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Pathology II > Path 2 Exam 2 > Flashcards

Path 2 Exam 2 Flashcards

1
Q

What are the most common pituitary tumors?

A

1 Prolactinoma (PRL)*, 2 Corticotropinoma (ACTH), 3 Somatotropinoma (GH)

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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
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3
Q

Type 1 diabetes is ___% of diabetes

A

5-10%

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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

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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)
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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

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7
Q 
Name disease S&S
 Asymptomatic until late
 Increased abdominal girth
 Weight loss
 Abdominal pain
 Dysuria or urinary frequency
 Constipation
A

Ovarian cancer

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8
Q

What hormones are found in the posterior pituitary?

A

Oxytocin, ADH

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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

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10
Q

What is the ice-pack test?

A

Icepack decreases Ach-esterase, relieving symptoms of Myasthenia Gravis. This can help diagnose MG

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11
Q

What is the first onset of bleeding (period) in females

A

Menarche

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12
Q

What are the RF for cervical cancer?

A

High parity (multiple childbirths) (4X)
Smoking (3X)
Oral contraceptive use (4X)
Unprotected sex

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13
Q

How often does Bell’s palsy happen?

A

Usually only once

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14
Q

Delivery, bed rest, and HTN management is tx for what?

A

Eclampsia

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15
Q

Where does prostate cancer typically metastasizes?

A

Bone, lymph node, lung, liver, & brain metastases more likely

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16
Q

What is the most common cause of proptosis and diplopia in adults?

A

The thyroid eye disease in Graves disease.

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17
Q 
Name disease: RF
 High parity (multiple childbirths)
 Smoking
 Oral contraceptive use
 Unprotected sex
A

cervical cancer

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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

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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
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20
Q

What is the most common form of Non-cutaneous cancer?

A

Breast cancer

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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

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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

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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

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24
Q

Who is at greatest risk for pelvic inflammatory disease?

A

Sexually active women under 25

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25
Q

What is the main purpose of the thyroid gland?

A

It regulates the basal metabolic rate.

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26
Q

Menstrual cycle days 14-28

A

Luteal phase

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27
Q

What hormones change during pregnancy?

A

Human chorionic gonadotropin, estrogen, progesterone. adrenocortical
HCG changes thyroxine 15% higher,

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28
Q

Name condition: Usually asymptomatic, Pain, Urinary retention, Menstrual irregularity

A

ovarian cysts

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29
Q

What is Endometriosis? Signs and symptoms? Risk factors? Effects? Tx?

A

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.

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30
Q

What is Duchenne muscular dystrophy?

A

x-linked early onset (3-5 years). Absence of dystrophin. Pseudohypertrophy (muscle replaced with fat). Death by early 30s

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31
Q

Generalized absence seizures symptoms

A

Staring spell, brief, immediate recovery

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32
Q

What is non-spastic cerebral palsy?

A

Damage outside of pyramidal tracts. 20% of cases. Hypotensicity and ataxia.

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33
Q

What is Pheochromocytoma?

A

Tumor of the adrenal medulla that causes secretion of excess catecholamines (NE)
90% benign /10% malignant.

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34
Q

DBM =≥ __mg/dL after 2 hour glucose bolus

A

200

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35
Q

Pheochromocytoma is from…

A

Excessive production and release of catecholamines

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36
Q

Pregnancy can cause (inc/dec) tear production

A

Decreased

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37
Q

DMB= ≥___ mg/dL for random reading of Blood glucose

A

200

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38
Q

Snowflake cataracts are more commonly found in _____

A

Type 1 diabetics

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39
Q

What is metabolic syndrome?

A

a cluster of biochemical and physiological abnormalities associated with the development of cardiovascular disease and type 2 diabetes.

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40
Q

What is tx of prostate cancer?

A

Watchful waiting (see if there is progression if pt is older)
Surgery
93% 15-year survival rate

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41
Q

Which prostatitis is the most common?

A

Chronic prostatitis, the non-bacterial version

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42
Q

What can rotational injury or acceleration/deceleration injury cause?

A

diffuse axonal injury

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43
Q

What’s the tx of pituitary adenoma?

A

Surgery or medication (to reduce hormone level in blood)

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44
Q

What can cause white dots in palpebral conj?

A

Conjunctival concretions of hyperparathyroidism

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45
Q

How do you diagnose Hashimoto’s Thyroiditis? Tx? Untreated complications?

A 
Dx: Anti-TPO (thyroperoxidase ) antibody titers, Serum TSH high, low T3, low T4.
 Tx: Levothyroxine (Synthroid)
 Complications:
 Cardiomegaly
 Heart failure
 Pleural effusion
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46
Q

Name condition: RF: obesity, young age

A

Polycystic Ovary syndrome

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47
Q

When should you call 911 for a seizure?

A

When it lasts for more than 10 minutes

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48
Q

TRH in the hypothalamus stimulates the ______ to make ___ which stimulates thyroid to make T4 and T3

A

the pituitary gland to make TSH

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49
Q

Pineal gland produces ____

A

Melatonin

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50
Q

What is Ophthalmia neonatorum? S&S? tx? Prevent?

A 
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
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51
Q

1st and 2nd leading cause of death from cancer in children?

A

1st Leukemia, 2nd is brain tumors.

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52
Q

What does parathyroid hormone do?

A

Increases osteoclast activity
Increases Ca reabsorption by kidneys
Increase Ca uptake by intestines

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53
Q

What does LH trigger?

A

It triggers ovulation and conversion of follicle to corpus luteum

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54
Q

What is Chronic Traumatic Encephalopathy?

A

Progressive degenerative disease of the brain from Accumulation of tau protein in neurons. From repeated brain injury.

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55
Q

What is the order of thyroid tests? (detail)

A 
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%)
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56
Q

What is the tx for Cushing’s syndrome?

A

Discontinue steroids
Surgery
Radiation
Medication

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57
Q

Name disease:
Muscle Spasms, Poor balance
Frequent falls, Inability to walk, Drooping eyelids, Scoliosis, Joint contractures, Restrictions of mobility, Respiratory difficulty*, Arrhythmias, Cardiomyopathy

A

Muscular Dystrophy

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58
Q

Name disease: weakness that worsens with activity?

