
What does the corpus luteum secrete?
Progesterone and estrogen
87
What is Premenstrual syndrome?
Affects 80% in the second half of cycle. (day 14-28)
88
What is the most common cause of death in Alzheimer's disease?
Bronchopneumonia
89
```
Name disease:
Numbness or tingling,
Unexplained weakness or
Fatigue,
Double vision,
Decreased acuity
```
Early symptoms of MS
90
What are infectious disorders of the CNS?
Treponema pallidum (syphilis) and Borrelia bacteria (lyme disease)
91
What is premature ovarian failure?
Menopause before the age of 40. 1% women
92
Name condition:
| Effects: pain, vaginal bleeding, prematurity, mortality
Placental Abruption
93
Coup vs contrecoup
Coup is head struck, contrecoup is rebound on opposite side of skull.
94
What are the primary brain tumor types? What are the secondary brain tumor types?
Glioma (30%), meningioma (benign), pituitary adenoma (benign), and nerve sheath tumors. Secondary is from lung (48%), breast, urogenital, osteosarcoma
95
Causes of bacterial meningitis? What complications can happen?
Strep. Pneumoniae*, Neisseria meningitides, H. influenzae type b. Hearing loss and brain damage
96
Symptoms of Bell's Palsy
Unilateral facial droop (eyelid does not close), diminished eye blink, hyperacusis, decreased lacrimation
97
Some blue light retinal fibers project to the ___
Pineal gland!
98
```
These can cause…..
Candida albicans*
Trichomonas vaginalis
Haemophilus vaginalis
Neisseria gonorrhoeae
Human papillomavirus
(HPV)
Herpes Virus type 2
```
Vulvovaginitis
99
DBM = ≥___% HbA1c level
6.5
100
How do you diagnose Myasthenia Gravis?
Tensilon (Edrophonium) /ice-pack test, Electromyography (EMG), Anti-ACH receptor Abs
101
What are the symptoms of Tay-Sach's disease? At what age does it start?
Motor development delay, Flaccid paralysis, Mental impairment, Blindness, Death. Starts at 6 months of age.
102
Purpose of CSF?
Buoyancy, Protection, Chemical stability, Prevention of brain ischemia (if BP falls, CSF production can also fall to facilitate blood flow)
103
Name disease: Pain, Bleeding, Local compression
Fibroid or Uterine leiomyoma
104
What are the ocular manifestations of Hypothyroidism?
```
1 *Eyebrows; Outer 1/3 missing
2 SLK (superior conj injection)
~50% cases have thyroid issues
3 Exophthalmos (but more common with hyperthyroidism)
```
105
If Guillain-Barré Syndrome is antibody-mediated autoimmune, what hypersensitivity type is it?
II
106
RF breast cancer?
```
Early onset of menses and late menopause
Postmenopausal HRT
Giving birth > 35 years
Low parity
Age
Radiation exposure
History of cancer
1st degree family history of breast cancer
```
107
What is Placental Abruption? Effects? Etiology? Risk factors?
Rare premature separation of the placenta.
Effects: pain, vaginal bleeding, prematurity, mortality
Causes: Idiopathic, blunt abdominal trauma, accel/deceleration injury
Risk factors: older, promiscuous, smoking, drug abuse, HTN
108
What surprising physiological changes happen during pregnancy?
Relaxin changes uterus, laxity (loosening of ligaments and joints), increased RBC (30%)
109
The two most important RF for T2D is…
Obesity and sedentary lifestyle
110
Cataracts can happen in what disease?
Hypoparathyroidism
111
Which disease? Risk factors: Chemical irritation, Trauma, allergic reactions, antibiotic therapy
Vulvovaginitis
112
What is the key to diagnose testicular cancer?
Self exams are the key to diagnosis until age 45
113
Which demographic has higher rates of diabetes?
AA females and native americans
114
______ is the #1 cause of End-stage renal disease
Diabetes
115
What are the signs and symptoms of Cervical cancer?
Abnormal vaginal bleeding
Persistent vaginal discharge
Pain and bleeding after intercourse
116
What is TSH-receptor antibody implicated in?
Graves disease
117
RF for gestational DM?
Race: AA, H/L, NA. Obesity, Family history of DM
118
_____ can cause regular menstrual cycle with extra bleeding
Uterine problems and systemic disorders
119
What does Huntington's disease affect? What kind of inheritance?
Basal ganglia and cortex. Autosomal dominant
120
What are the causes of epilepsy?
Idiopathic, Stroke, Dementia, TBI, Infections, Tumors, Congenital defect or perinatal brain injury
121
__% of 20 year MS pts are not disabled and can still walk. They typically have a(n) _____ lifespan
66%. Normal lifespan
122
How does Alzheimer's affect genders?
Women more than men
123
Which EOMS are more likely to be affected in thyroid eye disease
IM SLO. Inferior is the most affected
124
How many Americans have prediabetes? What percentage will progress to type II within 10 years?
80 million. 50%
125
Menstrual cycle: ovulation day
Day 14
126
What pushes preeclampsia into eclampsia?
Seizures
127
What is normal pressure hydrocephalus?
