Patho Exam 3 Flashcards
What causes the vasomotor flushes (hot flashes) that are associated with declining ovarian function with age?
Rapid changes in estrogen levels. (increase in vasomotor flushes due to decreased estrogen causing loss of thermoregulation)
Where is the usual site of fertilization of an ovum?
Ampulla of the Fallopian tubes. (distal third)
Having ejected a mature ovum, the ovarian follicle develops into a(n):
Corpus Luteum. (Ovarian follicles continuously grow and undergo atresia; once follicle reaches maturation and discharges into its ovum; after ovulation, follicle develops into corpus luteum.
Which hormone promotes the development of the lobular ducts in the breasts?
Estrogen
Which hormone relaxes the myometrium and prevents lactation until the fetus is born?
Progesterone
A surge of which hormone causes the corpus luteum to produce progesterone?
Luteinizing Hormone
What directly causes ovulation during the menstrual cycle?
Sudden increase of Luteinizing Hormone (LH)
Which hormone stimulates gonads to produce both male and female hormones?
Luteinizing Hormone (LH)
Which gland produces the associated hormones that are found in high levels in a female fetus?
Anterior pituitary follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
Which anatomic structure secretes Follicle-stimulating hormone (FSH) and Luteinizing hormone (LH)?
Anterior Pituitary
During the follicular or proliferative phase of ovulation:
Estrogen causes endometrial growth
Which statement is true regarding the major difference between male and female sex hormone production?
In a man, sex hormone production is relatively constant.
Where in the male body does spermatogenesis occur?
Seminiferous tubules
The human zygote has a total of how many chromosomes?
46
The release of which chemical mediator causes primary dysmenorrhea?
Prostaglandins
Treatment for Primary Dysmenorrhea:
NSAIDs are treatment of choice because they reduce COX enzyme activity thus prostaglandin production; they work in majority of woman and are most effective if started at 1st sign of bleeding.
(Hormonal contraception, Nitro path, Regular exercise and stress reduction, heat, acupuncture, high frequency TENS, thiamine and vitamin E & herbs)
Which condition is considered a clinical cause of amenorrhea?
Failure to ovulate
Considering the pathophysiologic characteristics of primary amenorrhea, what anatomic structure is involved in compartment II?
Ovary
Considering the pathophysiologic characteristics of primary amenorrhea, what anatomic structure is involved in compartment IV?
Hypothalamus
Considering the mediating factors of premenstrual syndrome (PMS), which medication may be used either continually or only during the menstrual period as a treatment for the condition?
SSRIs
Which statement regarding pelvic inflammatory disease (PID) is true?
Contracting this infection increases the risk of uterine cancer.
When a woman’s uterus is assessed as protruding through the entrance of the vagina to the hymen, which grade of prolapse does this indicate?
2
Grade 1-4 of Pelvic Organ Prolapse:
0= normal position, no prolapse 1= decent halfway to hymen 2= decent reaches the hymen 3= decent halfway past hymen 4= max possible decent for each site
What is a recognized treatment for the symptoms often associated with pelvic organ prolapse? (Select all that apply.) (4)
Pessary,
Kegel exercises, Estrogen therapy, Surgical repair.
What theory is used to describe the cause of endometriosis?
Endometrial tissue passes through the Fallopian tubes and into the peritoneal cavity and remains responsive to hormones.
What are the common clinical manifestations of endometriosis? (Select all that apply.) (2)
Infertility & Dysmenorrhea
Which virus is a precursor for developing cervical intraepithelial neoplasia (CIN) and cervical cancer?
HPV
Which description is used when a progressive neoplastic change involves the full epithelial thickness of the cervix?
Cervical carcinoma in situ
Cervical cancer prevention:
the prevention of HPV with vaccination is the key to preventing cervical cancer
Which of the following is NOT considered a cause of Galactorrhea?
Proliferation of the lactiferous ducts of the breast
In the 95% of those with delayed puberty, the problem is caused by which condition?
Physiologic hormonal delays
What term is used to identify a condition in which the foreskin cannot be retracted over the glans penis?
Phimosis
Priapism has been associated with the abuse of what substance?