A

Myasthenia Gravis

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59
Q

Absence of monthly flow is…

A

Amenorrhea

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60
Q 
Bladder incontinence
 Impotence
 Diarrhea
 Perspiration
 can indicate what?
A

Autonomic neuropathy (Diabetic)

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61
Q

What are sunset eyes?

A

Parinaud’s Syndrome/Dorsal Midbrain Syndrome.

The eyes bulge in pediatric hydrocephalus, causing white of eye to be shown in upper eye.

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62
Q

What are the adrenal disorders?

A

Cushing’s Syndrome, Addison’s Disease, Conn’s Disease, Pheochromocytoma

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63
Q

What are most common causes of head injuries?

A

Car accidents, falls, assaults

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64
Q

Causes of viral meningitis?

A

Enteroviruses, HSV 2, Varicella zoster, Mumps, Influenza, HIV

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65
Q

What causes Alzheimer’s disease?

A

Buildup of amyloid plaques and neurofibrillary tangles

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66
Q

Diabetic neuropathy affects ____% of diabetics

A

60-70%

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67
Q

What results indicate diabetes?

A

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

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68
Q

What med can cause issues during surgery?

A

Alpha blockers (you get poor dilation during surgery)

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69
Q

What are the risk factors of brain tumors?

A

Ionizing radiation, Immunosuppression, Hereditary syndromes

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70
Q

Too heavy menstrual flow is

A

Menorrhagia

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71
Q

What is the most common cause of hypothyroidism in the US? In the world?

A

Hashimoto’s thyroiditis. Iodine deficiency

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72
Q

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

A

Mild TBI

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73
Q

What is the goal of HBA1c levels for diabetic patients?

A

Get them below 6.5%

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74
Q

Acromegaly vs gigantism? Acromegaly symptoms? How do you diagnose and treat acromegaly?

A

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

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75
Q

What are ovarian cysts? Signs and symptoms? Treatment?

A

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

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76
Q

What is the most common form of breast cancer? What %?

A

74-80% are Ductal carcinoma.

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77
Q

What can cause hypertensive crisis?

A

Pheochromocytoma

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78
Q

Why is increased protein kinase C in diabetes bad? It causes….

A

Vasoconstriction of smooth muscle
Vascular permeability
Basement membrane thickening
Abnormal angiogenesis (enhances VEGF)

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79
Q

Papilledema can indicate what?

A

Early sign of increased cranial pressure, Brain tumors

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80
Q

Qualitative diagnoses for metabolic syndrome:

A

High blood glucose, high TG, Low HDL, HTN, large waistline, large waistline and apple shape

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81
Q

What leads reproductive cancer deaths?

A

Ovarian cancer

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82
Q

Chronic red eye that can cause foreign body sensation can be….

A

Adult inclusion conjunctivitis

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83
Q

What are RF for T1D?

A

-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

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84
Q

Chlamydia trachomatis, then Neisseria gonorrhoeae. Pelvic surgery, IUD, Abortion procedures, Infection with pregnancy CAN CAUSE

A

Pelvic Inflammatory Disease

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85
Q

What is hirsutism associated with?

A

Abnormal hair growth in Polycystic Ovary Syndrome

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86
Q

What does the corpus luteum secrete?

A

Progesterone and estrogen

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87
Q

What is Premenstrual syndrome?

A

Affects 80% in the second half of cycle. (day 14-28)

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88
Q

What is the most common cause of death in Alzheimer’s disease?

A

Bronchopneumonia

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89
Q 
Name disease:
 Numbness or tingling,
 Unexplained weakness or
 Fatigue,
 Double vision,
 Decreased acuity
A

Early symptoms of MS

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90
Q

What are infectious disorders of the CNS?

A

Treponema pallidum (syphilis) and Borrelia bacteria (lyme disease)

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91
Q

What is premature ovarian failure?

A

Menopause before the age of 40. 1% women

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92
Q

Name condition:

Effects: pain, vaginal bleeding, prematurity, mortality

A

Placental Abruption

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93
Q

Coup vs contrecoup

A

Coup is head struck, contrecoup is rebound on opposite side of skull.

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94
Q

What are the primary brain tumor types? What are the secondary brain tumor types?

A

Glioma (30%), meningioma (benign), pituitary adenoma (benign), and nerve sheath tumors. Secondary is from lung (48%), breast, urogenital, osteosarcoma

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95
Q

Causes of bacterial meningitis? What complications can happen?

A

Strep. Pneumoniae*, Neisseria meningitides, H. influenzae type b. Hearing loss and brain damage

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96
Q

Symptoms of Bell’s Palsy

A

Unilateral facial droop (eyelid does not close), diminished eye blink, hyperacusis, decreased lacrimation

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97
Q

Some blue light retinal fibers project to the ___

A

Pineal gland!

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98
Q 
These can cause…..
 Candida albicans*
 Trichomonas vaginalis
 Haemophilus vaginalis
 Neisseria gonorrhoeae
 Human papillomavirus
 (HPV)
 Herpes Virus type 2
A

Vulvovaginitis

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99
Q

DBM = ≥___% HbA1c level

A

6.5

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100
Q

How do you diagnose Myasthenia Gravis?

A

Tensilon (Edrophonium) /ice-pack test, Electromyography (EMG), Anti-ACH receptor Abs

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101
Q

What are the symptoms of Tay-Sach’s disease? At what age does it start?

A

Motor development delay, Flaccid paralysis, Mental impairment, Blindness, Death. Starts at 6 months of age.

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102
Q

Purpose of CSF?

A

Buoyancy, Protection, Chemical stability, Prevention of brain ischemia (if BP falls, CSF production can also fall to facilitate blood flow)

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103
Q

Name disease: Pain, Bleeding, Local compression

A

Fibroid or Uterine leiomyoma

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104
Q

What are the ocular manifestations of Hypothyroidism?

