Patho exam 3 (the rest) Flashcards
Which bone disorder is characterized by “soft” bones?
Rickets
SLE produces antibodies against all but which of the following?
WBCs
Which symptom accompanies hemorrhage into the stomach?
Coffee ground vomitus
Which intestinal disorder is an autoimmune disease?
Crohn disease
Tell whether the following statement is true or false:
Paralytic intestinal obstruction causes audible peristalsis
False
Tell whether the following statement is true or false:
Anabolic reactions release energy.
False
Which pancreatic hormone decreases blood glucose levels?
Insulin
Tell whether the following statement is true or false:
Type 2 DM is more common than Type 1 DM.
True
Which of the following is not a complication of diabetes mellitus?
All of the above
Which hormone(s) stimulate the ovaries and testes?
FSH and LH
Tell whether the following statement is true or false.
Simple goiter is caused by increased production of thyroid hormone.
False
Which of the following substances makes bile more susceptible to digestive enzymes?
Fats
Which of the following is the least virulent strain of hepatitis?
HAV
Tell whether the following statement is true or false.
The exocrine pancreas produces insulin.
False
the pancreas is both an
exocrine and endocrine gland
The pancreas makes digestive enzymes that come from its
acinar cells.
The pancreas makes digestive enzymes that come from its acinar cells. The enzymes go through ducts and eventually get to the
duodenum.
The pancreas secretes enzymes to break down carbs, protein, and fats. The enzymes are inactive when secreted, but become active in the
duodenum
In order to neutralize stomach acid, the pancreas secretes bicarbonate
bicarbonate
Acute pancreatitis is a reversible inflammation effecting the
acini (aka acinar cells)
Acute pancreatitis is caused by premature
activation of pancreatic enzymes
In acute pancreatitis, the disease happens in the pancreas itself, but it can sometimes
effect other organs
In acute pancreatitis, the pancreas is digested by
by its own enzymes (as noted above, the enzymes are being secreted prematurely)
The most critical enzyme causing this digestion of the pancreas is
trypsin
Once the pancreas starts digesting itself because of trypsin and the other enzymes, there’s an
inflammatory response
In pancreatitis, the inflammatory response causes even more severe tissue damage than the
enzymes
In pancreatitis the inflammatory response damages the pancreas and
other organs.
The most common factors associated with acute pancreatitis are
alcohol abuse and gallstones
It is possible that alcohol abuse and gallstones block pancreatic ducts, which starts the process of
premature secretions and inflammation
Acute pancreatitis is also associated with hyperlipidemia, hypercalcemia, infection, abdominal/surgical trauma, and
thiazide diuretics
Acute pancreatitis is diagnosed when someone has at least 2 of these findings
- abdominal pain (may radiate to other areas too)
- amylase or lipase (which are pancreatic secretions) elevated more than 3 times the normal limit
- classic signs of abdominal imaging
It’s also possible to have elevated WBC count and elevated bilirubin
To detect gallstones, you can use an
ultrasound
To detect necrosis or fluid retention you can use a
CT scan
A physical exam of someone with pancreatitis might find
fever, tachycardia, hypotension
pancreatitis Treatment includes
- pain relief
- letting the pancreas rest by having the patient NPO
- restoring lost plasma volume (I guess this means via IV since the patient is NPO)
For pancreatitis, Gastric suctioning can be used to empty the stomach, which
decreases the production of pancreas secretions
Complications of pancreatitis can include
-infection
-fluid retention
-cysts
The cyst may be evidenced by jaundice
The beginning of chronic pancreatitis involves
permanent destruction of the exocrine pancreas and fibrosis
Later in chronic pancreatitis you have destruction of the
endocrine pancreas.
THE MAIN DIFFERENCE BETWEEN ACUTE AND CHRONIC PANCREATITIS IS THAT
CHRONIC IS IRREVERSIBLE
The most common cause of CP is
alcohol abuse
Less common causes of CP are
blockage of the ducts and a hereditary condition. But again, alcohol is by far the most common cause.
Episodes in CP are usually less __ than in acute pancreatitis.
severe
The episodes of CP may be triggered by
alcohol or over eating.
CP can eventually lead to
diabetes and malabsorption syndrome
Treatment of CP includes
- treating biliary tract disease if present
- low fat diet
- no alcohol ever
- pancreatic enzymes can be given to help with malabsorption syndrome
- surgery may be needed to remove an obstruction
largest organ
liver
The liver makes __, which emulsifies fats
bile
It doesn’t chemically change fats, it just physically breaks them into smaller pieces
bile from the liver
The liver’s main job is to
filter the blood coming from the digestive tract, before passing it to the rest of the body.
The liver also makes
proteins important for blood clotting and other functions.
