Patho test 2 Flashcards
Syndrome of inappropriate antidiretic hormone secretion (SIADH) is characterized by ____ levels of ADH in the absence of normal control mechanisms.
high
An anterior pituitary adenoma usually causes ___ of hormones from the adenoma itself and ___ of hormones from the surrounding pituitary cells.
hypersecretion; hyposecretion
Women who have gestational diabetes have ___ risk for type 2 diabetes later in life.
increased
An individual with type 1 diabetes who have the dawn phenomenon has a ___ blood glucose in the early morning than in the middle of the night.
increased
Cretinism is caused by untreated congenital ___.
hypothyroidism
In autoimmune diabetes, also called type ___ diabetes, pancreatic beta cells are destroyed by autoreactive ___.
1A ; cytotoxic T lymphocytes
Persons who have type 1 diabetes have a deficit of insulin and ____ and a relative excess of ___.
amylin ; glucagon
In diabetes, microvascular disease refers to ____ whereas macrovascular disease refers to ___.
destruction of capillaries ; accelerated atherosclerosis.
What are some characteristics of cushings disease?
facial flush; moon face; purple striae, trunk obesity, thin extremities, easy bruising, pendulous abd.
Caused by a problem in the gland that secretes a hormone whose action is directed toward other tissues rather than to another gland
Primary endocrine disorder
cortisol excess causes
lipolysis and altered fat distribution
Reason why people with Cushings bruise so easily
excess cortisol causes proteins to break down and make small blood vessels fragile
Reason why people with Cushings have hyperpigmentation
ACTH excess causes excess production of MSH which stimulates melanin
Caused by a problem with a gland that secretes a hormone whose target tissues are another gland that it stimulates or suppresses.
Secondary endocrine disorder
It is the effects of having too much thyroid hormone, as seen with hyperthyoidism
thyrotoxicosis
The effects of dangerously high levels of thyroid hormone
thyrotoxic crisis
S/S of thyrotoxic crisis
high fever, extreme tachycardia, and potential death from heart failure or cardiac dysrythmias.
caused by a problem in the hypothalamus of the posterior pituitary that decreases ADH release
neurogenic diabetes insipidus
caused by a problem in the kidney itself that causes insensitivity to ADH.
nephrogenic diabetes insipidus
Hypersecretion of growth hormone in adults
acromegaly
Occurs with hypersecretion of growth hormone in children and adolescents whose epphyseal plates have not yet closed, so their big bones are able to grow
gigantism
Lethargy, hyponatremia, perhaps seizure, decreased plasma osmolality, concentrated urine
SIADH
Lethargy, cold intolerance, hoarseness, nonpitting boggy edema around eyes, course hair, decreased body temperature
Hypothyroidism
Hypertension, tachycardia, palpitations, severe HA, diaphoresis, heat intolerance, weight loss, constipation.
pheochromocytoma
Virilizations: lack of breast development, hirsutism, increased muscle bulk
adrenal adenoma causing hypersecretion of androgens in a woman
polyuria, decreased level of consciousness, kussmaul breathing, acetone smell of breath, hyperglycemia, decreased blood pH, ketonuria, glycosuria.
diabetic ketoacidosis
tachycardia, diaphoresis, tremor, pallor, confusion, decreased level of consciousness, perhaps seizure
hypoglycemia
hypertension, hypokalemia, increased blood pH, increased urine potassium
primary hyperaldosteronism
polydipsia, nocturia, polyuria, increased appetite, weight loss, hyperglycemia, glycosuria
type 1 diabetes mellitus
polydipsia, nocturia, polyuria, hypernatrremia, increased plasma osmolality, large volume of dilute urine
diabetes insipidus
weakness, fatigue, hypotension, hyperkalemia, hypoglycemia, elevated ACTH
Addison Disease
Failure of the hypothalamus to secrete its usual hormones presents clinically as ___ disease.
pituitary
Tumors of chromaffin cells of the adrenal medulla are called ____.
pheochromocytomas
Excessive water intake that decreases plasma osmolality by overwhelming the ADH mechanisms is called ___ diabetes insipidus.
dipsogenic
When necrosis or another problem in the anterior pituitary causes deficiency of all its hormones, the individuals has ___.
panhypopituitasism
Prolactin-secreting tumors in the ___ pituitary are called ___ in women, they cause ___.
anterior ; prolactinomas; galactorrhea (milk production not associated with childbirth).