Cocaine
What term is used to identify a fibrotic condition that causes lateral curvature of the penis during erection, which is associated with a local vasculitis-like inflammatory reaction and decreased tissue oxygenation?
Peyronie disease
Cryptorchidism can be defined as which of the following?
Testicular maldescent
The risk of which cancer is greater if the man has a history of cryptorchidism?
Testicular
How does the epididymis become infected?
The pathogenic microorganisms ascend the vasa deferentia from an already infected urethra or bladder.
Symptoms of benign prostatic hyperplasia (BPH) are a result of which pathophysiologic condition?
Compression of the urethra
Which statements are true regarding prostate cancer? (Select all that apply.) (4)
A familial history of prostate cancer is a risk factor.
Dietary habits seem to play a role in its development. African American men have an increased risk for its development.
Being over 65 years of age increases the risk for developing prostate cancer.
Which term is used to identify the movement of gas and air into and out of the lungs?
Ventilation
The adequacy of a person’s alveolar ventilation is assessed best by monitoring which mechanism?
ABG
Movement of blood into and out of the capillary beds of the lungs to body organs and tissues:
Perfusion
The exchange of O2 and CO2 during cellular metabolism :
Respiration
Which part of the brainstem provides basic automatic rhythm of respiration by sending efferent impulses to the diaphragm and intercostal muscles?
Dorsal respiratory group (DRG)
Movement of gases between air spaces in the lungs and the bloodstream:
Diffusion
Which normal physiologic change occurs in the aging pulmonary system?
Stiffening of the chest wall
What are the effects of aging on the pulmonary system? (4)
Decreased chest wall compliance. Decreased lung recoil.
Reduced ventilatory reserve.
Decreased partial pressure of arterial oxygen (PaO2)
The sternocleidomastoid and scalene muscles are referred to as which group?
Accessory Muscles of inspiration
Major muscles of inspiration:
Diaphragm and external intercostal muscles
What is the primary cause of respiratory distress syndrome (RDS) of the newborn?
Surfactant deficiency.
(RDS is primarily caused by surfactant deficiency and secondarily by a deficiency in alveolar surface area for gas exchange)
An increase in surface tension caused by decreased surfactant production results in which alteration?
Increase in alveoli fluid collection
Which structures secrete surfactant?
Type II alveolar cells
Surfactant produced by type II alveolar cells facilitates alveolar distention and ventilation by which mechanism?
Decreasing surface tension in the alveoli
Which chemoreceptors monitor arterial blood indirectly by sensing pH changes in CSF?
Central chemoreceptors
Hypoventilation that results in the retention of carbon dioxide will stimulate which receptors in an attempt to maintain a normal homeostatic state?
Central chemoreceptors
Which receptors are located near the respiratory center?
Central chemoreceptors
Which chemoreceptors monitor pH, partial pressure of carbon dioxide (PaCO2), and partial pressure of oxygen (PaO2) in arterial blood?
Peripheral chemoreceptors
Which receptors are located in the aortic bodies, aortic arch, and carotid bodies?
Peripheral chemoreceptors
How low must the partial pressure of arterial oxygen (PaO2) drop before the peripheral chemoreceptors influence ventilation?
Below 70 mm Hg
Which chemoreceptors are sensitive to noxious aerosols (vapors), gases, and particulate matter (e.g., inhaled dusts), which cause them to initiate the cough reflex when stimulated?
Irritant receptors
Which chemoreceptors decrease ventilatory rate and volume when stimulated, an occurrence sometimes referred to as the Hering-Breuer expiratory reflex?
Stretch chemoreceptors
Which receptors are located in the smooth muscles of airways?
Stretch chemoreceptors
Which chemoreceptors known as J-receptors initiate rapid, shallow breathing and are sensitive to increased pulmonary capillary pressure?
Pulmonary C-fiber receptors
What is the purpose of the spirometry measurement?
To measure the volume and flow rate during forced expiration
Sitting up in a forward-leaning position generally relieves which breathing disorder?
Orthopnea
Increased ventilatory rate, large tidal volume, and no expiratory pause:
Hyperpnea/Kussmaul respirations
Respirations that are characterized by alternating periods of deep and shallow breathing are a result of which respiratory mechanism?