When blood glucose is high, the liver
converts glucose to glycogen
Converting glucose to glycogen is called
glycogenesis
When blood glucose is low, the liver
breaks down glycogen. This is called glycogenolysis
Liver failure occurs when 80 to
90% of liver function is lost
Someone with liver failure might have __ breath
sweet/musty
Liver failure can cause ___ problems
blood problems (anemia, leukopenia, coagulation problems etc)
The blood problems associated with liver failure mean the person might
bruise and bleed easily
Liver failure can disrupt sex
hormones
women with liver failure may have
menstrual problems, lose libido, or become sterile
men with liver failure may have
low testosterone, testes atrophy, gynecomastia
Liver failure can also cause fluid retention because
aldosterone is not being broken down
Liver failure can cause skin symptoms like
vascular spiders, erythema in the palms, clubbing fingers, and jaundice.
Liver failure can affect the central nervous system. It can cause
minor neuro changes like confusion, all the way up to terminal coma.
The central nervous system problems are possibly because a diseased liver is not able to handle
neuro toxins
When liver failure causes neuro problems its called hepatic
encephalopathy
Treatment of liver failure includes
- managing symptoms
- preventing infections
- providing enough calories and protein
- providing fluids and electrolytes
Cirrhosis is the
end stage of liver disease. Involves scarring
In cirrhosis, a lot of the liver tissue has been replaced by __ tissue
fibrous
The fibrous tissue in cirrhosis disrupts
blood flow, which eventually kills the liver
The fibrous tissue in cirrhosis disrupts blood flow, which eventually kills the liver. Also causes
portal hypertension and blocks bile pathways.
the most common cause of cirrhosis is
alcohol
in addition to alcohol, cirrhosis can be caused by
metabolic disorders where minerals build up in the liver
when cirrhosis is caused by a metabolic disorders where minerals build up in the liver, the minerals are
iron and copper
Cirrhosis involves the formation of ___ in the liver.
nodules
in cirrhosis sometimes there are no symptoms until the disease is
really serious.
Cirrhosis symptoms
Symptoms can be weight loss, anorexia, weakness, diarrhea
There are other manifestations similar to liver failure like hepatic encephalopathy and bleeding.
chloride level
95 to 105
Phosphorus level
2.5 to 4.5
Magnesium level
1.5 to 2.5
Crohn disease involves
inflammation of various parts of the GI tract. The cause is unknown.
Crohn disease effects
women in their 20s and 30s (but men too)
Crohn disease is evidenced by
lesions in the mucosa of the GI
Crohn disease all layers of the GI are affected, especially the
submucosa
Crohn disease the bowel gets a __ appearance
“cobblestone” appearance.
Crohn disease bowel wall becomes
stiff
Crohn disease Symptoms include
- diarrhea
- colicky pain
- weight loss
- fluid/electrolyte problems
- fever
- malaise
Children with Crohn disease may not
grow properly because they’re not absorbing nutrients.
A common complication of Crohn disease is
fistulas (tunnels connecting different parts of the body)
People with Crohn disease need a diet high in
calories, vitamins, and proteins, but low in fats.
Drug therapy and surgery may be needed for
Crohn disease
This disease can affect one or all layers of the GI wall
Peptic Ulcer Disease
Peptic Ulcer Disease can be caused by
H. pylori infection or excessive use of NSAIDs
Peptic Ulcer Disease can be caused by H. pylori infection or excessive use of NSAIDs. These causes are even more likely to cause ulcers if the person
smokes, takes corticosteroids, or has certain genetic factors/certain blood type.
Peptic Ulcer Disease symptoms
pain when the stomach is emptying or in the middle of the night.
Peptic Ulcer Disease pattern
The pain occurs for weeks or months at a time and then stops for a little while.
Peptic Ulcer Disease pain can be relieved by
Eating and taking antacids
Peptic Ulcer Disease can also cause
hemorrhage
in Peptic Ulcer Disease, the bleeding can be
be sudden and severe, or it can be insidious and produce only occult blood.
In acute hemorrhage the stool can be
tarry or red. Also you can have coffee-ground like vomit
When an ulcer burns all the way through the layers of the tract it’s called
perforation
When the ulcer goes even further, into an adjacent organ, it’s called
penetration
The goal of peptic ulcer disease is to
eliminate the cause which completely cures you (unlike with crohns disease which has no cure).
during treatment of Peptic Ulcer Disease, avoid
NSAIDs
stomach cancer:
Risk factors include
- genetic factors
- carcinogenic foods (like preserved foods)
- autoimmune gastritis
- Adenomas and polyps.
- chronic infection of H. pylori
Often people don’t have any symptoms of stomach cancer until it’s
very serious
Another reason that stomach cancer is hard to diagnose is that the symptoms are
pretty vague and could mean anything, like vomiting and weight loss.