Persons who have longstanding diabetes may develop hypoglycemia without the usual sympathetic nervous system manifestations, a condition called ___.
hypoglycemia unawareness
A person who has hypothyroidism can develop a nonpitting boggy edema called ___, that same term, when used with the word coma, indicates the ___ level of consciousness associated with severe hypothyroidism.
myxedema ; decreased
Type 1 diabetes often is diagnosed when the acute complication ____.
diabetic ketoacidosis.
Enlargement of the thyroid gland is called a ___ and is a response to increased stimulation by ___.
goiter ; TSH
Persons who have primary hyperparathyroidism are predisposed to form kidney ___.
stones
____ is caused by hypersecretion of ACTH from the anterior pituitary, but the term ____ is used for any condition involving chronic exposure to excessive cortisol.
Cushing disease; Cushing syndrome
Two basic components of the pathophys behind type 2 DM?
insulin resistance ; pancreatic beta cell dysfunction
The risk for developing gonorrhea from intercourse with an infected heterosexual partner is great for
women
In the United States , the prevalence of syphilis is highest among
men
The rash of ___ syphilis is unusual because it appears ____ as well as on the torso.
secondary; on palms of hands and soles of feet
____ who develop chancroid infection usually are asymptomatic.
women
Persons who are symptomatic for chancroid infection develop…
painful genital ulcers and buboes
HPV serotypes 16 and 18 are associated with
anogenital cancer
HPV serotypes 6 and 11 are associated with _
genital warts
Trichomoniasis is caused by a
parasite
Trichomoniasis adheres to
squamous epithelium
Although trichomonas infection may be asymptomatic in men or women, women who have symptoms usually report
pruritis and a copious frothy discharge that smells very unpleasant
Genital warts are __ contagious and are caused by a ____
highly; virus
Persons who have HSV infection can transmit the virus
whether or not they have symptoms
An anaerobic spirochete
syphilis
circular, double stranded DNA virus that has numerous strains
HPV genital warts
gram-negative diplococci
gonorrhea
gram-negative intracellular bacterium
chylamydia
linear, double stranded DNA virus that has latent stage in neurons
herpes simplex virus
a painless ulcer with indurated edges
chancre
a painful, swollen abscessed lymph node
bubo
condylomata lacuminata are genital warts caused by
HPV
condylomata lata are flat warts characteristic of
syphilis
pubic lice that attach to hair and bite the skin for nourishment
crabs
mites that burrow into the skin to lay eggs
scabies
The bacteria that causes gonorrhea attach to host ___ cells of mucous membranes at the site of initial infection.
epithelial
Untreated genital gonococcal infection that spreads can cause ___ in men and ____ in women, both of which can lead to sterility.
epididymitis; pelvic inflammatory disease
Gonorrhea transmitted by an infected mother before or during birth typically manifests as an ____ infection in the neonate and develops 1 to 12 ____ after birth.
eye; days
excessive scratching of pruritic lesions such as from scabies or pubic lice can lead to
secondary infection
granulaoma inguinale, also known as ___ , is a chronic progressive destructive bacterial infection of genitals.
Donovanosis
The chronic STI lymphogranuloma venereum begins as infection of the genital ___ and then spreads to the ___ tissue.
skin; lymph
Hepatitis ____ definitely can be transmitted sexually, and hepatitis A and C may have the potential for sexual transmission also.
B
Typical lesions of genital herpes begin as painful ____ that break open and then crust over before they heal.
vesicles
Recurrent episodes of genital herpes typically are ____ severe and have ___ duration than the primary episode.
less; shorter
The most common manifestations a women with chlamydia can transmit to her infant
conjunctivitis and pneumonia
Much cardiovascular development occurs between weeks ___ of gestation; most congenital heart defects have begun to develop by the ___ week of gestation
4 to 7; 8th
The umbilical vein carries __ blood in fetal life
oxygenated
After birth, systemic vascular resistance ___ and the pulmonary vascular resistance ___
increases; decreases
Neonates have ____ cardiac reserve because they have ___ cardiac output and high oxygen demand.
little; high
Bluish color of mucous membranes and nail beds caused by presence of deoxygenated hemoglobin is called ____
cyanosis
Heart failure in children is ___ manifested by peripheral edema and neck vein distension
rarely
The most common congenital heart defect is ___ septal defect; many of these defects ___ close spontaneously.
ventricular; will
Fetal oxygenation occurs in the _______.
placenta
Pulmonary overcirculation caused by an uncorrected congenital heart defect causes the smooth muscle layer in the pulmonary arterial tree to _______ and the lumens to ______.