Decreased blood flow to the medulla oblongata (Cheyne-Stokes respirations)
The collapse of lung tissue caused by the lack of collateral ventilation through the pores of Kohn is referred to as what type of atelectasis?
Absorption
Kussmaul respirations as a respiratory pattern may be associated with which characteristic(s)? -
Slightly increased ventilatory rate.
Large tidal volumes.
No expiratory pause
What is the most common cause of pulmonary edema?
Left-sided heart failure
Pulmonary edema in acute respiratory distress syndrome (ARDS) is the result of an increase in:
Capillary permeability
Pulmonary edema and pulmonary fibrosis cause hypoxemia by which mechanism?
Impairing alveolocapillary membrane diffusion
Pulmonary edema usually begins to develop at a pulmonary capillary wedge pressure or left atrial pressure of how many millimeters of mercury (mm Hg)?
20 mm Hg
What causes pneumoconiosis?
Inhalation of inorganic dust particles
Which condition is a fulminant form of respiratory failure characterized by acute lung inflammation and diffuse alveolocapillary injury?
ARDS
Which structure(s) in acute respiratory distress syndrome (ARDS) release inflammatory mediators such as proteolytic enzymes, oxygen-free radicals, prostaglandins, leukotrienes, and platelet-activating factor?
Neutrophils
In acute respiratory distress syndrome (ARDS), alveoli and respiratory bronchioles fill with fluid as a result of which mechanism?
Inactivation of surfactant and the impairment of type II alveolar cells
Which immunoglobulin (Ig) may contribute to the pathophysiologic characteristics of asthma?
IgE
Which statement about the late asthmatic response is true?
The release of toxic neuropeptides contributes to increased bronchial hyperresponsiveness.
The most successful treatment for chronic asthma begins with which action?
Avoidance of the causative agent
Clinical manifestations of inspiratory and expiratory wheezing, dyspnea, nonproductive cough, and tachypnea are indicative of which condition?
Asthma
Which inflammatory mediators are produced in asthma? (Select all that apply.) (4)
Histamine, Bradykinin, Leukotrienes, Prostaglandins
Which factor contributes to the production of mucus associated with chronic bronchitis?
Increased Goblet cell size
The progression of chronic bronchitis is best halted by which intervention?
Smoking cessation
In tuberculosis, the body walls off the bacilli in a tubercle by stimulating which action?
Apoptotic infected macrophages that activate cytotoxic T cells
Which statements regarding Mycobacterium tuberculosis are true regarding the bacilli’s ability to go into dormancy? (Select all that apply.) (3)
Neutrophils and macrophages all play a role in its dormancy.
The immune system is the controlling factor regarding its length of dormancy.
The bacilli are sealed off in tubercles to allow for dormancy.
What medical term is used to identify the accumulation of air in the pleural space?
Pneumothorax
Which pleural abnormality involves a site of pleural rupture that acts as a one-way valve, permitting air to enter on inspiration but preventing its escape by closing during expiration?
Tension pneumothorax
Which condition is NOT a cause of chest wall restriction?
Pneumothorax
Clinical manifestations of inspiratory crackles, increased tactile fremitus, egophony, and whispered pectoriloquy are indicative of which respiratory condition?
Pneumonia
Which symptom is NOT a clinical manifestation of croup?
Course Rhonchi. (Typically, a prodrome of rhinorrhea, sore throat, and low-grade fever is exhibited for a few days with croup. The child then develops the characteristic harsh (seal-like) barking cough, hoarse voice, and inspiratory stridor)
Which type of croup is most common?
Viral
Which statement best describes acute respiratory distress syndrome (ARDS)?
A pulmonary disease characterized by severe hypoxemia, decreased pulmonary compliance, and the presence of bilateral infiltrates on chest x-ray imaging
What is the primary cause of respiratory distress syndrome (RDS) of the newborn?
Surfactant deficiency
What is the primary problem resulting from respiratory distress syndrome (RDS) of the newborn?
Atelectasis
What is the chief predisposing factor for respiratory distress syndrome (RDS) of the newborn?
Premature birth
Which statement about the advances in the treatment of respiratory distress syndrome (RDS) of the newborn is incorrect?