Normal pressure but abnormal CSF volume
128
Neisseria gonorrhoeae can cause….
gonococcal conjunctivitis (Hyper-acute mucopurulent discharge)
129
What are the 3 categories of microvascular damage from DBM?
| 3 macrovascular damage?
Retinopathy, nephropathy, neuropathy
Coronary artery disease, Peripheral artery diease, cerebrovascular disease
130
Partial Simple seizures symptoms
Have no loss of awareness and have limited symptoms
131
Inflammation of the 7th cranial nerve is…
Bell's palsy
132
Chorea is a symptom of what?
Huntington's disease. Chorea is involuntary writhing movements.
133
What happens during menopause?
Cessation of the menstrual cycle x 1 yr
Generally occurring in the late 40s or early 50s
Remaining follicles become unresponsive to FSH and LH
Production of FSH and LH rises sharply.
DRY EYE
134
Chlamydia trachomatis can cause…
Urethritis, Adult inclusion conjunctivitis
135
What is treatment of Bell's palsy?
Spontaneous recovery, steroids for inflammation. Make sure it's not a stroke, infection, or trauma, tumor.
136
What else is a major endocrine gland?
The placenta
137
What are the symptoms of diabetes?
```
Polyuria - lots of peeing
Polydipsia -lots of thirst
Polyphagia - constant eating, cells can't take in glucose
Blurred vision
Weight loss - cells atrophy
Extreme fatigue
Slow healing sores
Frequent infections
Tingling or numbness in the hands or feet
```
138
Macrovascular diabetic disease ultimately leads to accelerated _____
Atherosclerosis
139
__% of the US population have diabetes
9% (30 million)
140
What is Krukenberg spindles?
release of posterior iris pigment deposits in lower 3rd of corneal endothelium, rarely can clog Trab M. (rare ocular change in pregnancy)
141
Cause of encephalitis? Signs and symptoms? How is treatment?
Usually viral: Herpes simplex 1 & 2, Arboviruses, Rabies virus. Seizures, stupor, coma. Supportive treatment
142
What is the 1st and 2nd most common neurodegenerative disorders?
Alzheimer's (1) and Parkinson's (2)
143
What is the most common cause of dementia?
Alzheimer's disease
144
What is thyroid disease gender ratio?
F > M
145
What is the blood pressure requirement for Preeclampsia?
140/90 after 20 weeks.
146
What are the ocular manifestations of preeclampsia?
Blur and preeclampsia retinopathy
147
What is Thyroid eye disease? What age typically?
50-70% “thyroid stare” in Graves Disease
*Most common cause of proptosis and diplopia in adults
Also occurs in hypothyroidism, not just hyper
6% of patients are euthyroid
148
Prostate screening?
Annually over 50, 45 at high risk
149
What is Pituitary Apoplexy? Most common causes? Symptoms (2 important ones)?
Pituitary apoplexy is vascular damage to the pituitary. Causes: *Pituitary adenoma, Pregnancy, Postpartum hemorrhage, Sickle-cell, DM, Shock Trauma. SYMPTOMS: headache, syncope, blurred vision, *ophthalmoplegia (double vision), *visual field defects, death possible (adrenal insufficiency,
hypotension/hypoglycemia/SAH)
150
Type ___ Diabetes is a polygenic disorder. Genes + environment
Type 2
151
What female disease can increase risk of prediabetes?
Having huge babies, Polycystic ovary syndrome
152
Name disease:
| Muscle spasms, Pain, Slurred speech, Blindness, Paralysis, Cognitive decline
Late symptoms of MS
153
What is the cause of Bell's palsy?
Inflammatory response after viral infection of (Varicella zoster virus, EBV, herpes simplex I)
154
Irregular but frequent periods is..
Metrorrhagia
155
How can you tell difference between malignant and benign tumors?
Malignant has inflammation and edema, starts to distort the brain tissue.
156
What is eclampsia? What are the complications? Treatment and prevention?
Seizures during preeclampsia.
Complications: Placental abruption, premature delivery, Disseminated intravascular coagulation (DIC)
Tx: Delivery, bed rest, and HTN management
157
Early and late Signs and Symptoms of Increased intracranial pressure:
Early: Vomiting, Headache, Papilledema.
| Late: Bradycardia, HTN, Respiratory changes, Herniation
158
Hb ___ can help diagnose DBM
A1c
159
What is a fibrocystic breast tissue?
Palpable breast mass that fluctuates with menstrual cycle (at older than 30-50 years)
160
What are the common (4) and uncommon (5) changes in pregnancy?
```
-----Common
Transient blur
Decreased corneal sensitivity
Increased corneal curvature
Decreased IOP
Decreased tear production
-----Uncommon
Transient loss of accommodation
Krukenberg spindles (release of posterior iris pigment)
Increased pigmentation around the eyes and cheeks (can be permanent)
Visual field loss (pituitary adenoma, can be permanent)
Ptosis
```
161
How do you treat Myasthenia Gravis?
Ach-esterase inhibitor, thymectomy, plasmapheresis (remove offending autoantibodies)
162
DBM = higher than ___mg/dL FBG
125
163
What is communicating vs noncommunicating hydrocephalus?