A 
1 *Eyebrows; Outer 1/3 missing
 2 SLK (superior conj injection)
 ~50% cases have thyroid issues
 3 Exophthalmos (but more common with hyperthyroidism)
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105
Q

If Guillain-Barré Syndrome is antibody-mediated autoimmune, what hypersensitivity type is it?

A

II

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106
Q

RF breast cancer?

A 
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
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107
Q

What is Placental Abruption? Effects? Etiology? Risk factors?

A

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

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108
Q

What surprising physiological changes happen during pregnancy?

A

Relaxin changes uterus, laxity (loosening of ligaments and joints), increased RBC (30%)

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109
Q

The two most important RF for T2D is…

A

Obesity and sedentary lifestyle

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110
Q

Cataracts can happen in what disease?

A

Hypoparathyroidism

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111
Q

Which disease? Risk factors: Chemical irritation, Trauma, allergic reactions, antibiotic therapy

A

Vulvovaginitis

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112
Q

What is the key to diagnose testicular cancer?

A

Self exams are the key to diagnosis until age 45

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113
Q

Which demographic has higher rates of diabetes?

A

AA females and native americans

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114
Q

______ is the #1 cause of End-stage renal disease

A

Diabetes

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115
Q

What are the signs and symptoms of Cervical cancer?

A

Abnormal vaginal bleeding
Persistent vaginal discharge
Pain and bleeding after intercourse

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116
Q

What is TSH-receptor antibody implicated in?

A

Graves disease

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117
Q

RF for gestational DM?

A

Race: AA, H/L, NA. Obesity, Family history of DM

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118
Q

_____ can cause regular menstrual cycle with extra bleeding

A

Uterine problems and systemic disorders

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119
Q

What does Huntington’s disease affect? What kind of inheritance?

A

Basal ganglia and cortex. Autosomal dominant

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120
Q

What are the causes of epilepsy?

A

Idiopathic, Stroke, Dementia, TBI, Infections, Tumors, Congenital defect or perinatal brain injury

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121
Q

__% of 20 year MS pts are not disabled and can still walk. They typically have a(n) _____ lifespan

A

66%. Normal lifespan

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122
Q

How does Alzheimer’s affect genders?

A

Women more than men

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123
Q

Which EOMS are more likely to be affected in thyroid eye disease

A

IM SLO. Inferior is the most affected

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124
Q

How many Americans have prediabetes? What percentage will progress to type II within 10 years?

A

80 million. 50%

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125
Q

Menstrual cycle: ovulation day

A

Day 14

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126
Q

What pushes preeclampsia into eclampsia?

A

Seizures

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127
Q

What is normal pressure hydrocephalus?

A

Normal pressure but abnormal CSF volume

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128
Q

Neisseria gonorrhoeae can cause….

A

gonococcal conjunctivitis (Hyper-acute mucopurulent discharge)

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129
Q

What are the 3 categories of microvascular damage from DBM?

3 macrovascular damage?

A

Retinopathy, nephropathy, neuropathy

Coronary artery disease, Peripheral artery diease, cerebrovascular disease

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130
Q

Partial Simple seizures symptoms

A

Have no loss of awareness and have limited symptoms

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131
Q

Inflammation of the 7th cranial nerve is…

A

Bell’s palsy

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132
Q

Chorea is a symptom of what?

A

Huntington’s disease. Chorea is involuntary writhing movements.

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133
Q

What happens during menopause?

A

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

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134
Q

Chlamydia trachomatis can cause…

A

Urethritis, Adult inclusion conjunctivitis

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135
Q

What is treatment of Bell’s palsy?

A

Spontaneous recovery, steroids for inflammation. Make sure it’s not a stroke, infection, or trauma, tumor.

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136
Q

What else is a major endocrine gland?

A

The placenta

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137
Q

What are the symptoms of diabetes?

A 
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
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138
Q

Macrovascular diabetic disease ultimately leads to accelerated _____

A

Atherosclerosis

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139
Q

__% of the US population have diabetes

A

9% (30 million)

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140
Q

What is Krukenberg spindles?

A

release of posterior iris pigment deposits in lower 3rd of corneal endothelium, rarely can clog Trab M. (rare ocular change in pregnancy)

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141
Q

Cause of encephalitis? Signs and symptoms? How is treatment?

A

Usually viral: Herpes simplex 1 & 2, Arboviruses, Rabies virus. Seizures, stupor, coma. Supportive treatment

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142
Q

What is the 1st and 2nd most common neurodegenerative disorders?

A

Alzheimer’s (1) and Parkinson’s (2)

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143
Q

What is the most common cause of dementia?

A

Alzheimer’s disease

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144
Q

What is thyroid disease gender ratio?

A

F > M

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145
Q

What is the blood pressure requirement for Preeclampsia?

A

140/90 after 20 weeks.

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146
Q

What are the ocular manifestations of preeclampsia?

A

Blur and preeclampsia retinopathy

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147
Q

What is Thyroid eye disease? What age typically?

A

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

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148
Q

Prostate screening?

A

Annually over 50, 45 at high risk

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149
Q

What is Pituitary Apoplexy? Most common causes? Symptoms (2 important ones)?

A

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)

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150
Q

Type ___ Diabetes is a polygenic disorder. Genes + environment

A

Type 2

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151
Q

What female disease can increase risk of prediabetes?

A

Having huge babies, Polycystic ovary syndrome

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152
Q

Name disease:

Muscle spasms, Pain, Slurred speech, Blindness, Paralysis, Cognitive decline

A

Late symptoms of MS

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153
Q

What is the cause of Bell’s palsy?

A

Inflammatory response after viral infection of (Varicella zoster virus, EBV, herpes simplex I)

154
Q

Irregular but frequent periods is..

A

Metrorrhagia

155
Q

How can you tell difference between malignant and benign tumors?

A

Malignant has inflammation and edema, starts to distort the brain tissue.

156
Q

What is eclampsia? What are the complications? Treatment and prevention?

