Patho Exam 2 Friday

Question 1

Peritonitis: Describe, manifestations, acute vs. Chronic

Answer 1

Inflammation of the peritoneum activates several protective mechanisms
A thick, sticky exudate that bonds nearby structures and temporarily seals them off
Abscesses may form in an attempt to wall off the infections
Peristalsis may slow down in a response to the inflammation, decreasing spread of toxins/bacteria
Causes: chemical irritation (e.g., ruptured gallbladder or spleen) or direct organism invasion (e.g., appendicitis and peritoneal dialysis)
Manifestations usually sudden and severe; classical manifestation is abdominal rigidity
Abdominal tenderness and pain, decreased peristalsis, intestinal obstruction, nausea/vomiting
Large volumes of fluid leak into the peritoneal cavity
Indicators of infection, sepsis, or shock
MEDICAL EMERGENCY
Rigid abdomen, severe pain, anorexia

Question 2

Bowel obstructions: describe, manifestations, most common

Answer 2

Manifestations: abdominal distension, abdominal cramping, colicky pain, nausea, vomiting, constipation, diarrhea, borborygmi, intestinal rushes, decreased or absent bowel sounds, restlessness, diaphoresis, tachycardia progressing to weakness, confusion, and shock/MOST COMMON CAUSE OF BOWEL OBSTRUCTIONS ARE ADHESIONS

Question 3

Hiatal hernia: describe manifestations, how does it feel

Answer 3

A stomach section protrudes upward through an opening in the diaphragm toward the lung
Causes: weakening of the diaphragm muscle, frequently resulting from increased intrathoracic pressure or increased intra-abdominal pressure; trauma; congenital defects
Risk factors: advanced age and smoking
Manifestations include indigestion, heartburn, frequent belching, nausea, chest pain, strictures, dysphagia, and soft upper abdominal mass (protruding stomach pouch)
Worsen with recumbent positioning, eating (especially after large meals), bending over, coughing
Intra abdominal pressure

Question 4

Diarrhea and antibiotics use: what can it lead to?

Answer 4

antibiotic: destruction of the normal gut flora!

Question 5

PUD: describe, manifestations

Answer 5

Peptic ulcer disease (PUD): lesions affecting stomach lining or duodenum
Leads to heartburn

Question 6

H Pylori: associated with ?

Answer 6

PUD

Question 7

Intussusception: describe, manifestations, what could this lead to?

Answer 7

Telescoping or invagination into an adjacent portion of the intestine.
Can lead to bowel obstructions

Question 8

Viral hepatitis : Review all

Answer 8

A—Fecal-Oral Route
B—Sexual Contact/ Needles/Tears and Saliva
C—Blood-to-Blood
D—Only if you already have Hep B
E—Fecal-Oral Route
Viral hepatitis is contagious but most will recover with sufficient time
Advancing age and comorbidity increase the likelihood that liver failure, liver cancer, or cirrhosis will develop

Question 9

Cleft palate: describe

Answer 9

Associated with genetic mutations

Question 10

Appendicitis: describe, manifestations, where is the pain usually?

Answer 10

Inflammation of the vermiform appendix, most often caused by an infection
Triggers local tissue edema, which obstructs the small structure
As fluid builds inside the appendix, microorganisms proliferate
Appendix fills with purulent exudate and area blood vessels become compressed
Ischemia and necrosis develop; pressure inside the appendix escalates, forcing bacteria and toxins out to surrounding structures
–Manifestations vary from asymptomatic to sudden and severe
Sharp abdominal pain develops, gradually intensifies (over about 12–24 hours), and becomes localized to the lower right quadrant of the abdomen (McBurney point)
Pain may occur anywhere in abdomen; will temporarily subside if the appendix ruptures, and then the pain will return and escalate
—Manifestations
Nausea, vomiting, abdominal distension, and bowel pattern changes
Indications of inflammation and infection (e.g., fever, chills, and leukocytosis)
Indications of peritonitis (e.g., abdominal rigidity, tachycardia, and hypotension)
–Urgent diagnosis and treatment are crucial
–RLQ pain, fever, nausea, diarrhea, rebound tenderness

Question 11

GERD: describe, manifestations, what can chronic GERD lead to?

Answer 11

Gastroesophageal reflux disease (GERD): chyme or bile periodically backs up from the stomach into the esophagus, irritating the esophageal mucosa
Causes: certain foods (e.g., chocolate, caffeine, carbonated beverages, citrus fruit, tomatoes, spicy or fatty foods, and peppermint), alcohol consumption, nicotine, hiatal hernia, obesity, pregnancy, certain medications (e.g., corticosteroids, beta blockers, calcium-channel blockers, and anticholinergics), nasogastric intubation, and delayed gastric emptying
Manifestations: heartburn, epigastric pain (usually after a meal or when recombinant), dysphagia, dry cough, laryngitis, pharyngitis, regurgitation of food, and sensation of a lump in the throat
—esophageal cancer

Question 12

Gastroenteritis-left untreated leads to?