Communicating, excess CSF can exit but there is reabsorption problem, noncommunicating is where there is an obstruction
164
What is the rule of 90s for testicular cancer?
90% are germ cell tumors
90% occur between 25 and 45 years of age
90% of tumors are malignant
90% are curable
165
What causes diabetic ketoacidosis?
No insulin > liver breaks down even more glucose > fatty acids are broken down > ketones are produced
166
What can cause macular crystalline deposits?
Tamoxifen (breast cancer tx)
167
Name disease: Memory loss, Confusion, Aggression, Depression, Dementia, Impulse control problems
Chronic Traumatic Encephalopathy
168
What is the Tensilon test?
Helps diagnose Myasthenia Gravis by disabling Ach esterase
169
_____ is the most common diabetic neuropathy?
Peripheral neuropathy
| In the toes, feet, legs, arms, hands
170
Cause: Sudden fever, Stiff neck
| Headache, Altered mental status
Meningitis
171
____ and ____ (hormone) prevents periods
Estrogen and progesterone
172
What are the early and signs and symptoms of thyroid eye disease?
```
Foreign body sensation
Redness
Tearing
Photophobia
Morning puffiness of the eyelids
```
173
What is most commonly associated with Thyroid Eye Disease?
Graves disease
174
What is traumatic pneumocephalus?
Air moves to the subdural space from injury to a nasal sinus. This can cause cerebrospinal rhinorrhea?
175
What is Amyotrophic Lateral Sclerosis? What are the clinical manifestations? What are the risk factors of ALS?
Progressive neurodegenerative disorder of upper and motor neurons. Affects men more than women. Weakness and wasting of extremities, paralysis. Does not affect personality or eyesight. Smoking, lead exposure, military service are risk factors.
176
What are S&S of fibrocystic breast changes?
Tenderness or pain in one or both breasts
Firm, regular in shape, mobile on palpation
Located in upper outer quadrant of breasts
Size fluctuates throughout menstrual cycle
177
```
Name condition:
Osteoporosis
Accelerated
atherosclerosis*
Macular degeneration
Cognitive impairment
```
Long-term estrogen deprivation from menopause
178
What are RF of Diabetic retinopathy?
DM
Smoking
HTN
Pregnancy
179
Painful, difficult menstruation is
Dysmenorrhea
180
5 year survival rate of breast cancer is ____% with no lymph involvement.
5 year survival rate is ___% with metastasis
98%
| 26%
181
How do you treat diabetes insipidus?
Treat with oral ADH. The pee is too dilute
182
```
Name disease:
Digital rectal exam
Serum PSA*
Transrectal ultrasonography
Transrectal biopsy
```
Prostate cancer
183
Too light menstrual flow and irregular periods is…
Oligomenorrhea
184
Low Ca causes secretion of ____ by ____
Parathyroid hormone by parathyroid
185
What is Gardasil?
It's a 3 shot series to protect against cervical cancer
186
What causes reduced capillary permeability in the BBB?
Endothelial tight junctions and Thickened basement membrane
187
What are the AE Of type 5 PDE inhibitors?
```
Headache
Facial flushing
Blue vision
Dyspepsia (indigestion)
Nasal congestion
Concern if also taking nitroglycerin
Non-arteritic ischemic optic neuropathy
```
188
What is placental Previa?
Growth of the placenta over the cervical opening.
189
What is a lumbar puncture good for?
Punting air, dye, or medications in. Sampling CSF
190
What are the causes of hypothyroidism?
Hashimoto's thyroiditis*
Insufficient Iodine dietary intake*
Congenital (birth) defects
Radiation treatments to the neck
Radioactive iodine used to treat hyperthyroidism
Surgical removal of part or all of the thyroid gland
Viral thyroiditis
191
_____ is the Leading cause of renal failure due to ______
Diabetic Nephropathy is the Leading cause of renal failure due to glomerulosclerosis
192
___ in the ____ stimulates the pituitary gland to make TSH which stimulates thyroid to make T4 and T3
TRH in the hypothalamus
193
What are S&S of breast cancer?
```
Persistent lump / thickening
Dimpling of the skin
Nipple retraction
Changes in breast contour
Redness on breast or nipple
Bloody discharge from nipple
```
194
```
Symptoms of what??
Emotional changes
Fatigue
Bloating
Headaches
Appetite changes
Painful and swollen Breasts
Swelling of hands and feet
```
Premenstrual cycle syndrome
195
Hypo/hyper thyroidism is more common than the other?
Hypothyroidism is more common
196
What is cerebral angiography?
Injection of contrast through the femoral artery. Visualize the cerebral arteries and assess for lesions
197
What are Fibroids? Signs/symptoms? Tx?
Uterine Leiomyomas, benign smooth muscle tumor. Affects blacks > Whites (3:1). Can make for risky future pregnancies
SIGNS AND SYMPTOMS
Pain, Bleeding, Local compression
Tx Observation, meds, surgery
198
Hypo/hyperthyroidism has familial associations?
Hyperthyroidism
199
What is concussion vs contusion?
Concussion is diffuse, microscopic damage (that probably won't show on MRI). Contusion is brain bruise, localized macroscopic damage (causing edema, increased ICP, and hemorrhage)
200
What are the symptoms of Diabetic Ketoacidosis?
| What complications can occur?