A

Seizures during preeclampsia.
Complications: Placental abruption, premature delivery, Disseminated intravascular coagulation (DIC)
Tx: Delivery, bed rest, and HTN management

157
Q

Early and late Signs and Symptoms of Increased intracranial pressure:

A

Early: Vomiting, Headache, Papilledema.

Late: Bradycardia, HTN, Respiratory changes, Herniation

158
Q

Hb ___ can help diagnose DBM

A

A1c

159
Q

What is a fibrocystic breast tissue?

A

Palpable breast mass that fluctuates with menstrual cycle (at older than 30-50 years)

160
Q

What are the common (4) and uncommon (5) changes in pregnancy?

A 
-----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
Q

How do you treat Myasthenia Gravis?

A

Ach-esterase inhibitor, thymectomy, plasmapheresis (remove offending autoantibodies)

162
Q

DBM = higher than ___mg/dL FBG

A

125

163
Q

What is communicating vs noncommunicating hydrocephalus?

A

Communicating, excess CSF can exit but there is reabsorption problem, noncommunicating is where there is an obstruction

164
Q

What is the rule of 90s for testicular cancer?

A

90% are germ cell tumors
90% occur between 25 and 45 years of age
90% of tumors are malignant
90% are curable

165
Q

What causes diabetic ketoacidosis?

A

No insulin > liver breaks down even more glucose > fatty acids are broken down > ketones are produced

166
Q

What can cause macular crystalline deposits?

A

Tamoxifen (breast cancer tx)

167
Q

Name disease: Memory loss, Confusion, Aggression, Depression, Dementia, Impulse control problems

A

Chronic Traumatic Encephalopathy

168
Q

What is the Tensilon test?

A

Helps diagnose Myasthenia Gravis by disabling Ach esterase

169
Q

_____ is the most common diabetic neuropathy?

A

Peripheral neuropathy

In the toes, feet, legs, arms, hands

170
Q

Cause: Sudden fever, Stiff neck

Headache, Altered mental status

A

Meningitis

171
Q

____ and ____ (hormone) prevents periods

A

Estrogen and progesterone

172
Q

What are the early and signs and symptoms of thyroid eye disease?

A 
Foreign body sensation
 Redness
 Tearing
 Photophobia
 Morning puffiness of the eyelids
173
Q

What is most commonly associated with Thyroid Eye Disease?

A

Graves disease

174
Q

What is traumatic pneumocephalus?

A

Air moves to the subdural space from injury to a nasal sinus. This can cause cerebrospinal rhinorrhea?

175
Q

What is Amyotrophic Lateral Sclerosis? What are the clinical manifestations? What are the risk factors of ALS?

A

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
Q

What are S&S of fibrocystic breast changes?

A

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
Q 
Name condition:
 Osteoporosis
 Accelerated
 atherosclerosis*
 Macular degeneration
 Cognitive impairment
A

Long-term estrogen deprivation from menopause

178
Q

What are RF of Diabetic retinopathy?

A

DM
Smoking
HTN
Pregnancy

179
Q

Painful, difficult menstruation is

A

Dysmenorrhea

180
Q

5 year survival rate of breast cancer is ____% with no lymph involvement.
5 year survival rate is ___% with metastasis

A

98%

26%

181
Q

How do you treat diabetes insipidus?

A

Treat with oral ADH. The pee is too dilute

182
Q 
Name disease:
 Digital rectal exam
 Serum PSA*
 Transrectal ultrasonography
 Transrectal biopsy
A

Prostate cancer

183
Q

Too light menstrual flow and irregular periods is…

A

Oligomenorrhea

184
Q

Low Ca causes secretion of ____ by ____

A

Parathyroid hormone by parathyroid

185
Q

What is Gardasil?

A

It’s a 3 shot series to protect against cervical cancer

186
Q

What causes reduced capillary permeability in the BBB?

A

Endothelial tight junctions and Thickened basement membrane

187
Q

What are the AE Of type 5 PDE inhibitors?

A 
Headache
 Facial flushing
 Blue vision
 Dyspepsia (indigestion)
 Nasal congestion
 Concern if also taking nitroglycerin
 Non-arteritic ischemic optic neuropathy
188
Q

What is placental Previa?

A

Growth of the placenta over the cervical opening.

189
Q

What is a lumbar puncture good for?

A

Punting air, dye, or medications in. Sampling CSF

190
Q

What are the causes of hypothyroidism?

A

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
Q

_____ is the Leading cause of renal failure due to ______

A

Diabetic Nephropathy is the Leading cause of renal failure due to glomerulosclerosis

192
Q

___ in the ____ stimulates the pituitary gland to make TSH which stimulates thyroid to make T4 and T3

A

TRH in the hypothalamus

193
Q

What are S&S of breast cancer?

A 
Persistent lump / thickening
 Dimpling of the skin
 Nipple retraction
 Changes in breast contour
 Redness on breast or nipple
 Bloody discharge from nipple
194
Q 
Symptoms of what??
 Emotional changes
 Fatigue
 Bloating
 Headaches
 Appetite changes
 Painful and swollen Breasts
 Swelling of hands and feet
A

Premenstrual cycle syndrome

195
Q

Hypo/hyper thyroidism is more common than the other?

A

Hypothyroidism is more common

196
Q

What is cerebral angiography?

A

Injection of contrast through the femoral artery. Visualize the cerebral arteries and assess for lesions

197
Q

What are Fibroids? Signs/symptoms? Tx?

A

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
Q

Hypo/hyperthyroidism has familial associations?

A

Hyperthyroidism

199
Q

What is concussion vs contusion?

A

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
Q

What are the symptoms of Diabetic Ketoacidosis?

What complications can occur?

A 
Altered mental status (from brain swelling)
 “Fruity” smelling breath (acetone)
 Hyperventilation (Kussmaul breathing)
 COMPLICATIONS:
 Cerebral edema
 Coma
 Death
201
Q

Antibiotic therapy can change the microbiota of the vagina and cause….

A

Vulvovaginitis

202
Q

What are the demyelinating diseases?