Answer 12

Inflammation of the stomach’s mucosal lining (may involve the entire stomach or a region)
Acute gastritis
Can be a mild, transient irritation, or it can be a severe ulceration with hemorrhage
Usually develops suddenly and is likely to be accompanied by nausea and epigastric pain

Question 13

Gallstones: describe, manifestations, where is the pain usually?

Answer 13

Cholelithiasis (gallstones): a common condition that varies in severity based on size, but affects both genders and all ethnic groups relatively equally
Cholecystitis: inflammation or infection in the biliary system caused by calculi
—Manifestations: biliary colic, abdominal distension, nausea, vomiting, jaundice, fever, and leukocytosis
—Obstruct the bile duct, severe RUQ pain.

Question 14

Dysphagia: definition, what might with see with someone who has this?

Answer 14

Difficulty swallowing could show signs of weight loss, anorexia
Causes: congenital atresia, esophageal stenosis or stricture, esophageal diverticula, tumors, stroke, cerebral damage, achalasia, Parkinson’s disease, Alzheimer’s disease, muscular dystrophy, Huntington’s disease, cerebral palsy, multiple sclerosis, amyotrophic lateral sclerosis, and Guillain-Barré syndrome
Manifestations: a sensation of food being stuck in the throat, choking, coughing, “pocketing” food in the cheeks, difficulty forming a food bolus, delayed swallowing, and odynophagia

Question 15

Duodenal Ulcer: describe, manifestations, when would the pain occur?

Answer 15

Epigastric pain 30 minutes to 2 hours after eating when stomach is empty or in the middle of the night.

Question 16

Crohns: describe, manifestations, what umbrella term does it fall under, where are the lesions?

Answer 16

Insidious, slow-developing, progressive condition often develops in adolescence
Characterized by patchy areas of inflammation involving the full thickness of the intestinal wall and ulcerations (skip lesions); wall is thick/rigid and lumen is narrowed
–Complications: malnutrition; anemia (especially iron deficiency); fistulas; adhesions; abscesses; intestinal obstruction; perforation; anal fissure; delayed growth and development; and fluid, electrolyte, and pH imbalances
—-Manifestations: abdominal cramping and pain (typically in the right lower quadrant), diarrhea, steatorrhea, constipation, palpable abdominal mass, melena, anorexia, weight loss, and indications of inflammation (e.g., fever, fatigue, arthralgia, and malaise)
—-Inflammatory Bowel Disease
Skip lesions

Question 17

Ulcerative Colitis : describe, manifestations, what umbrella term does it fall under, where are the lesions?

Answer 17

Progressive condition of the rectum and colon mucosa usually develops in 20s–30s
Manifestations: diarrhea (usually frequent [as many as 20x daily], watery stools with blood and mucus), tenesmus, proctitis, abdominal cramping, nausea, vomiting, weight loss, and indications of inflammation (e.g., fever, fatigue, arthralgia, and malaise)
—Inflammatory bowel disease
Lesions are limited to the intestinal mucosa

Question 18

Acute gastritis: described manifestations

Answer 18

Acute gastritis
Can be a mild, transient irritation, or it can be a severe ulceration with hemorrhage
Usually develops suddenly and is likely to be accompanied by nausea and epigastric pain
—Manifestations include indigestion, heartburn, epigastric pain, abdominal cramping, nausea, vomiting, anorexia, fever, and malaise
Hematemesis and dark, tarry stools can indicate ulceration and bleeding

Question 19

Stress Ulcer: describe, manifestations

Answer 19

Stress ulcers
Develop because of a major physiological stressor on the body due to local tissue ischemia, tissue acidosis, bile salts entering the stomach, and decreased GI motility
Curling’s ulcers: stress ulcers associated with burns
Cushing’s ulcers: stress ulcers associated with head injuries
Most frequently develop in the stomach; ulcers can form within hours of an event; often hemorrhage is first indicator as ulcer develops rapidly and is masked by primary problem
Complications: GI hemorrhage, obstruction, perforation, and peritonitis

Question 20

Occult blood: what is it, when would we might need to assess for it?

Answer 20

OCCULT BLOOD IN STOOL

Gastric Cancer

Question 21

Diverticulitis: describe, manifestations, where is the pain usually?