Administering oxygen to mothers during preterm labor increases their arterial oxygen before the birth of the fetus.
When considering the signs and symptoms of acute respiratory distress syndrome (ARDS), the absence of which condition is considered characteristic?
Heart failure
The risk for respiratory distress syndrome (RDS) decreases for premature infants when they are born between how many weeks of gestation?
30 and 36
Which statement accurately describes childhood asthma?
An obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperactivity, and inflammation
Which criterion is used to confirm a diagnosis of asthma in an 8-year-old child?
Reduced expiratory flow rates confirmed by spirometry testing
Children diagnosed with chronic asthma are likely to exhibit which symptoms? (Select all that apply.) (4)
Nasal flaring, Musical expiratory wheezing, Substernal retractions, Diaphoresis
Which T-lymphocyte phenotype is the key determinant of childhood asthma?
CD4 T-helper Th2 lymphocytes
Which cytokines activated in childhood asthma produce an allergic response?
IL-4, IL-5, and IL-13
Examination of the throat in a child demonstrating signs and symptoms of acute Epiglottitis may contribute to which life-threatening complication?
Laryngospasms
High fever, irritability, sore throat, inspiratory stridor, “hot potato voice,” severe respiratory distress, Tripod position with drooling and dysphagia are Clinical manifestations of:
Epiglottitis
Cystic fibrosis is caused by which process?
Autosomal recessive inheritance
Which statement best describes cystic fibrosis?
Pulmonary disorder involving an abnormal expression of a protein-producing viscous mucus that obstructs the airways, pancreas, sweat ducts, and vas deferens
What are the abnormalities in cytokines found in children with cystic fibrosis (CF)?
Deficit of IL-10 and an excess of IL-1, IL-8, and TNF-a
Which cardiac chamber has the thinnest wall and why?
The right and left atria; they are low-pressure chambers that serve as storage units and conduits for blood
Which chamber of the heart endures the highest pressures?
Left Ventricle
What is the process that ensures mitral and tricuspid valve closure after the ventricles are filled with blood?
Increased pressure in the ventricles pushes the valves to close.
Regarding the heart’s valves, what is a function of the papillary muscles?
These muscles prevent backward expulsion of the atrioventricular valve.
During the cardiac cycle, why do the aortic and pulmonic valves close after the ventricles relax?
Blood fills the cusps of the valves and causes the edges to merge, closing the valves.
What can shorten the conduction time of action potential through the atrioventricular (AV) node?
Catecholamines
The significance of the atrial kick is that it affects the contraction of the:
Left atria, which increases the blood volume into the ventricle.
Where in the heart are the receptors for neurotransmitters located?
Myocardium and coronary vessels
Reflex control of total cardiac output and total peripheral resistance is controlled by what mechanism?
Sympathetic stimulation of the heart, arterioles, and veins
Pressure in the left ventricle must exceed pressure in which structure before the left ventricle can eject blood?
Aorta
What is the major determinant of the resistance that blood encounters as it flows through the systemic circulation?
Muscle layer of the arterioles
The right lymphatic duct drains into which structure?
Right subclavian vein
What is an expected change in the cardiovascular system that occurs with aging?
Arterial stiffening
What is the initiating event that leads to the development of atherosclerosis?
Injury to the endothelial cells that line the artery walls
When endothelia cells are injured, what alteration contributes to atherosclerosis?
Cells are unable to make the normal amount of vasodilating cytokines.
What effect does atherosclerosis have on the development of an aneurysm?
Atherosclerosis erodes the vessel wall.
Which statement best describes thromboangiitis obliterans (Buerger disease)?
Inflammatory disorder of small- and medium-size arteries in the feet and sometimes in the hands
What is the effect of oxidized low-density lipoproteins (LDLs) in atherosclerosis?
LDLs cause smooth muscle proliferation.
Which elevated value may be protective of the development of atherosclerosis?
HDL
Which statements are true regarding fatty streaks? (Select all that apply.) (4)
Fatty streaks progressively damage vessel walls.
Fatty streaks are capable of producing toxic oxygen radials.
When present, inflammatory changes occur to the vessel walls.
Oxidized low-density lipoproteins (LDLs) are involved in their formation.