thicken; narrow
Failure in the endocardial cushions to fuse during fetal life causes an _______ canal defect and frequently occurs in children who have _______ syndrome.
atrioventricular; down
Underdevelopment of the left heart is termed _______ left heart syndrome.
hypoplastic
With transportation of the great arteries, the aorta arises from the _______ ventricle, and the pulmonary artery arises from the _______ ventricle; unless additional defects are present, this defect is incompatible with _______ life.
right; left; extrauterine
The condition in which the pulmonary artery and the aorta are a single blood vessel is called _______ _______.
truncus arteriosus
Young children who develop _______ disease have vasculitis of unknown cause and often develop aneurysms of their _______ arteries that may regress as the condition resolves.
Kawasaki; coronary
Sustained hypertension in children often is associated with underlying _______ disease.
renal
The presence of parental obesity is associated with childhood _______.
obesity
Because fetal circulation bypasses the lungs, most blood entering the right side of the heart passes through ________ __________ and enters systemic circulation.
ductus arteriosus
Right to left shunting in fetal circulation occurs through what structure in fetal hearts not found normally in adult hearts?
Foramen ovale
an opening between the atria
foramen ovale
All structures of the fetal heart and vascular system are present by what week of fetal gestation?
8th
A fetal vessel that joins the pulmonary artery to the aorta (so fetal circulation bypasses the lungs) is called
ductus arteriosus
What structure connects the inferior vena cava to the umbilical vein in the fetus?
ductus venosus
Systemic vascular resistance in a fetus increases after birth as a result of severance of the umbilical cord (placenta was low-resistance) causing what structural change to occur in the infant’s myocardium over time?
thickening of left ventricular myocardium.
During fetal life, the right and left ventricles have
equal thickness
During fetal life, systemic and pulmonary resistance is
the same
At what week of gestation do most congenital heart defects begin to develop?
8th
direction of blood shunt in ventricular septal defect
left to right
direction of blood shunt in tricuspid atresia
right to left
direction of blood shunt in coarctation of the aorta
no shunt
direction of blood shunt in atrial septal defect
left to right
direction of blood shunt in tetralogy of fallot
right to left
direction of blood shunt in pulmonic stenosis
no shunt
direction of blood shunt in patent ductus arteriosus
left to right
direction of blood shunt in aortic stenosis
no shunt
In fetal life, blood flows through the ductus arteriosus from the
pulmonary artery to the aorta
If the ductus arteriosus does not close after birth, blood flows from
the aorta to the pulmonary artery
a congenital heart defect that causes a right to left blood shunt is caused by
cyanosis and hypoxemia
clinical manifestations of a right to left blood shunt include
poor feeding and weight gain, dyspnea on exertion, fatigue.
A congenital heart defect that causes a left to right blood shunt is caused by
pulmonary overcirculation or acyanotic heart failure
clinical manifestation of a left to right blood shunt include
failure to thrive, dyspnea, tachypnea, frequent resp infections.
when blood pressure is high in the arms and low in the legs
coarctation of the aorta
this is a normal blood vessel during fetal life but is supposed to close at birth
ductus arteriosus
atrial septal defect causes this clinical manifestation
murmur
The typical murmur of TOF is a
pulmonary systolic ejection murmur.
cyanosis does not occur with
left to right shunts
If your patient complains of constipation, would hyperthyroidism by suspected?
No, everything is revved up
What is a manifestation of hypocalcemia
tetany
What is the most common cause of acromegaly
excess GH due to adenoma
hyperglycemia, hyperosmolar, non-ketotic
Type II DM
What is target organ for ACTH?
adrenal cortex
excessive secretion of GH in an adult can cause
hyperglycemia
The hypothalamus controls this by the direct involvement of regulating hormones
anterior pituitary gland
When calcium levels are high, this is increased and inhibits osteoclasts
thyrocalcitonin
Those taking cortisone for long periods and who suddenly stop will likely suffer from what due to what?
adrenal insufficiency due to suppression of adrenal cortex
What organ secretes renin
kidneys
42-year old prostitute who became sexually active at age 14 is at risk for developing what?