```
Altered mental status (from brain swelling)
“Fruity” smelling breath (acetone)
Hyperventilation (Kussmaul breathing)
COMPLICATIONS:
Cerebral edema
Coma
Death
```
201
Antibiotic therapy can change the microbiota of the vagina and cause….
Vulvovaginitis
202
What are the demyelinating diseases?
Leukodystrophy, MS, and Guillain-Barré Syndrome
203
```
Name disease: TX
Hysterectomy
Radiation therapy
Chemotherapy
Prophylactic oophorectomy or salpingo-oophorectomy
```
Ovarian cancer
204
Which Leukodystrophy is x-linked?
Adrenoleukodystrophy
205
Tx of Guillain-Barré Syndrome?
Plasmapheresis (separating antibodies), IV immunoglobulin (removes autoantibodies), Supportive, Spontaneous recovery (usually)
206
Which hormone begins the menstrual cycle?
FSH
207
20% of ___+ year olds have diabetes
55 years +
208
What are the 5 types of endocrine disorders?
Hypo/hyperfunction of a gland, then receptor defect, primary or secondary messenger defect
209
Partial complex seizures symptoms
Loss of awareness, automatisms (lip-smacking, etc)
210
What are natural protective barriers against prostatitis?
Long urethra, urination, ejaculation
211
What can diabetes cause?
Cerebrovascular disease
diabetic retinopathy
coronary heart disease
Nephropathy
Neuropathy
peripheral vascular disease in the lower limbs
ulceration and amputation for diabetic foot
212
MS: __% asymptomatic or mildly symptomatic after diagnosis. __% rapidly progress. __% mild to moderately symptomatic
20% asymptomatic or mildly symptomatic after diagnosis. 20% rapidly progress. 60% mild to moderately symptomatic
213
Pregnancy can cause (inc/dec) corneal curvature
Increased
214
VHL …..
….prevents the growth of tumors
215
Name disease:
| EFFECTS: Infertility, Chronic pain, Ectopic pregnancy
Pelvic Inflammatory Disease
216
Name disease:
Abnormal vaginal bleeding
Persistent vaginal discharge
Pain and bleeding after intercourse
Cervical cancer
217
What is the diagnosis for Metabolic Syndrome? Numbers
```
FBG > 100 mg/dL
TG level 150 mg/dL (or on meds for TG)
Low HDL level 135/85 mmHg (or on meds for HTN)
Large waistline:
> 40 inches for men
> 35 inches for women
“Apple” shape
```
218
What is Sheehan's syndrome?
Woman bleeds too much in childbirth causing a stroke of the pituitary
219
What is Swelling of lower legs legs?
Myxedema
220
What are the common symptoms of Cushing's syndrome?
Truncal obesity, moon face, buffalo hump, skin atrophy, collagen breakdown causing "Stretch marks", facial hair growth
221
T4 and T4 is stored in the ____ and there is a storage that can last for _____ months
Colloid and can last for 2-3 months
222
Name disease:
RISK FACTORS
childless and over 30-40 years
Endometriosis
223
What is relapsing-remitting MS? What % is progressive MS?
90% of MS respond well to treatment. MS goes into remission (but can come back). Progressive is 20%
224
What's the ocular manifestation of pituitary adenoma?
Tunnel vision (Bitemporal visual field loss). Defect starts superior then spreads inferior
225
Who shouldn't take oral contraceptives?
Smokers, liver disorders, coronary heart disease, and breast cancer patients
226
What are the risk factors for preeclampsia?
```
First pregnancy
Multiple pregnancy
Obesity
>35 years of age
Hx of diabetes, HTN, kidney disease
```
227
Low vitamin D or light can cause ___in children or ____ in adults
"Rickets” in children
| “Osteomalacia” in adults
228
How do you diagnose MS? How tx MS?
2 or more attacks and MRI showing lesions. Tx Immunosuppression, Amino acid injections, Corticosteroids, Management of symptoms
229
What causes a cherry red spot in the macula?
Lysosomal storage disease (Tay-Sach's)
230
What does proteinuria strongly indicate?
Eclampsia
231
What is a molar pregnancy/hydatidiform mole? What are the signs and symptoms? Treatment?
It a defect of fertilization where a placenta grows but there some fetus (partial) or no fetus (complete). 1 in 1200 pregnancies.
Bleeding in early pregnancy, HTN in early pregnacy, Severe nausea and vomiting.
Tx: Suction curettage
232
What is typical head trauma called?
Closed (blunt) head trauma
233
What is the treatment of choice for ED?
Type 5 phosphodiesterase inhibitors, they prevent degradation of cGMP to increase NO
234
Outer 1/3 eyebrows missing can indicate….
Hypothyroidism
235
What are symptoms of syncope prodrome?
Dizziness, loss of vision/hearing, weakness, pallor, clammy skin, nausea.
236
Tay-Sachs disease is what type?
Lysosomal storage disease, inherited metabolic disorder. Systemic affecting neurons, too.
237
What thyroid hormone is more plentiful?
T4 is more plentiful than T3
238
What are the causes of hypopituitarism?