Appendicitis is most common for people in their
20s and 30s
Appendicitis: The cause is unknown, but the condition results in the appendix wall being
perforated
Appendicitis: addition to pain and nausea, you will have increased
WBC count and temperature.
Appendicitis: If you palpate, tenderness
and rebound tenderness are common.
Appendicitis: The appendix must be
removed
gallbladder function
It stores excess bile from the liver.
the gallbladder opens up and the bile comes out when the duodenum is
full
A kidney disease that effects the tubules, interstitium, and pelvis of the kidney.
pyelonephritis
Acute pyelonephritis is caused by
bacterial infection.
Chronic pyelonephritis is caused by
bacteria as well as other factors such as reflux.
Most kidney infections are secondary to
UTIs
The bacteria that usually causes acute pyelonephritis is
E. coli
When acute pyelonephritis occurs in a woman without other contributing factors (like blockage) it’s called
uncomplicated acute pyelonephritis
When acute pyelonephritis occurs in children or adults with additional contributing factors is called
complicated acute pyelonephritis
Factors that contribute to the development of acute pyelonephritis include
- obstruction
- catheters
- reflux
- pregnancy
- neurogenic bladder
the main reason that bacteria are able to enter and infect the kidney.
Dysfunction of the vesicourteral orifice
Another acute pyelonephritis involves ischemia and is called
Papillary Necrosis
Papillary necrosis effects the renal
renal pyramids
Papillary necrosis is most common in people with
diabetes
Acute pyelonephritis can usually be easily treated with
antibiotics
Chronic pyelonephritis is more serious. There is scarring and atrophy of the
renal cortex and renal calyces
In chronic, pyelonephritis, instead of just a bacterial infection alone, there’s a combination of factors like
obstruction and/or reflux.
the most common cause of chronic pyelonephritis
reflux
Chronic pyelonephritis tends to have a recurrent history of
UTI
Chronic pyelonephritis can cause
renal failure
Renal failure is evidenced by
elevation in serum creatinine, no urine formation, and needing dialysis
Acute Kidney failure can result from loss of blood to the kidneys, which is called
pre-renal injury
Acute Kidney failure can also occur from conditions that block elimination of urine, which is called
post-renal injury
Acute Kidney failure can also occur problems within the kidney itself, which is called
intra-renal injury
Intra-renal injury is usually caused by
tubular necrosis
Acute Kidney failure is
reversible
Acute kidney failure is treated with fluids, dialysis, or
renal replacement therapy.
Chronic kidney failure results in permanent loss of
nephrons
Chronic kidney failure also results in decline in renal function for a period of more than _ months.
3 months
Chronic kidney failure can cause
diabetes
The best way to measure kidney function is
GFR
Chronic kidney failure can have a wide range of effects including
skeletal, skin, sexual, and neuromuscular.
The 2 kinds of treatment of Chronic kidney failure are conservative
conservative management and renal replacement therapy.
Conservative treatment is to prevent further damage to the kidney and
assist the body in compensating.
Renal replacement therapy includes
dialysis or kidney transplant
It’s used for advanced urecemia or electrolyte problems.
Renal replacement therapy (includes dialysis or kidney transplant)
In children, Chronic kidney failure can be
inherited or acquired
The best renal therapies for children are
CCPD, NIPD, and transplantation.
stones tend form in only
1 kidney at a time.
For types of stones
- calcium
- magnesium ammonium phosphate
- uric acid
- cystine
The causes of calcium, uric acid, and cystine stones are
self explanatory, i.e. calcium stones are caused by hypercalcemia
The causes of calcium, uric acid, and cystine stones are self explanatory, i.e. calcium stones are caused by hypercalcemia. Any other causes she gives are probably going to be
magnesium-ammonium-phosphate stones
The most common kidney stones are
Calcium stones
magnesium-ammonium-phosphate stones are also called
struvite stones
magnesium-ammonium-phosphate stones usually require
surgical removal.
Uric acid stones can develop during
gout
The major symptom of kidney stones is
pain
A disorder caused by an imbalance between the amount of insulin available and the amount of insulin needed
Diabetes
in diabetes, the imbalance causes problems metabolizing
carbs, protein, and fats.
Type 1
the beta cells are destroyed and there’s absolutely no insulin.
Type 2
when there’s not enough insulin or the body can’t use the insulin that’s available.