HIV
In BPH, enlargement of periurethral tissue of the prostate gland can cause…
obstruction
Hormones are known as
chemical messengers
Alterations in the conduction of impulses through the AV node lead to disturbances from where to where?
atria to ventricle
represents the inability of the circulation to adequately perfuse tissue
circulatory shock
hormones produced by the adrenal cortex
cortisol, aldosterone, androgens
the hormone that has an antidiuretic effect and whose chemical structure is similar to ADH?
oxytocin
the role played by the SA node
begins depolarization
Heart valves control
one-way flow
the vessels that represent most of the peripheral vascular resistance that controls BP?
arterioles and small arteries
two things that can cause an endocrine hormonal problem
overproduction and underproduction
substance that brings about the greatest increase in the rate of respiration
CO2
electrolyte changes in adrenal insufficiency
hyperkalemia and hyponatremia
tumor of chromaffin cells in the adrenal medulla
pheochromocytoma
effects of pheochromocytoma
Epi and NE released causing paroxysmal hypertension
major problem in emphysema
alveoli are less able to recoil and expel air
cause of TB
mycobacterium
how PE is diagnosed
VQ scan or CT
hormones necessary for growth and development of female breast
estrogen and progesterone
hormones that have an affect on blood glucose
insulin, glucagon, cortisol, GH, epi
cortisol can increase risk for developing
diabetes
the posterior pituitary serves as a repository for which 2 hormones?
ADH and oxytocin
Where is ADH and oxytocin produced
hypothalamus
symptoms for Graves disease
exophthalmos, goiter, hyperthyroid state
A patient loses pituitary function, what hormones do you replace him with?
cortisol, ADH, and synthroid IV
The patient who loses pituitary function cannot recieve ACTh because
it doesn’t last long in the blood.
QRS complex represents
ventricular contraction
in atrial systole, the valves are
open
atelectasis is
alveolar collapse
primary hypertension is
idiopathic
where are the pulmonary veins?
coming back to the left atrium
which age group is most likely to be carriers of the flu?
children
how does SARS differ from EBOLA?
SARS is airbone, Ebola is droplet.
How fast did SARS spread?
29 countries in a short spring/summer
consequence of aortic stenosis
left ventricular hypertrophy
common congenital heart defect
VSD
consequence of mitral stenosis
left atrial hypertrophy
the tendency of lung tissue to collapse inward all the time
elastic recoil
a heart murmur significantly affects
heart rate
most common cause of hypoxemia
ventilation-perfusion inequality
persons with obstructive resp disorders have most difficulty with
expiration
where is the pericardial space?
between the visceral and parietal pericardium
metabolic syndrome is very
common
s/s of metabolic syndrome
hypertension, high lipids, early hyperglycemia, overweight
At what age is SIDS most common?
3-4 months
what is the cause of diabetes insipidus?
lack of ADH
hypothyroidism in adults in called
myxedema
distended and torturous superficial veins in which blood has pooled because of damaged valves
varicose veins
ischemic pain in lower extremities that occurs while walking but disappears when resting
intermittent claudication
inflammatory disease of peripheral arteries that usually is associated with smoking
thromboangitis obliterans
vasospastic disease of peripheral arteries in which episodes of ischemia and pallor are followed by rubor and parasthesias
raynaud disease
inflammation of the membraneous sac that surrounds the heart
pericarditis
compression of heart by pericardial fluid
tamponade
Post-thrombotic syndrome is characterized by chronic persistent pain and ____ of a limb that had a deep venous thrombosis.
edema and ulceration
A major danger of DVT is development of ____ thromboembolism; a danger of an arterial thrombus is development of ____ thromboembolism.
pulmonary; systemic
Superior vena cava (SVC) syndrome occurs when a tumor or other mass ______ the SVC causing _____ in the upper extremities and head.
compresses; severe hypertension
Factors that cause primary hypertension increase peripheral vascular ____ and/or cause sustained _____ in blood volume.
resistance; increase
In HTN, the pressure-natriuresis relationship shifts so that the hypertensive individual excretes ___ sodium in the urine.
less
Persons who have uncomplicated hypertension usually have ____ signs and symptoms in addition to their elevated BP; treatment usually begins with _____.
no; lifestyle modifications
The term “dissecting aneurysm” means that blood enters an artery wall and _____
runs between the layers of the wall
Risk for MI increases with low blood levels of ___ and with high blood levels of ___
HDL; LDL
Cardiac valve damage in rheumatic fever is caused by ___ whereas cardiac valve damage in infective endocarditis is caused by ___.
an abnormal immune response; streptococci or other organisms
A clot in a blood vessel that breaks loose and circulates is called a
thromboembolis
Sluggish circulation from chronic venous insufficiency may cause a venous __________ ulcer.
stasis
Rapidly progressive hypertension with a diastolic pressure above 140 mmHg is called ____________ hypertension and can damage the ____________.