Tumor, Infarctions (trauma/TBI, DM, etc.), radiation, Surgery, Postpartum Hemorrhage (Sheehan’s Syndrome)
239
What are causes of syncope?
Fainting can be from orthostatic hypotension, vasovagal syncope (standing too long, anxiety of needles, space monkeys), cardiogenic syncope
240
How is epilepsy diagnosed?
2 or more unprovoked seizures typically required for diagnosis
241
What is Parinaud’s Syndrome/Dorsal Midbrain Syndrome? What are the signs sympoms?What's the cause?
Upward gaze deficit due to involvement of vertical gaze centers in dorsal midbrain (sup colliculus).
Symptoms: diplopia, difficulty looking up
Signs: lid retraction, defective upgaze, convergence retraction nystagmus, mydriasis with light near dissociation, papilledema
Causes: *pinealomas, *hydrocephalus, CVA, MS, trauma
242
What are leukodystrophies? What diseases they include? What kind of cell death?
Progressive disruption of myelin sheaths. Metachromatic Leukodystrophy (MLD), Adrenoleukodystrophy. The cells die causing inflammation.
243
What symptoms of Alzheimer's are early vs. late stage?
Early is memory loss and disorientation, Late is motor loss and aphasia.
244
What is the problem with ED?
Weak parasympathetic signal or little NO release
245
What can happen in long-term estrogen deprivation?
```
Osteoporosis
Accelerated
atherosclerosis*
Macular degeneration
Cognitive impairment
```
246
IM cephalosporin can treat…
gonococcal conjunctivitis
247
What are the ocular manifestation of Parkinson's?
Decreased blink rate, blepharospasm, decreased convergence amplitudes.
248
What are tx of fibrocystic breast tissue?
```
Analgesia
Heat or cold for swelling
Well-fitting bra
Oral contraceptive
Danazol
```
249
RF for diabetic nephropathy?
*Hyperglycemia
*Hypertension
Genetic predisposition
Hypercholesterolemia
Smoking
250
What Increases risk of bleeding during labor and delivery because of growth of the placenta over the cervical opening.
placental Previa
251
What is Adult inclusion conjunctivitis? From what? How tx?
From Chlamydia, it's a Conjunctivitis that does not respond to topical meds.
Follicles in inferior conj. Treated w/ 1gm oral azithromycin.
252
What are the neurologic tests for brain tumors?
Myelogram
253
Symptoms can be what?
| HA, VF change, VA loss
Pituitary Adenoma
254
What are the effects of chronic hyperglycemia?
1 Glycation of proteins
2 Excess sorbitol in cells
3 Increased activation of Protein Kinase C
255
What is the classic triad of meningitis? Which meningitis is more common?
Sudden fever, stiff neck, HA, (altered mental status). Viral is most common (but bacteria, fungi, and parasites can cause it too)
256
When is it best to start mammograms?
Age 40-50 annually until 75 or when have 7 years left
257
PETs are good for….
Showing function rather than structural.
258
Addison’s Disease is from…
Low cortisol and/or low aldosterone
259
How is Huntington's diagnosed?
MRI
260
What antagonizes insulin?
Estrogen/progesterone! = gestational diabetes
261
What is the most prevalent noncutaneous cancer in men?
Prostate cancer
262
What is Addison's disease? What causes Addison's disease? How diagnose?
Primary adrenal insufficiency (not enough cortisol/aldosterone release). 80% are autoimmune destruction of adrenal gland. Diagnose with ACTH stimulation test or presence of anti-adrenal antibodies.
263
What is spastic Cerebral palsy?
Upper motor neuron damage. 70-80% of cases. Has hypertonic, tense muscles
264
High FSH and LH can indicate what?
Menopause
265
What are signs and symptoms of Pheochromocytoma?
```
Hypertension
Headache
Flushing
Diaphoresis
Tachycardia
Heat intolerance
Weight loss
```
266
What are they important symptoms of hypothyroidism?
```
Lethargy
Cold intolerance
Bradycardia
Goiter
Decreased appetite
Constipation
```
267
What disease does not affect personality or eyesight
Amyotrophic lateral sclerosis
268
What is the tx BPH?
Medication (alpha-blockers), surgery. Eunuchs don't get it!
269
What disease is non-inflammatory disease of striated muscle?
Muscular dystrophy
270
What are other ocular manifestation of DM?
Myopic shift, 2x glaucoma risk, decreased corneal senstivity, CN 2-7 palsies, macular edema, diabetic retinopathy
271
Blue vision can be from….
Type 5 PDE inhibitors (ED treatment). Affects blue cones. Concerning for pilots!
272
What does a goiter happen?
Mostly in Hypothyroidism (and also hyperthyroidism)
273
Menstrual cycle days 1-4
Menstrual phase
274
How do you treat pituitary adenomas?
Radiation or surgery
275
Hba1c can indicate average blood glucose concentration over ______(time)
2-3 months
276
___ is the #1 cause of death in Type 1 diabetics?
diabetic nephropathy
277
MRIs are good for…
Soft tissue, safety (not ionizing)
278
What are the sites of infection for pelvic inflammatory disease?