Answer 21

Conditions related to the development of diverticula, outwardly bulging pouches of the intestinal wall that occur when mucosa sections or large intestine submucosa layers herniate through a weakened muscular layer
May be congenital or acquired
Thought to be caused by a low-fiber diet and poor bowel habits that result in chronic constipation
–Diverticulitis: diverticula become inflamed, usually because of retained fecal matter (often asymptomatic until it becomes serious)
Potential for fatal obstruction, infection, abscess, perforation, peritonitis, hemorrhage, and shock
Manifestations: abdominal cramping, passing frank blood, low-grade fever, abdominal tenderness (usually left lower quadrant), abdominal distension/mass, constipation, obstipation, nausea, and leukocytosis
—-Left lower quadrant pain
Fever
Nausea and vomiting

Question 22

Colorectal Cancer: describe, manifestations

Answer 22

High-sensitivity fecal occult blood test every year plus fecal immunochemical tests
–Manifestations: lower abdominal pain and tenderness, blood in the stool (occult or frank), diarrhea, constipation, intestinal obstruction, narrow stools, unexplained anemia (usually iron deficiency), and unintentional weight loss

Question 23

Jaundice: definition, what organ are we concerned for?

Answer 23

Leads to jaundice (yellowing of the skin)

–Liver

Question 24

Portal Hypertension: what is it, what does it lead to?

Answer 24

Portal hypertension-Portal vein backs up with blood

—Portal hypertension is treated with a surgically implanted shunt

Question 25

Esophageal varices: what is it, manifestations? What can it lead to?

Answer 25

Esophageal Varices-hematemesis

Esophageal varices are treated with endoscopic bands, shunts, or sclerotherapy

Question 26

Hematemesis: definition

Answer 26

Hematemesis: blood in the vomitus
Has a characteristic “coffee grounds” appearance resulting from protein in the blood being partially digested
Blood is irritating to the gastric mucosa
Can occur from any conditions that cause upper GI bleeding

Question 27

Pyelonephritis: describe, manifestations : Pre, Intra, Post ? major organism

Answer 27

Acute or chronic infection that has reached one or both kidneys
Kidneys become grossly edematous and fill with exudate, compressing renal artery and potentially developing abscesses or necrosis
Complications: renal failure, recurrent UTIs, and sepsis
Manifestations: severe UTI symptoms, flank pain, and increased blood pressure
—Most common organism: Ecoli-Acute
At risk: ascending urinary tract (going back up)
Intrarenal injury

Question 28

Dialysis : what is it for? What major electrolyte should we watch out for if a patient skipped dialysis and why?

Answer 28

To remove excess fluid and waste
—When your kidneys are damaged, they produce less erythropoietin (EPO), a hormone that signals your bone marrow—the spongy tissue inside most of your bones—to make red blood cells. With less EPO,your body makes fewer red blood cells, and less oxygen is delivered to your organs and tissues.

Question 29

Obstruction in the renal system: Pre, Intra, Post: KNOW ALL THREE-REMEMBER TOP, MIDDLE BOTTOM

Answer 29

Prerenal–Sudden and severe drop in blood pressure(shock) or interruption of blood flow to the kidneys from severe injury or illness.
Intrarenal–Direct damage to the kidneys, by inflammation, toxins, drugs, infection, or reduced blood supply
Postrenal–Sudden obstruction of urine flow due to enlarged prostate, kidney stones, bladder tumor, or injury

Question 30

Oliguric phase of AKI

Answer 30

Oliguric (daily urine output <400 mL): electrolyte disturbances, fluid volume excess, azotemia, and metabolic acidosis

Question 31

Diruretic phase of AKI

Answer 31

Diuretic phase (daily urine output >5 L): electrolyte disturbances, dehydration, and hypotension

Question 32

Recovery phase of AKI

Answer 32

Recovery phase: glomerular function gradually returns to normal

Question 33

CKD-HTN/DM

Answer 33

Hypertension

Diabetes

Question 34

Glomerulonephritis : describe, manifestations: Nephritic syndrome

Answer 34

Acute or chronic bilateral inflammatory disorder of the glomeruli that typically follows a streptococcal infection; leading cause of renal failure
Inflammatory changes impair the kidneys’ ability to excrete waste and excess fluid
Nephrotic and nephritic syndromes are the most prevalent forms
—Results in increased glomerular capillary permeability, leading to marked proteinuria, lipiduria, hypoalbuminemia, and anasarca
Other manifestations: hypoalbuminemia, dark and cloudy urine, immunoglobulins in the urine
—-Manifestations: gross hematuria, urinary casts and leukocytes, low GFR, azotemia, oliguria, and high blood pressure

Question 35

Flow of filtration through the kidneys

Answer 35

Each nephron contains multiple sections responsible for filtering specific substances
Bowman’s capsule: double membrane that surrounds the glomerulus
Glomerulus: cluster of capillaries
Blood enters glomerulus through an afferent arteriole, leaves it through efferent

Question 36

Nephrolithiasis: describe, manifestations: Pre, Intra, Post ?

Answer 36

Presence of renal calculi, hard crystals composed of minerals that the kidneys normally excrete, in renal pelvis, ureters, or bladder
—-Manifestations: colicky pain in the flank area that radiates to the lower abdomen and groin; bloody, cloudy, or foul-smelling urine; dysuria; frequency; genital discharge; nausea; vomiting; fever; and chills
——–Post renal injury
Dehydration
If have fever, hypotension, tachycardia-could be septic this is a medical emergency if so
Colicky pain, CVA tenderness, hematuria

Question 37

Bladder cancer: describe, manifestations, who is at risk.