A

Leukodystrophy, MS, and Guillain-Barré Syndrome

203
Q 
Name disease: TX
 Hysterectomy
 Radiation therapy
 Chemotherapy
 Prophylactic oophorectomy or salpingo-oophorectomy
A

Ovarian cancer

204
Q

Which Leukodystrophy is x-linked?

A

Adrenoleukodystrophy

205
Q

Tx of Guillain-Barré Syndrome?

A

Plasmapheresis (separating antibodies), IV immunoglobulin (removes autoantibodies), Supportive, Spontaneous recovery (usually)

206
Q

Which hormone begins the menstrual cycle?

A

FSH

207
Q

20% of ___+ year olds have diabetes

A

55 years +

208
Q

What are the 5 types of endocrine disorders?

A

Hypo/hyperfunction of a gland, then receptor defect, primary or secondary messenger defect

209
Q

Partial complex seizures symptoms

A

Loss of awareness, automatisms (lip-smacking, etc)

210
Q

What are natural protective barriers against prostatitis?

A

Long urethra, urination, ejaculation

211
Q

What can diabetes cause?

A

Cerebrovascular disease
diabetic retinopathy
coronary heart disease
Nephropathy
Neuropathy
peripheral vascular disease in the lower limbs
ulceration and amputation for diabetic foot

212
Q

MS: __% asymptomatic or mildly symptomatic after diagnosis. __% rapidly progress. __% mild to moderately symptomatic

A

20% asymptomatic or mildly symptomatic after diagnosis. 20% rapidly progress. 60% mild to moderately symptomatic

213
Q

Pregnancy can cause (inc/dec) corneal curvature

A

Increased

214
Q

VHL …..

A

….prevents the growth of tumors

215
Q

Name disease:

EFFECTS: Infertility, Chronic pain, Ectopic pregnancy

A

Pelvic Inflammatory Disease

216
Q

Name disease:
Abnormal vaginal bleeding
Persistent vaginal discharge
Pain and bleeding after intercourse

A

Cervical cancer

217
Q

What is the diagnosis for Metabolic Syndrome? Numbers

A 
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
Q

What is Sheehan’s syndrome?

A

Woman bleeds too much in childbirth causing a stroke of the pituitary

219
Q

What is Swelling of lower legs legs?

A

Myxedema

220
Q

What are the common symptoms of Cushing’s syndrome?

A

Truncal obesity, moon face, buffalo hump, skin atrophy, collagen breakdown causing “Stretch marks”, facial hair growth

221
Q

T4 and T4 is stored in the ____ and there is a storage that can last for _____ months

A

Colloid and can last for 2-3 months

222
Q

Name disease:
RISK FACTORS
childless and over 30-40 years

A

Endometriosis

223
Q

What is relapsing-remitting MS? What % is progressive MS?

A

90% of MS respond well to treatment. MS goes into remission (but can come back). Progressive is 20%

224
Q

What’s the ocular manifestation of pituitary adenoma?

A

Tunnel vision (Bitemporal visual field loss). Defect starts superior then spreads inferior

225
Q

Who shouldn’t take oral contraceptives?

A

Smokers, liver disorders, coronary heart disease, and breast cancer patients

226
Q

What are the risk factors for preeclampsia?

A 
First pregnancy
 Multiple pregnancy
 Obesity
 >35 years of age
 Hx of diabetes, HTN, kidney disease
227
Q

Low vitamin D or light can cause ___in children or ____ in adults

A

“Rickets” in children

“Osteomalacia” in adults

228
Q

How do you diagnose MS? How tx MS?

A

2 or more attacks and MRI showing lesions. Tx Immunosuppression, Amino acid injections, Corticosteroids, Management of symptoms

229
Q

What causes a cherry red spot in the macula?

A

Lysosomal storage disease (Tay-Sach’s)

230
Q

What does proteinuria strongly indicate?

A

Eclampsia

231
Q

What is a molar pregnancy/hydatidiform mole? What are the signs and symptoms? Treatment?

A

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
Q

What is typical head trauma called?

A

Closed (blunt) head trauma

233
Q

What is the treatment of choice for ED?

A

Type 5 phosphodiesterase inhibitors, they prevent degradation of cGMP to increase NO

234
Q

Outer 1/3 eyebrows missing can indicate….

A

Hypothyroidism

235
Q

What are symptoms of syncope prodrome?

A

Dizziness, loss of vision/hearing, weakness, pallor, clammy skin, nausea.

236
Q

Tay-Sachs disease is what type?

A

Lysosomal storage disease, inherited metabolic disorder. Systemic affecting neurons, too.

237
Q

What thyroid hormone is more plentiful?

A

T4 is more plentiful than T3

238
Q

What are the causes of hypopituitarism?

A

Tumor, Infarctions (trauma/TBI, DM, etc.), radiation, Surgery, Postpartum Hemorrhage (Sheehan’s Syndrome)

239
Q

What are causes of syncope?

A

Fainting can be from orthostatic hypotension, vasovagal syncope (standing too long, anxiety of needles, space monkeys), cardiogenic syncope

240
Q

How is epilepsy diagnosed?

A

2 or more unprovoked seizures typically required for diagnosis

241
Q

What is Parinaud’s Syndrome/Dorsal Midbrain Syndrome? What are the signs sympoms?What’s the cause?

A

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
Q

What are leukodystrophies? What diseases they include? What kind of cell death?

A

Progressive disruption of myelin sheaths. Metachromatic Leukodystrophy (MLD), Adrenoleukodystrophy. The cells die causing inflammation.

243
Q

What symptoms of Alzheimer’s are early vs. late stage?

A

Early is memory loss and disorientation, Late is motor loss and aphasia.

244
Q

What is the problem with ED?

A

Weak parasympathetic signal or little NO release

245
Q

What can happen in long-term estrogen deprivation?

A 
Osteoporosis
 Accelerated
 atherosclerosis*
 Macular degeneration
 Cognitive impairment
246
Q

IM cephalosporin can treat…

A

gonococcal conjunctivitis

247
Q

What are the ocular manifestation of Parkinson’s?

A

Decreased blink rate, blepharospasm, decreased convergence amplitudes.