Diabetes can also be caused by another disease that destroys the beta cells or another disease that causes
glucose imbalance
A symptom of type 1 can be weight loss
(despite eating a normal amount)
Oral diabetic drugs can sometimes be used for treating type
2
Acute complication of diabetes includes
ketoacidosis
Types of UTIs include
bacteriuria, cystitis, pyelonephritis
Factors that increase the risk for UTI include
UT blockage
Urine sitting still in the tract for a long time
Reflux
Changes that happen to the tract during pregnancy and during aging
Catheters
The most common bacteria of UTIs is
E. coli
Other UTI bacteria include
enterococcus, staphyloccus, klebsiella, proteus, pseudomonas.
metabolic syndrome is characterized by: o\_\_\_ \_\_\_ resistance high levels of \_\_\_\_ low \_\_\_ hyper\_\_\_ \_\_\_\_ disease
Obesity insulin resistance high levels of triglycerides low HDL hypertension cardiovascular disease
metabolic syndrome is characterized by:
o___
obesity
metabolic syndrome is characterized by:
___ resistance
insulin
metabolic syndrome is characterized by:
high levels of ____
triglycerides
metabolic syndrome is characterized by:
low ___
HDL
metabolic syndrome is characterized by:
hyper___
hypertension
metabolic syndrome is characterized by:
____ disease
cardiovascular disease
metabolic syndrome also involves risk for
type 2 diabetes
Often call “wear and tear” arthritis
osteoarthritis
osteoarthritis is a slowly destructive disorder of the
articular cartilage
osteoarthritis can have a congenital or
acquired cause
osteoarthritis Risk factors include- o\_\_ age m\_\_ j\_\_ i\_\_ n\_\_\_ o\_\_\_
old age
multiple joint involvement
neuropathy
obesity
Inflammation in osteoarthritis causes the loss of cartilage to be
progressive
A chronic systemic inflammatory disorder affecting multiple joints
rheumatoid arthritis
rheumatoid arthritis is a chronic systemic inflammatory disorder affecting
multiple joints
rheumatoid arthritis involves inflammatory changes in the
synovium of the joint
in rheumatoid arthritis there is formation of a destructive granulation tissue called
pannus
RA leads to
joint instability and deformity
Gout is a joint disease caused by
crystals
Gout: Specifically there are ___ urate crystals in the joint cavity
monosodium
An acute attack of gout involves
pain, redness, swelling at a joint
Gout is accompanied with
hyperuricemia (Increased serum uric acid level)
Metabolic disease with decreased bone density.
Osteoporosis
The most common causes of Osteoporosis are
aging and decreased estrogen after menopause
In pancreatitis, inflammation produces large volumes of
serous exudate
In pancreatitis, inflammation produces large volumes of serous exudate which leads to
Hypovolemia and Hypocalcemia
In CP you can have glucose control problems because of damage to
islets of Langerhans
In CP you can also have signs of biliary obstruction because of underlying
bile tract disorders or duct compression by tumors
The liver weighs
3.3 lbs
The liver is enclosed in the
glisson capsule
The hepatic sinusoids are lined with 2 types of cells; the typical capillary endothelial cells and the
kupffer cells
Liver has a dual blood supply; venous supply the hepatic portal vein and arterial supply through the
hepatic artery
In the liver the sinusoids empty into central veins, which send the blood to the
hepatic vein
At the back of each hepatic cell, bile is released into a
canaliculus
The section of the liver emptying into one vein is a
lobule
The liver also serves as an ___ organ
excretory organ
miscellaneous liver failure results are
hypokalemia and fluid loss
hand tremor associated with liver failure
Asterixis
Liver cells contain fat deposits; liver is enlarged
Steatosis
In biliary disorders, the bile flow
slows down
In biliary disorders, alkaline phosphatase is
released into blood
A symptom of biliary disorders can be
itching
Cirrhosis associated cirrhosis with alcoholism ,
viral hepatitis and biliary disease
In cirrhosis a late manifestation of cirrhosis and portal hypertension is
Ascites
In cirrhosis scar tissue partially blocks sinusoids and bile
canaliculi
gallstones are aka
cholelithiasis
cholecystitis is inflammation caused by irritation due to concentrated
bile
Inflammation of the common bile duct
Cholangitis
Stones in the common bile duct
Choledocholithiasis
Acute diabetes complications can include
Somogyi effect and Dawn phenomenon
Diabetic neuropathy includes diminished
perception
In gestational diabetes, blood sugar usually returns to normal soon after
delivery
if you’ve had gestational diabetes, you’re at risk for type
2 diabetes
osteoarthritis often secondary to
physical damage
In osteoarthritis the joint tries to heal itself, but that actually causes even more damage and the formation of
osteophytes or spurs
In osteoarthritis the cartilage contains more water, less
collagen
rheumatoid arthritis involves a genetic
predisposition
a risk factor for rheumatoid arthritis is
smoking
RA treatment:
- NSAIDs
- Corticosteroids
- (COX)-2 inhibitors
- DMARDs; retard the progression
- Biological agents