malignant; brain
Postural hypotension, also called ____________ hypotension , is a systolic blood pressure decrease of at least __ mmHg or a diastolic blood pressure decrease of at least __mmHg within 3 minuets of standing and is a significant risk factor for ___________.
orthostatic; 20; 10; falls
The risk factors for peripheral arterial disease are the same as the risk factors for _______; the risk factors for contrary artery disease are the same risk factors for _________.
atherosclerosis; atherosclerosis
Clot formation at the site of rupture of an atherosclerotic plaque causes tissue __________ , which leads to ________ if blood flow is not restored.
ischemia; infarction
Persons who are obese have decreased levels of ______, an antiatherogenic adipokine.
adiponectine
Tissue healing after myocardial infarction creates a noncontractile _______.
scar
The ischemic injury from a sudden blockage of a coronary artery can be exacerbated by _______ injury when blood flow is restored.
reperfusion
Acute rheumatic fever is characterized by carditis, acute migratory ________ , chorea, and _______ marginatum, which occur 1 to 5 weeks after streptococcal infection of the _______.
polyarthritis ;erythema; pharynx
Heart failure in which the cardiac output is increased but still insufficient to meet the body’s oxygen and nutrient needs is called _______ heart failure.
high-output
Right atrial and right ventricular dilation and hypertrophy
tricuspid regurgitation
Left atrial hypertrophy and dilation
mitral stenosis
Left ventricular hypertrophy and dilation
aortic stenosis
Left atrial and left ventricular dilation and hypertrophy
mitral regurgitation
Nonspecific marker of inflammation measured to asses cardiac risk
CRP
Another term for Peinzmetal angina
variant
Blood clot that is attached to the endothelium in a blood vessel or cardiac chamber
thrombus
Valve cusps billow backward into valve opening when valve should be closed
prolapse
Acronym for type of lipoprotein that migrates into arterial walls in atherosclerosis
LDL
Acronym for elevated systolic blood pressure accompanied by normal diastolic blood pressure
ISH
Name three factors that promote venous thrombosis (triad of Virchow)
venous stasis, hypercoagulability, venous endothelial damage
involves persistently ischemic myocardium that undergoes metabolic adaptation to survive until perfusion is restored
myocardial hibernation
involves temporary loss of contractile ability after perfusion has been restored.
myocardial stunning
when the cardiac chambers are enlarged and the myocardium has decreased contractility
diastolic cardiomyopathy
when the cardiac chambers have decreased diastolic volume because the myocardium is rigid and noncompliant
restrictive cardiomyopathy
narrowing of a valve that impedes the forward flow of blood
valvular stenosis
incomplete closure of a valve which allows blood to leak backward through the valve
valvular regurgitation
a sudden weight gain of 2 lbs indicates a gain of
1 L of fluid
a complication of thyroid surgery
injury to parathyroid gland causing hypcalcemia and tetany
when kidneys don’t receive enough ADH signals causing large amounts of dilute urine
diabetes insipidus
those with Addison disease typically complain of
lightheadedness when standing up
Addison disease involves the lack of
aldosterone and cortisol
a complication of diabetic autonomic neuropathy can cause
gastroperesis
diabetic nephropathy is manifested by
microalbuminuria
anorgasmia is disorder of
organsm
decreased libido is a disorder of
desire
dyspareunia is disorder of
sexual pain
hypoactive sexual desire is disorder of
desire
vaginismus is disorder of
sexual pain
ductal carcinoma in situ ____ progress to advanced breast cancer
dose not always
PID includes infection of
uterus, fallopian tubes, and ovaries
pain with sexual intercourse
dyspareunia
pain with defecation
dyschezia
polycystic ovary syndrome causes androgen and estrogen levels to be
increased
when the foreskin cannot be retracted over the glans penis
phimosis
the foreskin is retracted and cannot be returned to its normal position over the glans penis
paraphimosis
prostate cancers grow
slowly
undescended testicles have an increased risk for
testicular cancer
stidor is high pitched sounds made during
inspiration
wheezing is high pitched sounds made during
expiration
alveolar collapse caused by gases being absorbed from alveoli that are obstructed
absorption atelectasis
alveolar collapse caused by external pressure on the alveoli
compression atelectasis
the pressure of the air in the pleural space is the same as barometric pressure because the air drawn into the pleural space during inspiration is forced back out during expiration
communication pneumothorax
the pressure of the air in the pleural space exceeds barometric pressure because air enters during inspiration but cannot exit during expiration
tension pneumothorax