The risk of developing coronary artery disease is increased up to threefold by which factor?
Hypertension
Nicotine increases atherosclerosis by the release of which neurotransmitter?
Epinephrine
Which risk factor is associated with coronary artery disease (CAD) because of its relationship with the alteration of hepatic lipoprotein?
Diabetes mellitus
Cardiac cells can withstand ischemic conditions and still return to a viable state for how many minutes?
20
Which inflammatory cytokines are released when endothelial cells are injured?
Tumor necrosis factor–alpha (TNF-a), interferon-gamma (IFN-a), and interleukin 1 (IL-1)
How does Angiotensin II increase the workload of the heart after a myocardial infarction (MI)?
By increasing the peripheral vasoconstriction
Which factor is responsible for the hypertrophy of the myocardium associated with hypertension?
Angiotensin II
An individual who is demonstrating elevated levels of troponin, creatine kinase–isoenzyme MB (CK-MB), and lactic dehydrogenase (LDH) is exhibiting indicators associated with which condition?
MI
What is the expected electrocardiogram (ECG) pattern when a thrombus in a coronary artery permanently lodges in the vessel and the infarction extends through the myocardium from the endocardium to the epicardium?
ST elevation myocardial infarction (STEMI)
Ventricular dilation and grossly impaired systolic function, leading to dilated heart failure, characterize which form of cardiomyopathy?
Congestive
A disproportionate thickening of the interventricular septum is the hallmark of which form of cardiomyopathy?
Hypertrophic
Amyloidosis, hemochromatosis, or glycogen storage disease usually causes which form of cardiomyopathy?
Restrictive
Impairs flow from the left ventricle:
Aortic Stenosis
Which assessment findings are clinical manifestations of aortic stenosis? (Select all that apply.) (3)
Angina, Syncope, HF
Back flow into left ventricle
Aortic Regurgitation
Which condition is a cause of acquired aortic regurgitation?
Rheumatic fever
Impairs flow from left atrium to left ventricle
Mitral Stenosis
Which predominantly female valvular disorder is thought to have an autosomal dominant inheritance pattern, as well as being associated with connective tissue disease?
Mitral Valve Prolapse
Back flow into left atrium
Mitral Regurgitation
Back flow into left ventricle
Tricuspid Regurgitation
What is the most common cause of infective endocarditis?
Bacterium
Which risk factors are associated with infective endocarditis? (Select all that apply.) (3)
IV drug use, Long-term indwelling catheterization, Heart valve disease.
In systolic heart failure, what effect does the renin-angiotensin-aldosterone system (RAAS) have on stroke volume?
Increased preload and increased afterload
What factors contribute to the development of orthostatic hypotension? (Select all that apply.) (4)
Altered body chemistry. Drug action of certain antihypertensive agents. Prolonged immobility. Effects of aging on postural reflexes
Most cardiovascular developments occur between which weeks of gestation?
Fourth and seventh week
Which congenital heart defects occur in trisomy 13, trisomy 18, and Down syndrome?
Ventricular septal defect (VSD) and patent ductus arteriosus (PDA)
Which event triggers congenital heart defects that cause acyanotic congestive heart failure?
Left-to-right shunts
What congenital heart defects are associated with intrauterine exposure to rubella? (Select all that apply.) (3)
Pulmonary stenosis (PS), Patent ductus arteriosa (PDA), Ventricular septal defect (VSD)
Common CHD of 5p (Cri du chat): (3)
VSD, PDA, ASD
Common CHD of Trisomy 13: (3)
VSD, PDA, dextrocardia
Common CHD of Trisomy 18: (3)
VSD, PDA, PS
Common CHD of Trisomy 21: (2)
AVSD, VSD
Common CHD of Turner syndrome: (3)
COA, AS, ASD
Common CHD of Klinefelter syndrome: (2)
PDA, ASD
An infant has a continuous machine-type murmur best heard at the left upper sternal border throughout systole and diastole, as well as a bounding pulse and a thrill on palpation. These clinical findings are consistent with which congenital heart defect?
Patent ductus arteriosus (PDA)
An infant diagnosed with a small patent ductus arteriosus (PDA) would likely exhibit which symptom?
Lack of symptoms