Answer 37

Smoking and exposure to chemicals puts patients at risks.

PAINLESS HEMAURIA!

Question 38

BPH: describe, manifestations: Pre, Intra, Post ? Risks ?

Answer 38

A common, nonmalignant enlargement of the prostate gland that occurs as men age; the exact cause is unknown but it may result in urinary stasis and UTIs
—As the prostate expands, it presses against the urethra and obstructs urine flow
Manifestations: frequency, urgency, retention, difficulty initiating urination, weak urinary stream, dribbling urine, nocturia, bladder distension, overflow incontinence, and erectile dysfunction
—Weak stream, nocturia, difficulty initiating stream
Men over 50 with BPH are at risks for UTIs.

Question 39

Renal Cell Carcinoma : describe, manifestations, what might we see?

Answer 39

Most frequently occurring kidney cancer in adults
Risk factors: being male and smoking
Metastasis to the liver, lungs, bone, or nervous system is common
Manifestations: asymptomatic, painless hematuria, abnormal urine color, dull and achy flank pain, urinary retention, palpable mass over the affected kidney, unexplained weight loss, anemia, polycythemia, hypertension, paraneoplastic syndromes, and fever

Question 40

UTI/cystitis: describe, manifestations, major organism/why are women at risks?

Answer 40

Major organism Ecoli
Women more at risk due to shorter urethra
Highest risks for UTI, sexually active women
#1 sign: dysuria
—-Inflammation of the bladder
The bladder and urethra walls become red and swollen
Causes: infection and irritants
Manifestations: UTI symptoms, abdominal pain, and pelvic pressure
Diagnosis and treatment follow those usually seen for UTIs

Question 41

Stress incontinence

Answer 41

Loss of urine from pressure exerted on the bladder by coughing, sneezing, laughing, exercising, or lifting something heavy
Occurs when the sphincter muscle of the bladder is weakened
Contributing factors: pregnancy, childbirth, menopause, cystocele, prostate removal, obesity, and chronic coughing

Question 42

Reflex incontinence

Answer 42

Urinary incontinence caused by trauma or damage to the nervous system
Detrusor hyperreflexia: increased detrusor muscle contractility that occurs even though there is no sensation to void
Urgency is generally absent

Question 43

How do you protect against urinary pathogens?

Answer 43

wipe front to back, pee after sex

Question 44

Chronic bacterial prostatitis: describe, manifestations

Answer 44

Inflammation of the prostate that can be acute or chronic
Causes: conditions that trigger the inflammatory process
—Manifestations: dysuria; difficulty urinating; frequency; urgency; nocturia; pain in the abdomen, groin, lower back, perineum, or genitals; painful ejaculations; indications of infection; and recurrent urinary tract infections

Question 45

Functional incontinence

Answer 45

Occurs in many older adults, especially people in nursing home, who have a physical or mental impairment that prevents toileting in time

Question 46

Hypospadias: describe

Answer 46

Hypospadias-meatus on the ventral portion of the penis

Question 47

Epispadias: describe

Answer 47

Epispadias-meatus on the dorsal portion of the penis

Question 48

Endometriosis describe/manifestations

Answer 48

Endometrium grows in areas outside the uterus
Most commonly grows in the fallopian tubes, ovaries, and peritoneum, but the tissue can grow anywhere in the body
The abnormal endometrial tissue continues to act as it normally would during menstruation
Blood becomes trapped and irritates the surrounding tissue
—-Complications: pain, cysts, scarring, adhesions, and infertility
Manifestations: dysmenorrhea, menorrhagia, pelvic pain, infertility, and pain during or after intercourse

Question 49

HPV-what can it lead to?

Answer 49

Cervical Cancer

Question 50

PID-describe/manifestations/organism

Answer 50

Infection of the female reproductive system; bacteria usually ascend from the vagina
Can be either acute or chronic
Causes: STI; bacteria introduced during childbirth, endometrial procedures, or abortions; and bacterial invasion from the bloodstream
Complications: reproductive structure obstructions, peritonitis, abscesses, septicemia, adhesions, strictures, chronic pelvic pain, ectopic pregnancies, infertility
Manifestations: indications of infection; pain or tenderness in the pelvis, lower abdomen, or lower back; abnormal vaginal and cervical discharge; bleeding after sexual intercourse; painful sexual intercourse; urinary frequency; dysuria; dysmenorrhea; amenorrhea; AUB; anorexia; and nausea and vomiting
Neisseria gonorrhae

Question 51

Syphilis/all 3 stages must know-what is the organism name?