248
Q

What are tx of fibrocystic breast tissue?

A 
Analgesia
 Heat or cold for swelling
 Well-fitting bra
 Oral contraceptive
 Danazol
249
Q

RF for diabetic nephropathy?

A

*Hyperglycemia
*Hypertension
Genetic predisposition
Hypercholesterolemia
Smoking

250
Q

What Increases risk of bleeding during labor and delivery because of growth of the placenta over the cervical opening.

A

placental Previa

251
Q

What is Adult inclusion conjunctivitis? From what? How tx?

A

From Chlamydia, it’s a Conjunctivitis that does not respond to topical meds.
Follicles in inferior conj. Treated w/ 1gm oral azithromycin.

252
Q

What are the neurologic tests for brain tumors?

A

Myelogram

253
Q

Symptoms can be what?

HA, VF change, VA loss

A

Pituitary Adenoma

254
Q

What are the effects of chronic hyperglycemia?

A

1 Glycation of proteins
2 Excess sorbitol in cells
3 Increased activation of Protein Kinase C

255
Q

What is the classic triad of meningitis? Which meningitis is more common?

A

Sudden fever, stiff neck, HA, (altered mental status). Viral is most common (but bacteria, fungi, and parasites can cause it too)

256
Q

When is it best to start mammograms?

A

Age 40-50 annually until 75 or when have 7 years left

257
Q

PETs are good for….

A

Showing function rather than structural.

258
Q

Addison’s Disease is from…

A

Low cortisol and/or low aldosterone

259
Q

How is Huntington’s diagnosed?

A

MRI

260
Q

What antagonizes insulin?

A

Estrogen/progesterone! = gestational diabetes

261
Q

What is the most prevalent noncutaneous cancer in men?

A

Prostate cancer

262
Q

What is Addison’s disease? What causes Addison’s disease? How diagnose?

A

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
Q

What is spastic Cerebral palsy?

A

Upper motor neuron damage. 70-80% of cases. Has hypertonic, tense muscles

264
Q

High FSH and LH can indicate what?

A

Menopause

265
Q

What are signs and symptoms of Pheochromocytoma?

A 
Hypertension
 Headache
 Flushing
 Diaphoresis
 Tachycardia
 Heat intolerance
 Weight loss
266
Q

What are they important symptoms of hypothyroidism?

A 
Lethargy
 Cold intolerance
 Bradycardia
 Goiter
 Decreased appetite
 Constipation
267
Q

What disease does not affect personality or eyesight

A

Amyotrophic lateral sclerosis

268
Q

What is the tx BPH?

A

Medication (alpha-blockers), surgery. Eunuchs don’t get it!

269
Q

What disease is non-inflammatory disease of striated muscle?

A

Muscular dystrophy

270
Q

What are other ocular manifestation of DM?

A

Myopic shift, 2x glaucoma risk, decreased corneal senstivity, CN 2-7 palsies, macular edema, diabetic retinopathy

271
Q

Blue vision can be from….

A

Type 5 PDE inhibitors (ED treatment). Affects blue cones. Concerning for pilots!

272
Q

What does a goiter happen?

A

Mostly in Hypothyroidism (and also hyperthyroidism)

273
Q

Menstrual cycle days 1-4

A

Menstrual phase

274
Q

How do you treat pituitary adenomas?

A

Radiation or surgery

275
Q

Hba1c can indicate average blood glucose concentration over ______(time)

A

2-3 months

276
Q

___ is the #1 cause of death in Type 1 diabetics?

A

diabetic nephropathy

277
Q

MRIs are good for…

A

Soft tissue, safety (not ionizing)

278
Q

What are the sites of infection for pelvic inflammatory disease?

A

Salpingitis (oviducts)

Oophoritis (ovaries)

279
Q

What is the MOA od diabetic neuropathy?

A

Demyelination

280
Q

What is the most common causes of death in people with type 2 DM?

A

Coronary artery disease (leading to MI) and strokes

281
Q

Metachromatic Leukodystrophy (MLD) is a deficiency in the activity of ___

A

Arylsulfatase (affects white matter)

282
Q

What is Vulvovaginitis? Symptoms? Risk factors? Cause?

A

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
Q

What does endothelial glycosylation of DBM do?

A

1 damage
2 BM thickens
3 Can cause obstruction/rupture of capillaries or small arteries

284
Q

What are the effects of Hormone replacement therapy?

A 
Hormone replacement therapy, but now long-te
 Decreases risk of:
 -Osteoporosis
 -Colorectal cancer
 Increases risk of:
 -Breast cancer
 -Stroke
 -Myocardial infarctions
285
Q

What can be the cause of a constant runny nose?

A

Traumatic pneumocephalus. CSF leaks out of nose

286
Q

Incidence of DM retinopathy increases with _____ of DM

A

Duration

287
Q

Which disease? Symptoms: Discharge, Erythema, Edema, Intense itching

A

Vulvovaginitis

288
Q 
Name disease:
 In infant...
 Bilateral
 Edema
 Chemosis
 Mucopurulent discharge
A

Ophthalmia neonatorum

289
Q

What are risk factors for ED?

A

Age
Vascular disease (Atherosclerosis, HTN, Diabetes, etc.)
Medications
Endocrine problems

290
Q

What is the order of thyroid tests? (wo/detail)

A

1 *Thyroid Panel: TSH, free T4, free T3
2 *Thyroid Stimulating Immunoglobulin
3 Thyroglobulin antibodies
4 TPO (thyroperoxidase) antibodies

291
Q

What are different level types of hormones?

A

Constant level, variable level, and cyclical

292
Q

What is a focal neuropathy?

A

It’s a neuropathy of any nerve in the body, but this is important for optometry because of cranial nerve palsies

293
Q

What is the most common cause of adult pituitary dysfunction?

A

Pituitary adenoma.

294
Q

What do oral contraceptives suppress? Progestins suppress what?

A

FSH, preventing ovulation.