Salpingitis (oviducts)
| Oophoritis (ovaries)
279
What is the MOA od diabetic neuropathy?
Demyelination
280
What is the most common causes of death in people with type 2 DM?
Coronary artery disease (leading to MI) and strokes
281
Metachromatic Leukodystrophy (MLD) is a deficiency in the activity of ___
Arylsulfatase (affects white matter)
282
What is Vulvovaginitis? Symptoms? Risk factors? Cause?
Inflammation of the vulva and vagina.
Symptoms: Discharge, Erythema, Edema, Intense itching
Risk factors: Chemical irritation, Trauma, allergic reactions, antibiotic therapy
Cause: STI, infection
283
What does endothelial glycosylation of DBM do?
1 damage
2 BM thickens
3 Can cause obstruction/rupture of capillaries or small arteries
284
What are the effects of Hormone replacement therapy?
```
Hormone replacement therapy, but now long-te
Decreases risk of:
-Osteoporosis
-Colorectal cancer
Increases risk of:
-Breast cancer
-Stroke
-Myocardial infarctions
```
285
What can be the cause of a constant runny nose?
Traumatic pneumocephalus. CSF leaks out of nose
286
Incidence of DM retinopathy increases with _____ of DM
Duration
287
Which disease? Symptoms: Discharge, Erythema, Edema, Intense itching
Vulvovaginitis
288
```
Name disease:
In infant...
Bilateral
Edema
Chemosis
Mucopurulent discharge
```
Ophthalmia neonatorum
289
What are risk factors for ED?
Age
Vascular disease (Atherosclerosis, HTN, Diabetes, etc.)
Medications
Endocrine problems
290
What is the order of thyroid tests? (wo/detail)
1 *Thyroid Panel: TSH, free T4, free T3
2 *Thyroid Stimulating Immunoglobulin
3 Thyroglobulin antibodies
4 TPO (thyroperoxidase) antibodies
291
What are different level types of hormones?
Constant level, variable level, and cyclical
292
What is a focal neuropathy?
It's a neuropathy of any nerve in the body, but this is important for optometry because of cranial nerve palsies
293
What is the most common cause of adult pituitary dysfunction?
Pituitary adenoma.
294
What do oral contraceptives suppress? Progestins suppress what?
FSH, preventing ovulation.
| Progestins suppress LH, blocking ovulation, thickening cervical mucus, reducing ovum and thinning endometrium
295
What is the gold standard for evaluating acute brain injury?
Glasgow coma scale.
296
What does the Glasgow coma scale include?
Eye opening, motor response, verbal response
297
What is the most common uterine tumor?
Fibroids or Uterine Leiomyomas
298
What are the risk factors of Myasthenia Gravis?
Thyroid diseases, Diabetes mellitus Type 1, Rheumatoid arthritis, Lupus, Demyelinating CNS diseases
299
What can cause osteoporosis?
Hyperthyroidism causes excess calcitonin which breaks down bone
300
What is used for diagnosis of ovarian cancer?
CA-125
301
What is hyperacusis a symptom of?
Bell's palsy
302
What complications can happen during pregnancy?
```
Gallstone formation
Coagulopathies
Transient hypotension
Morning sickness (1st trimester)
Frequent urination
Immunosuppression leads to
-Sinus congestion
-Gingivitis
Decreased gastrointestinal motility (constipation)
Peripheral edema
```
303
You will minimize risk of diabetic retinopathy with a HbA1c of ___% or lower
7%
304
What is cerebral palsy?
Group of syndromes. Permanent, non-progressive damage to motor control areas of the brain
305
What are the fasting plasma glucose for normal, prediabetes, and diabetes?
Prediabetes is 100-125 mg/dL
306
___% of breast cancer is inherited? ___% are estrogen-responsive?
5-10% 66% are estrogen-responsive, meaning cancer has estrogen receptors on them.
307
Pregnancy can cause (inc/dec) corneal sensitivity
Decreased
308
```
S&S
nervousness
sweating
tremor
HA
Confusion
Loss of consciousness with decreased respiratory
```
Hypoglycemic emergency (#1 cause of this is insulin overdose)
309
What is graves disease?
Excess secretion of thyroid hormone because of antibody that stimulates TSH receptor. It is most commonly associated with thyroid eye disease
310
___% of MS patients have ocular symptoms
66% (optic neuritis)
311
What are the signs and symptoms of hypoparathyroidism?
```
Muscle cramps and spasm**
Brittle nails
Dry hair
Dry, scaly skin
Abdominal pain
Paresthesia
Seizures
```
312
What does damaging pericytes do?
They normally reculate capillary blood flow in CNS and retina. Once pericytes are damaged or destroyed, retinal capillaries become leaky (microaneurysms)
313
What is Pelvic Inflammatory Disease? Causes? Effects? Treatment?
Inflammation of the pelvis that can come from vulvovaginitis.
#1 cause is Chlamydia trachomatis, then Neisseria gonorrhoeae. Pelvic surgery, IUD, Abortion procedures, Infection with pregnancy
EFFECTS: Infertility, Chronic pain, Ectopic pregnancy
Tx: Early and aggressive antibiotic therapy
314
What are the signs and symptoms of preeclampsia?