Answer 51

Stage one: Primary syphilis
1+ painless chancres form at site 2–3 weeks after infection
Often go unnoticed and disappear about 4–6 weeks later, even without treatment
Bacteria become dormant, and no other symptoms are present
Contagious, but may not test positive, so testing should be repeated at a later date
Stage two: Secondary syphilis
Occurs about 2–8 weeks after the first chancres form
Treatment in the primary stage can decrease the likelihood of developing this stage
Manifestations: generalized, nonpruritic, brown-red rash; malaise; fever; and patchy hair loss
Symptoms will often go away without treatment, and again, the bacteria become dormant
Will test positive (if untreated) and is contagious, especially with direct contact with the rash
Stage three: Latent or tertiary syphilis
Begins when the secondary symptoms disappear and lasts 1–4 years
Can last for years; infection spreads to the brain, nervous system, heart, skin, and bones
Complications: blindness, paralysis, dementia, cardiovascular disease, pathologic fractures, and death
Will test positive (if untreated) and is only contagious during the early part of this stage
—Treponema pallidum

Question 52

Neonatal conjunctivitis-why are we worried

Answer 52

Blindness

Question 53

Perimenopausal women-describe, whats going on with the estrogen

Answer 53

dysfunctional uterine bleeding associated with irregular estrogen production.

Question 54

Why would we have cessation of the menstruation?

Answer 54

Menopause:

Complete cessation of the menstrual cycle-decreased estrogen production.

Question 55

Gonorrhea and Chlamydia/describe/manifestations

Answer 55

Chlamydia trachomatis: intracellular parasite that requires a host cell to reproduce
The most commonly reported STI in the United States; prevalence rates increasing
–Complications: neonatal conjunctivitis, PID, epididymitis, prostatitis, infertility, and ectopic pregnancy
—-Caused by Neisseria gonorrhoeae, an aerobic bacterium with many drug-resistant strains
–Complications: neonatal conjunctivitis, PID, epididymitis, prostatitis, infertility, ectopic pregnancy, arthritis, dermatitis, and endocarditis
—–Manifestations: if present, include dysuria; urinary frequency/urgency; penile, vaginal, or rectal discharge; redness/edema at urinary meatus (in men); testicular tenderness/pain; rectal pain; painful intercourse; sore throat; and white blisters that darken and disappear
—–Manifestations: if present, include dysuria; penile, vaginal, or rectal discharge; testicular tenderness or pain; rectal pain; and painful sexual intercourse
(chlamydia)

Question 56

HSV 1/2/describe manifestations

Answer 56

Caused by the herpes simplex virus (HSV)
Two forms
HSV type 1 typically occurs above the waist and manifests as a cold sore
HSV type 2 typically occurs below the waist
Each type can affect the mouth or the genitals through oral-genital contact
—-Manifestations: asymptomatic, a painful lesion, malaise, low-grade fever, and groin lymph node enlargement

Question 57

PCOS: describe/manifestations

Answer 57

A hormonal disorder causing enlarged ovaries with small cysts on the outer edges.
The cause of polycystic ovary syndrome isn’t well understood, but may involve a combination of genetic and environmental factors.
–Symptoms include hirtuisim, amenorrhea, infertility.

Question 58

Cystocele: describe/manifestations

Answer 58

bladder protrudes into anterior wall of the vagina
—Manifestations: may be asymptomatic, visualization of the bladder from the vaginal opening, feeling of fullness in the pelvis or vagina, stress incontinence, retention, frequency, urgency, and pain or urine leakage during sexual intercourse

Question 59

Prostatitis:describe/manifestations

Answer 59

Inflammation of the prostate that can be acute or chronic
Causes: conditions that trigger the inflammatory process
—Manifestations: dysuria; difficulty urinating; frequency; urgency; nocturia; pain in the abdomen, groin, lower back, perineum, or genitals; painful ejaculations; indications of infection; and recurrent urinary tract infections
——-Tender prostate
Painful urination

Question 60

Candida: describe/manifestations

Answer 60

Yeast infection caused by the common fungus Candida albicans
Opportunistic infection that can arise anywhere in the body
In the reproductive system, candidiasis most frequently occurs in the vagina and is a common cause of vaginitis (inflammation of the vagina)
—Manifestations: thick, white vaginal discharge that resembles cottage cheese; vulvular erythema and edema; vaginal and labial itching and burning; white patches on the vaginal wall; dysuria; and painful sexual intercourse

Question 61

Epididimitis: describe/manifestations

Answer 61

Causes: ascending bacterial infections or sexually transmitted infections, tuberculosis, and the antidysrhythmic medication amiodarone (Cordarone)
—Manifestations: indicators of infection; scrotal tenderness, erythema, and edema; penile discharge; bloody semen; painful ejaculation; dysuria; and groin pain
—Unilateral testicle pain
Red, swollen

Question 62

Balanitis: describe manifestations

Answer 62

Inflammation of the glans penis

Question 63

Testicular torsion: describe manistations

Answer 63

Abnormal rotation of the testes on the spermatic cord
Causes: trauma, but can also occur spontaneously
Manifestations: sudden scrotal edema and pain
—MEDICAL EMERGENCY

Question 64

Definition amenorrhea, dysmenorrhea

Answer 64

Amenorrhea 
Absence of menstruation 
May be primary, secondary, or normal 
Dysmenorrhea 
Painful menstruation

Question 65

First sign of breast cancer

Answer 65

Painless lump

Question 66

How would you describe the hormone release and regulation system?