Progestins suppress LH, blocking ovulation, thickening cervical mucus, reducing ovum and thinning endometrium

295
Q

What is the gold standard for evaluating acute brain injury?

A

Glasgow coma scale.

296
Q

What does the Glasgow coma scale include?

A

Eye opening, motor response, verbal response

297
Q

What is the most common uterine tumor?

A

Fibroids or Uterine Leiomyomas

298
Q

What are the risk factors of Myasthenia Gravis?

A

Thyroid diseases, Diabetes mellitus Type 1, Rheumatoid arthritis, Lupus, Demyelinating CNS diseases

299
Q

What can cause osteoporosis?

A

Hyperthyroidism causes excess calcitonin which breaks down bone

300
Q

What is used for diagnosis of ovarian cancer?

A

CA-125

301
Q

What is hyperacusis a symptom of?

A

Bell’s palsy

302
Q

What complications can happen during pregnancy?

A 
Gallstone formation
 Coagulopathies
 Transient hypotension
 Morning sickness (1st trimester)
 Frequent urination
 Immunosuppression leads to
 -Sinus congestion
 -Gingivitis
 Decreased gastrointestinal motility (constipation)
 Peripheral edema
303
Q

You will minimize risk of diabetic retinopathy with a HbA1c of ___% or lower

A

7%

304
Q

What is cerebral palsy?

A

Group of syndromes. Permanent, non-progressive damage to motor control areas of the brain

305
Q

What are the fasting plasma glucose for normal, prediabetes, and diabetes?

A

Prediabetes is 100-125 mg/dL

306
Q

___% of breast cancer is inherited? ___% are estrogen-responsive?

A

5-10% 66% are estrogen-responsive, meaning cancer has estrogen receptors on them.

307
Q

Pregnancy can cause (inc/dec) corneal sensitivity

A

Decreased

308
Q 
S&S
 nervousness
 sweating
 tremor
 HA
 Confusion
 Loss of consciousness with decreased respiratory
A

Hypoglycemic emergency (#1 cause of this is insulin overdose)

309
Q

What is graves disease?

A

Excess secretion of thyroid hormone because of antibody that stimulates TSH receptor. It is most commonly associated with thyroid eye disease

310
Q

___% of MS patients have ocular symptoms

A

66% (optic neuritis)

311
Q

What are the signs and symptoms of hypoparathyroidism?

A 
Muscle cramps and spasm**
 Brittle nails
 Dry hair
 Dry, scaly skin
 Abdominal pain
 Paresthesia
 Seizures
312
Q

What does damaging pericytes do?

A

They normally reculate capillary blood flow in CNS and retina. Once pericytes are damaged or destroyed, retinal capillaries become leaky (microaneurysms)

313
Q

What is Pelvic Inflammatory Disease? Causes? Effects? Treatment?

A

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
Q

What are the signs and symptoms of preeclampsia?

A 
Blur and preeclampsia retinopathy.
 Edema of the hands/face/eyes
 Sudden weight gain
 Proteinuria*
 Oliguria - decreased urination from glomeruli swelling
 Nausea and vomiting.
315
Q 
Name disease:
 Abdominal tenderness
 Cervical/adnexa pain
 Fever
 Elevated WBC count
A

Pelvic Inflammatory Disease

316
Q

What is diffuse axonal injury?

A

Rotational injury or acceleration/deceleration injury that’s on a microscopic level. Lesions develop in white matter that degrade after trauma.

317
Q

Thyroid hormones affect the cell in ____

A

The nucleus (the drug is lipophilic)

318
Q

What are the S&S of prostate cancer?

A 
ASYMPTOMATIC UNTIL ADVANCED STAGES
 Similar to BPH (benign prostatic hyperplasia)
 Urinary retention
 Obstruction to flow
 Decreased stream
 Hesitancy
 Infection due to retention
319
Q

What is Disseminated intravascular coagulation (DIC)? What condition is it associated with?

A

High blood pressure can damage endothelial tissue can initiate widespread coagulation. Can cause strokes and ischemias. This is associated with Eclampsia

320
Q

What has an earlier age onset? Hypo/hyperthyroidism?

A

Hyperthyroidism (15-40 years)

321
Q

How is prostate cancer diagnosed?

A

Digital rectal exam
Serum PSA* (prostate specific antigen, but not very sensitive)
Transrectal ultrasonography
Transrectal biopsy

322
Q

____ is used for epilepsy surgical candidates and tumor biopsy

A

PET scans

323
Q

Generalized tonic-clonic seizures symptoms

A

Dramatic loss of consciousness, Tonic-clonic convulsions of all extremities, Incontinence, Amnesia of the event

324
Q

Lack of ACTH causes what?

A

Addison’s

325
Q

Name disease: Diplopia, Ptosis, Mask-like facial

Expression, Dysphagia, Weak voice

A

Myasthenia Gravis

326
Q

What is an addisonian crisis?

A

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
Q

What can pinealoma cause?

A

Parinaud’s Syndrome/Dorsal Midbrain Syndrome

328
Q

What is diagnosis of ALS? Treatment?

A

EMG, Nerve conduction studies, MRI, Serum laboratory testing. Riluzole (glutamate inhibitor).

329
Q

Cushing disease vs syndrome….

A

Cushing Disease is excessive anterior pituitary secretion of ACTH; adenoma
More common in women.
Cushing Syndrome is excessive level of cortisol

330
Q

What is common breast cancer chemo?

A

Tamoxifen

331
Q

What are the S&S of prostatitis and BPH?

A 
Similar to BPH (benign prostatic hyperplasia.
 Urinary retention
 Obstruction to flow
 Decreased stream
 Hesitancy
 Infection due to retention
332
Q

What is gonococcal conjunctivitis? How do you treat it?

A

Hyper-acute mucopurulent discharge (usually from Neisseria gonorrhoeae), can lead to peripheral ulcers and K perforation.
Tx with IM cephalosporin

333
Q

What determines hormonal potency?

A

Concentration and receptors: specificity (fit), affinity (strength), and number

334
Q

____ regulate capillary blood flow in the CNS and retina

A

Pericytes

335
Q

What is a major cause of unconsciousness and persistent vegetative state?