```
Blur and preeclampsia retinopathy.
Edema of the hands/face/eyes
Sudden weight gain
Proteinuria*
Oliguria - decreased urination from glomeruli swelling
Nausea and vomiting.
```
315
```
Name disease:
Abdominal tenderness
Cervical/adnexa pain
Fever
Elevated WBC count
```
Pelvic Inflammatory Disease
316
What is diffuse axonal injury?
Rotational injury or acceleration/deceleration injury that's on a microscopic level. Lesions develop in white matter that degrade after trauma.
317
Thyroid hormones affect the cell in ____
The nucleus (the drug is lipophilic)
318
What are the S&S of prostate cancer?
```
ASYMPTOMATIC UNTIL ADVANCED STAGES
Similar to BPH (benign prostatic hyperplasia)
Urinary retention
Obstruction to flow
Decreased stream
Hesitancy
Infection due to retention
```
319
What is Disseminated intravascular coagulation (DIC)? What condition is it associated with?
High blood pressure can damage endothelial tissue can initiate widespread coagulation. Can cause strokes and ischemias. This is associated with Eclampsia
320
What has an earlier age onset? Hypo/hyperthyroidism?
Hyperthyroidism (15-40 years)
321
How is prostate cancer diagnosed?
Digital rectal exam
Serum PSA* (prostate specific antigen, but not very sensitive)
Transrectal ultrasonography
Transrectal biopsy
322
____ is used for epilepsy surgical candidates and tumor biopsy
PET scans
323
Generalized tonic-clonic seizures symptoms
Dramatic loss of consciousness, Tonic-clonic convulsions of all extremities, Incontinence, Amnesia of the event
324
Lack of ACTH causes what?
Addison's
325
Name disease: Diplopia, Ptosis, Mask-like facial
| Expression, Dysphagia, Weak voice
Myasthenia Gravis
326
What is an addisonian crisis?
Life-threatening low cortisol causing liver dysfunction and low sugar and low aldosterone causes excessive water and Na loss causing low bp, shock, and coma/death.
327
What can pinealoma cause?
Parinaud’s Syndrome/Dorsal Midbrain Syndrome
328
What is diagnosis of ALS? Treatment?
EMG, Nerve conduction studies, MRI, Serum laboratory testing. Riluzole (glutamate inhibitor).
329
Cushing disease vs syndrome….
Cushing Disease is excessive anterior pituitary secretion of ACTH; adenoma
More common in women.
Cushing Syndrome is excessive level of cortisol
330
What is common breast cancer chemo?
Tamoxifen
331
What are the S&S of prostatitis and BPH?
```
Similar to BPH (benign prostatic hyperplasia.
Urinary retention
Obstruction to flow
Decreased stream
Hesitancy
Infection due to retention
```
332
What is gonococcal conjunctivitis? How do you treat it?
Hyper-acute mucopurulent discharge (usually from Neisseria gonorrhoeae), can lead to peripheral ulcers and K perforation.
Tx with IM cephalosporin
333
What determines hormonal potency?
Concentration and receptors: specificity (fit), affinity (strength), and number
334
____ regulate capillary blood flow in the CNS and retina
Pericytes
335
What is a major cause of unconsciousness and persistent vegetative state?
diffuse axonal injury
336
Diabetes is the ___st/nd leading cause of death in the US. The leading cause of…., major contributor to….
```
7th leading cause of death in US
leading cause of:
Kidney failure
nontraumatic lower limb amputation
New cases of blindness in adults
Major contributor to: heart disease and stroke
```
337
Name disease: Resting tremors, Mask-like expression, Slow, quiet speech, Shuffling gait, Stooped posture, Rigid muscles
Parkinson's disease
338
Why do you want to taper steroid use?
To avoid Cushing syndrome (excess cortisol)
339
How do you treat cerebral palsy?
Muscle relaxants, Anticonvulsant drugs, Orthopedic surgery / appliances
340
What are the causes of hyperthyroidism?
Graves’ disease*
- Excess dietary iodine
- Thyroiditis (usually viral, but can become hypothyroidism)
- Benign thyroid or pituitary adenoma
- Tumors of the testes or ovaries (because human gonadotropin hormone can stimulate thyroid)
- Over medication of hypothyroidism
341
What are risk factors for prostate cancer?
```
Age (>50 yoa)
Race (AA>CA&HA)
Dietary factors
Hormones
Familial factors
```
342
Name condition:
| Risk factors: older, promiscuous, smoking, drug abuse, HTN
Placental Abruption
343
Why are type 5 PDE inhibitors bad with nitroglycerin?
They can compound the effects of vasodilation and cause rapid BP decrease, causing stroke!
344
Name disease: Persistent or progressive headache, Repeated vomiting or nausea, Convulsions or seizures, An inability to awaken from sleep, Dilation of one or both pupils, Slurred speech, Weakness or numbness in the extremities, Loss of coordination; Increased confusion, restlessness, or agitation
Severe TBI. Also includes mild TBI symptoms
345
What is the Dx, Tx, and complications of Hyperthyroidism?