Answer 66

Endocrine system is a complex messaging and control system
Uses hormones secreted by glands located throughout the body
Hormones are classified/described in regards to action, source, or chemical structure
—-Uses a negative and positive feedback system to regulate hormone release
—-Hormone release and regulation:
Negative feed back loop system

Question 67

What does the Pituitary gland release? Specifically, the anterior pituitary?

Answer 67

anterior: Prolaction, ACTH, GH and posterior pituitary gland
Secretes several hormones: TSH, growth hormone, adrenocorticotropic hormone (ACTH), follicle-stimulating hormone, luteinizing hormone, prolactin melanocyte-stimulating hormone, antidiuretic hormone, and oxytocin

Question 68

What does the hypothalamus do?

Answer 68

Hypothalamus stimulates pituitary gland to produce thyroid-stimulating hormone (TSH), which stimulates T3 and T4
Iodine is required to synthesize thyroid hormones

Question 69

What does the pancreas do and what does it release?

Answer 69

Islets of Langerhans cell types:
Alpha cells secrete glucagon when serum glucose levels fall
GLUCAGON INCREASES BLOOD GLUCOSE LEVELS TO MAINTAIN HOMEOSTASIS
Beta cells secrete insulin when serum glucose levels increase and amylin to enhance insulin
Delta cells secrete somatostatin, which regulates insulin and glucagon

Question 70

What does the Thyroid do?

What does it release?

Answer 70

Located at the base of the neck below the larynx; two lobes, one on either side of the trachea, connected by a thin band of tissue
A vascular gland, containing several functional units (follicles) that produce three hormones:
Thyroxine (T4), triiodothyronine (T3), and thyrocalcitonin (calcitonin)
T3/T4 (95% of thyroid hormones) regulate cellular metabolism and growth/development
Hypothalamus stimulates pituitary gland to produce thyroid-stimulating hormone (TSH), which stimulates T3 and T4
Iodine is required to synthesize thyroid hormones
Calcitonin regulates serum calcium levels, inhibiting osteoclast activity (decreases calcium release from the bone) and stimulating osteoblast activity (increases calcium deposits in the bone)

Question 71

What do the adrenal glands do?

What do they release?

Answer 71

Mineralocorticoids: primarily aldosterone, which acts to conserve sodium and water
Glucocorticoids: primarily cortisol, which increases serum glucose levels
Gonadocorticoids, or sex hormones: male and female hormones are secreted in minimal amounts in both sexes, but hormones from the testes and ovaries usually mask

Question 72

What does Calcitonin do and what does it regulate?

Answer 72

Calcitonin regulates serum calcium levels, inhibiting osteoclast activity (decreases calcium release from the bone) and stimulating osteoblast activity (increases calcium deposits in the bone)

Question 73

What does the Parathryoid do?

What does it release?

Answer 73

Secrete the parathyroid hormone (PTH), which works opposite of calcitonin to regulate serum calcium levels
PTH is secreted when serum calcium levels drop
PTH increases serum calcium levels by increasing osteoclast activity (increases calcium release from the bone) as well as increasing absorption of calcium in the gastrointestinal tract and kidneys

Question 74

What is the definition of enuresis?

Answer 74

bedwetting

Question 75

What are all of the normal vital signs?

Answer 75

Blood pressure: 90/60 mm Hg to 120/80 mm Hg.
Breathing: 12 to 18 breaths per minute.
Pulse: 60 to 100 beats per minute.
Temperature: 97.8°F to 99.1°F (36.5°C to 37.3°C); average 98.6°F (37°C)

Question 76

Describe Acromegaly

Manifestations

Answer 76

Acromegaly: Excessive growth hormone after the epiphyseal plates of the long bones have fused.
Can be from a pituitary adenoma with excessive secretion of growth hormone.

Question 77

Describe Dwarfism

Manifestation

Answer 77

Dwarfism: short stature caused by deficient levels of growth hormone, somatotropin, or somatotropin-releasing hormone
—Dwarfism: deficiency in somatotropin.