A

diffuse axonal injury

336
Q

Diabetes is the ___st/nd leading cause of death in the US. The leading cause of…., major contributor to….

A 
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
Q

Name disease: Resting tremors, Mask-like expression, Slow, quiet speech, Shuffling gait, Stooped posture, Rigid muscles

A

Parkinson’s disease

338
Q

Why do you want to taper steroid use?

A

To avoid Cushing syndrome (excess cortisol)

339
Q

How do you treat cerebral palsy?

A

Muscle relaxants, Anticonvulsant drugs, Orthopedic surgery / appliances

340
Q

What are the causes of hyperthyroidism?

A

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
Q

What are risk factors for prostate cancer?

A 
Age (>50 yoa)
 Race (AA>CA&HA)
 Dietary factors
 Hormones
 Familial factors
342
Q

Name condition:

Risk factors: older, promiscuous, smoking, drug abuse, HTN

A

Placental Abruption

343
Q

Why are type 5 PDE inhibitors bad with nitroglycerin?

A

They can compound the effects of vasodilation and cause rapid BP decrease, causing stroke!

344
Q

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

A

Severe TBI. Also includes mild TBI symptoms

345
Q

What is the Dx, Tx, and complications of Hyperthyroidism?

A 
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
Q

CT scans are good for…

A

Looking at bones, space-occupying lesions, they’re fast and inexpensive.

347
Q

What is dry eye associated with?

A

Polycystic Ovary syndrome, Menopause

348
Q

What kinds of infections can cause vulvovaginitis?

A

Bacteria, fungi, virus

349
Q

The primary pathology of DBM is ____

A

Vascular damage

350
Q

How can you get Floppy iris syndrome?

A

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
Q

What is a myelogram? What does it detect?

A

A neurologic test that is a dye to detect spinal tumor,

Herniated disks, Vascular malformations, CSF leaks

352
Q

Name disease:

Dysmenorrhea, Excessive menstrual bleeding, Pain, Dyspareunia, Pain with defecation

A

Endometriosis

353
Q

What can cause hypoparathyroidism? How is gender ratio? How tx?

A 
Neck surgery*
 Autoimmune disease
 Radiation Tx of thyroid
 Inherited disorders
 Men=women
 Tx: Calcium carbonate and Vitamin D
354
Q

Pregnancy can cause (inc/dec) IOP

A

Decreased

355
Q

TRH in the hypothalamus stimulates the pituitary gland to make TSH which stimulates the ____ to make _____

A

thyroid to make T4 and T3

356
Q

Name condition: Hirsutism, Androgen excess, Infertility, Obesity, Acne, DRY EYE

A

Polycystic Ovary syndrome

357
Q

What is the usual cause of urethritis?

A 
USUALLY INFECTIOUS
 Chlamydia trachomatis*
 Neisseria gonorrhoeae
 Mycoplasma genitalium
 Trichomonas vaginalis
358
Q

What are complications of epilepsy?

A

Difficulty learning, aspiration, brain damage (can be permanent), drowsiness from medication.

359
Q

What are the causes of cervical cancer?

A

HPV (16 and 18)

360
Q

Name disease:

Periodic hemorrhage of ectopic tissue, Peritoneal irritation, Adhesion formation

A

Endometriosis

361
Q

What do oral contraceptives reduce and increase?

A

Endometrial cancer, ovarian cancer, ectopic pregnancy, etc.

increase risk of venous thromboembolism, MI, stroke, and gallstones

362
Q

Causes of ICP fluctuations:

A

Brain edema, CSF obstructions, Intracranial hemorrhage, tumor

363
Q

What are the late signs and symptoms of thyroid eye disease?

A

Exophthalmos
Persistent eyelid swelling
Diplopia
Decreased vision in one or both eyes (optic nerve compression)

364
Q

What it sorbitol?

A

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
Q

Diabetes insipidus is a lack of what?

A

ADH

366
Q

What is Guillain-Barré Syndrome? What is the cause?

A

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
Q

Cushing’s Syndrome is from…

A

High cortisol

368
Q

Conn’s Disease is from….

A

Primary hyperaldosteronism

369
Q

1gm oral azithromycin can treat…

A

Chlamydia (that causes Adult inclusion conjunctivitis)

370
Q 
Name condition: S&S
 Asymptomatic
 Discharge
 Dysuria
 Painful intercourse
 Hematuria
A

Urethritis

371
Q

What happens in Myasthenia Gravis? Demographics?

A

Antibodies block or destroy acetylcholine receptor sites causing weakness. Affects women more than men

372
Q

What are the ocular complications of Cushing Syndrome?

A

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
Q

How do you dx and tx Pheochromocytoma?

A 
Diagnosis:
 -Serum and urine levels of
 -catecholamines
 -Abdominal MRI
 Treatment
 -Surgery
 -Alpha- and beta-blockers
374
Q

What is oliguria? What condition?

A

Preeclampsia and

375
Q

What is thyroperoxidase (TPO) and Thyroglobulin antibodies implicated in?

A

Hashimoto’s (autoimmune thyroid damage) and Graves (auto-ab mimics TSH)

376
Q

____ in urine indicates pregnancy through a ____

A

HCG through lateral flow Elisa test

377
Q

Menstrual cycle days 5-14

A

Follicular phase

378
Q

What can cause Excessive level of cortisol? (Cushing syndrome)

A

Adrenal adenoma
Adrenal carcinoma
Ectopic ACTH (cancer)
Exogenous steroid use*.

379
Q

Which hormone is life-threatening if cut off?

A

ACTH because….

380
Q

During aging, what do changes in the ovaries cause?

A

Depleted follicles, decreasing Estrogen and progesterone levels, degeneration in uterus and vagina

381
Q 
Name disease: RF
 Family history of cancer*
 Personal history of cancer
 >55 years of age
 Nulliparous
A

Ovarian cancer

382
Q

What are common comorbidities of cerebral palsy?

A

Epilepsy and cognitive impairment

Pathology II (9 decks)

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