```
Diagnosis
-Thyroid scan
-Serum TSH
-Thyroid-stimulating Ig
Treatment
-Anti-thyroid medications
-Radioactive iodine treatment
-Surgery
Complications
-Atrial fibrillation
-Osteoporosis
-Thyroid eye disease
-Edematous and erythematous skin
-Thyrotoxic crisis
```
346
CT scans are good for…
Looking at bones, space-occupying lesions, they're fast and inexpensive.
347
What is dry eye associated with?
Polycystic Ovary syndrome, Menopause
348
What kinds of infections can cause vulvovaginitis?
Bacteria, fungi, virus
349
The primary pathology of DBM is ____
Vascular damage
350
How can you get Floppy iris syndrome?
Having alpha blockers (BPH tx) can cause the iris to not dilate enough or the iris can be trapped in one place in the angle
351
What is a myelogram? What does it detect?
A neurologic test that is a dye to detect spinal tumor,
| Herniated disks, Vascular malformations, CSF leaks
352
Name disease:
| Dysmenorrhea, Excessive menstrual bleeding, Pain, Dyspareunia, Pain with defecation
Endometriosis
353
What can cause hypoparathyroidism? How is gender ratio? How tx?
```
Neck surgery*
Autoimmune disease
Radiation Tx of thyroid
Inherited disorders
Men=women
Tx: Calcium carbonate and Vitamin D
```
354
Pregnancy can cause (inc/dec) IOP
Decreased
355
TRH in the hypothalamus stimulates the pituitary gland to make TSH which stimulates the ____ to make _____
thyroid to make T4 and T3
356
Name condition: Hirsutism, Androgen excess, Infertility, Obesity, Acne, DRY EYE
Polycystic Ovary syndrome
357
What is the usual cause of urethritis?
```
USUALLY INFECTIOUS
Chlamydia trachomatis*
Neisseria gonorrhoeae
Mycoplasma genitalium
Trichomonas vaginalis
```
358
What are complications of epilepsy?
Difficulty learning, aspiration, brain damage (can be permanent), drowsiness from medication.
359
What are the causes of cervical cancer?
HPV (16 and 18)
360
Name disease:
| Periodic hemorrhage of ectopic tissue, Peritoneal irritation, Adhesion formation
Endometriosis
361
What do oral contraceptives reduce and increase?
Endometrial cancer, ovarian cancer, ectopic pregnancy, etc.
| increase risk of venous thromboembolism, MI, stroke, and gallstones
362
Causes of ICP fluctuations:
Brain edema, CSF obstructions, Intracranial hemorrhage, tumor
363
What are the late signs and symptoms of thyroid eye disease?
Exophthalmos
Persistent eyelid swelling
Diplopia
Decreased vision in one or both eyes (optic nerve compression)
364
What it sorbitol?
Glucose converts into sorbitol, causing water to come in and cause cataracts and nerve dysfunction.
It increases risk of cataracts because lens fibers swell, causing apoptosis and increased free-radical formation.
Myopic shift
365
Diabetes insipidus is a lack of what?
ADH
366
What is Guillain-Barré Syndrome? What is the cause?
Acute, idiopathic polyneuritis of the PNS. Paralysis starts in the legs and moves up. Autoimmune that triggers from GI/respiratory infection. Disrupts myelin sheaths.
367
Cushing’s Syndrome is from…
High cortisol
368
Conn’s Disease is from….
Primary hyperaldosteronism
369
1gm oral azithromycin can treat…
Chlamydia (that causes Adult inclusion conjunctivitis)
370
```
Name condition: S&S
Asymptomatic
Discharge
Dysuria
Painful intercourse
Hematuria
```
Urethritis
371
What happens in Myasthenia Gravis? Demographics?
Antibodies block or destroy acetylcholine receptor sites causing weakness. Affects women more than men
372
What are the ocular complications of Cushing Syndrome?
Cataracts
Steroid-response glaucoma
Visual field defects (if they have adenoma)
Microvascular retinopathy (DM because cortisol increase blood sugar)
Central serous choroidopathy (leaky RPE causes swelling)
373
How do you dx and tx Pheochromocytoma?
```
Diagnosis:
-Serum and urine levels of
-catecholamines
-Abdominal MRI
Treatment
-Surgery
-Alpha- and beta-blockers
```
374
What is oliguria? What condition?
Preeclampsia and
375
What is thyroperoxidase (TPO) and Thyroglobulin antibodies implicated in?
Hashimoto's (autoimmune thyroid damage) and Graves (auto-ab mimics TSH)
376
____ in urine indicates pregnancy through a ____
HCG through lateral flow Elisa test
377
Menstrual cycle days 5-14
Follicular phase
378
What can cause Excessive level of cortisol? (Cushing syndrome)
Adrenal adenoma
Adrenal carcinoma
Ectopic ACTH (cancer)
Exogenous steroid use*.
379
Which hormone is life-threatening if cut off?
ACTH because….
380
During aging, what do changes in the ovaries cause?
Depleted follicles, decreasing Estrogen and progesterone levels, degeneration in uterus and vagina
381
```
Name disease: RF
Family history of cancer*
Personal history of cancer
>55 years of age
Nulliparous
```
Ovarian cancer
382
What are common comorbidities of cerebral palsy?
Epilepsy and cognitive impairment