Question 78

Describe Pheochromocytoma

Manifestations

Answer 78

Rare tumor of the adrenal medulla that excretes epinephrine and norepinephrine; can be life-threatening, occurring as a single or multiple tumors in one or both adrenal glands
Rarely malignant
Manifestations: hypertension, tachycardia, forceful heartbeat, profound diaphoresis, abdominal pain, sudden onset of severe headaches, anxiety, feeling of extreme fright, pallor, and weight loss
Complications: hypertensive crisis, stroke, renal failure, psychosis, and seizures

—Is a benign tumor, however can be life-threatening due to the amount of epinephrine and norepinephrine being released.

Question 79

Describe Diabetes: in depth: polyuria, polydipsia, polyphagia

Answer 79

—–A group of conditions characterized by hyperglycemia resulting from defects in insulin production, insulin action, or both
Impaired insulin production or action results in abnormal carbohydrate, protein, and fat metabolism because of the glucose transportation issue

polyuria–excessive urination
polydipsia—excessive thirst
polyphasic—-excessive eating

Question 80

Diabetes Type I: beta cells? manifestations

Answer 80

Previously called insulin-dependent and juvenile-onset, it develops when the body’s immune system destroys pancreatic beta cells
Must have insulin
Usually strikes children and young adults, although disease onset can occur at any age
Exact cause unknown, but most likely a viral or environmental trigger in genetically susceptible people that causes an autoimmune reaction
—Diabetes Type I: Complete destruction of pancreatic beta cells.
NO INSULIN: NEEDS EXOGENOUS INSULIN
Normally occurs in childhood
Polyuria
Polydypsia
Polyphagia

Question 81

Diabetes Type II: beta cells ? manifestations

Answer 81

Previously called non–insulin-dependent and adult-onset
In adults, type 2 accounts for about 90–95% of all newly diagnosed cases
Usually begins as insulin resistance
The pancreas gradually loses its ability to produce insulin
—With type 2 diabetes, the body either doesn’t produce enough insulin, or it resists insulin.
Symptoms include increased thirst, frequent urination, hunger, fatigue, and blurred vision. In some cases, there may be no symptoms.
Treatments include diet, exercise, medication, and insulin therapy.

Question 82

What is glucagon?

Answer 82

GLUCAGON INCREASES BLOOD GLUCOSE LEVELS TO MAINTAIN HOMEOSTASIS

Question 83

What can Diabetes lead to?

Answer 83

Retinopathy
Peripheral Neuropathy
Nephropathy
Delayed wound healing

Question 84

Describe Hypoglycemia: manifestations

Answer 84

Pale
Tremors
Diaphoretic
Could have altered mental status if too low.

Question 85

Describe DKA: manifestations

Answer 85

The condition develops when your body can’t produce enough insulin. Insulin normally plays a key role in helping sugar (glucose) — a major source of energy for your muscles and other tissues — enter your cells. Without enough insulin, your body begins to break down fat as fuel. This process produces a buildup of acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis if untreated.
Rapid breathing
Flushed skin
Ketones in urine

Question 86

What is a hemoglobin AIC

Answer 86

Hemoglobin AIC: measurement of blood glucose over 2-3 months.

Question 87

What is an accucheck

Answer 87

Accucheck: immediate blood sugar result.

Question 88

Describe hyperparathyroidism

Manifestations

Answer 88

Hyperparathyroidism iswhen your parathyroid glands create too much parathyroid hormone in the bloodstream.
Can lead to weak, brittle bones.
Causes could be from a thyroid tumor…think about it the glands sit in the thyroid.
If left untreated this can lead to hypercalcemia.
—

Question 89

What would happen if their parathryoids were surgically removed?

Answer 89

You may experiencetemporary changes to your voice, including hoarseness, which generally improves within the first month after your surgery.You may also experience temporary low blood calcium levels, which can often be managed with calcium supplements.
Trousseau, Chovosteks sign

Question 90

Describe Cushings

Manifestations/what can it cause?

Answer 90

Condition of excessive amounts of glucocorticoids, cortisol
Causes: iatrogenic from ingestion of glucocorticoid medications, adrenal tumors that secrete glucocorticoids, pituitary tumors that secrete ACTH and cortisol, and paraneoplastic syndrome
Manifestations: obesity (especially around the trunk), “moon” face, “buffalo hump,” muscle weakness, delayed growth and development, acne, purple striae, thin skin that bruises easily, delayed wound healing, osteoporosis, hirsutism, insulin resistance, hypertension, edema, hypokalemia, mood changes, and psychosis

Question 91

Describe Addisons:

Manifestations

Answer 91

Addison’s disease
Deficiency of adrenal cortex hormones (glucocorticoids, mineralocorticoids, and androgens)
Causes: autoimmune conditions, infections, hemorrhage, tumors, and pituitary dysfunction that results in insufficient ACTH levels
Manifestations: hypotension, changes in heart rate, hypoglycemia, chronic diarrhea, hyperpigmentation, pallor, extreme weakness, fatigue, anorexia, mouth lesions on the inside of a cheek, nausea, vomiting, salt craving, slow and sluggish movement, unintentional weight loss, mood changes, depression, and hyperkalemia

Question 92

Describe SIADH-in depth

Manifestations

Answer 92

Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a condition in which the body makes too much antidiuretic hormone (ADH). This hormone helps the kidneys control the amount of water your body loses through the urine. SIADH causes the body to retain too much water.

ADH is a substance produced naturally in an area of the brain called the hypothalamus. It is then released by the pituitary gland at the base of the brain.

Causes
There are many reasons why the body needs to make a lot of ADH. Common situations when ADH is released into the blood when it should not be produced (inappropriate) include:

Medicines, such as certain seizure drugs, antidepressants, cancer drugs, opiates (less often), and heart, diabetes, and blood pressure drugs
Surgery under general anesthesia
Disorders of the brain, such as injury, infections, and stroke
Brain surgery in the region of the hypothalamus
Tuberculosis, cancer, chronic infections, and lung disease, such as pneumonia
Substance abuse

---Too much ADH
Holding on to fluid!
Retaining Sodium
Retaining Water
Hyponatremia: why? It is so diluted!!!

Question 93

Describe DI-in depth

Manifestations

Answer 93

Diabetes insipidus (DI) is an uncommon condition in which the kidneys are unable to prevent the excretion of water.
DI is not the same asdiabetes mellitus types 1 and 2. However, untreated, both DI and diabetes mellitus cause constant thirst and frequent urination. People with diabetes mellitus have high blood sugar (glucose) because the body is not able to use blood sugar for energy. Those with DI have normal blood sugar levels, but their kidneys are not able to balance fluid and salt in the body.
Causes
During the day, your kidneys filter all your blood many times. Normally, most of the water is reabsorbed, and only a small amount of concentrated urine is excreted. DI occurs when the kidneys cannot concentrate the urine normally, and a large amount of dilute urine is excreted.
The amount of water excreted in the urine is controlled by antidiuretic hormone (ADH).ADHis also called vasopressin. ADH is produced in a part of the brain called the hypothalamus. It is then stored and released from the pituitary gland. This is a small gland just below the base of the brain.

–Insufficient ADH
Could be damage to the ADH cells from trauma, surgery or a tumor.
They cant stop peeing!

Question 94

Describe Hypothyroidism-in depth

Manifestations

Answer 94

High TSH, Low T3, T4
People may experience:
Whole body:fatigue, lethargy, or feeling cold
Developmental:delayed puberty or slow growth
Hair:hair loss or dryness
Also common:brittle nails, constipation, dry skin, enlarged thyroid, high cholesterol, irritability, sensitivity to cold, sexual dysfunction, slow heart rate, sluggishness, weight gain, or irregular uterine bleeding

Question 95

Describer Hyperthyroidism-in depth

Manifestations

Answer 95

A condition of excessive levels of thyroid hormones, resulting in a hypermetabolic state
Causes: excessive iodine, Graves’ disease, nonmalignant thyroid tumors, thyroid inflammation, and taking large amounts of thyroid hormone replacement
Manifestations: sudden weight loss, tachycardia, hypertension, increased appetite, nervousness, anxiety or anxiety attacks, irritability, tremor (usually a fine trembling in the hands), diaphoresis, changes in menstrual patterns, increased sensitivity to heat, diarrhea, goiter, difficulty sleeping, and exophthalmos

Question 96

Give examples of lab values for each (TSH is up or down? T3/T3 is up or down)

Answer 96

Free T4---0.9-2.4
T4-----5.3-10.5
Free T3---2.10 to 4.40
T3----70 to 204
TSH---0.4 to 4.2

Question 97

Describe Hashimotis

Manifestations

Answer 97

Hashimoto Thyroiditis
Autoimmune
-enlargement of the tongue
-pale, dry skin
-memory lapses, depression
-joint pain and stiffness
-muscle aches
-excessive, prolonged menstrual periods

Question 98

Describe Myxedema Coma

Manifestations

Answer 98

Myxedema: rare and life-threatening advanced hypothyroidism 
Manifestations include marked hypotension, respiratory depression, hypothermia, lethargy, and coma	
--Medical Emergency
Thyroid is TOO Low
Non-pitting edema
Hypothermia
Hypoventilation
Resp. Acidosis
Bradycardia
Hypotension

Question 99

Describe Graves Disease

Manifestations

Answer 99

Graves’ disease isan immune system disorder that results in the overproduction of thyroid hormones (hyperthyroidism).
—Symptoms include anxiety, hand tremor, heat sensitivity, weight loss, puffy eyes and enlarged thyroid, bulging eyes: exopthalamus, tachycardia.

Question 100

Describe Throidtoxicosis/Thryoid storm

Manifestations

Answer 100

Thyrotoxicosis isa condition in which you have too much thyroid hormone in your body
–Medical emergency: fever, decreased LOC, abdominal pain, irregular heart rate, tachycardia