Pathophysiology 2 Flashcards
The kidney excretes nitrogenous wastes in the form of BUN, this is made in the:
○ A: Liver
○ B: Kidney
○ C: Heart
○ D: Colon
A: Liver
§ In LR Failure- BUN↓, NH₃↑ § Protein>N>NH₃>LR>BUN>KD>Excretion
• Sperm production by the seminiferous tubular cells is controlled by:
○ A: LH ○ B: FSH ○ C: Testosterone ○ D: Estrogen
○ B: FSH
○ LH & FSH- from anterior pituituary gland
§ FSH-Seminiferous tubular cells-Sperm
§ LH-Testosterone-Leydic cells
• In chronic renal failure, the anemia is d/t:
○ A: lack of erythropoetin ○ B: lack of renin ○ C: persistent hematuria ○ D: repeated blood testing
○ A: lack of erythropoetin
§ Stimulates bone marrow RBC production
• The active form of vitamin D is made in the:
○ A: Liver ○ B: Lung ○ C: Kidney ○ D: Skin
○ C: Kidney
○ Source vit D= sun + food
§ LR convert to 25 D
§ KD convert to 1,25 D (active form)
• During a normal menstrual cycle, ovulation occurs on:
○ A: first day ○ B: 14th day ○ C: 28th day ○ D: 7th day
○ B: 14th day
§ Ovulation- d/t LH surge § Maximum fertility= days 14-21 +/-
○ 1st day= day of 1st bleed
○ 28th day= cycle completion
○ 7th day= end of bleed (5-7 days)
• In type 2 Diabetes Mellitus
○ A: there is no insulin ○ B: patients cannot utilize insulin properly ○ C: the insulin produced is biologically inactive ○ D: none of the above
○ B: patients cannot utilize insulin properly
• Chronic complications of Diabetes Mellitus include all except:
○ A: heart disease ○ B: kidney disease ○ C: liver disease ○ D: blindness
○ C: Liver disease
○ HKBL² § Heart disease § Kidney disease § Blindness § Limb loss
• Acute complications of diabetes include all except:
○ A: DKA ○ B: Hypoglycemia ○ C: Acute pancreatitis ○ D: infections
○ C: acute pancreatitis
○ DKA= diabetic ketoacidosis
○ Infections d/t WBC’s not functioning as well
• The commonest kind of kidney stone is:
○ A: calcium stones ○ B: triple phosphate stones ○ C: uric acid stones ○ D: cystine stones
○ A: calcium stones= 80%
○ Triple phosphate (struvite)- w/ chronic UTI
○ Uric acid stone- w/ gout, any disease w/ ↑cellular nucleus destruction
• RBC casts are seen in diseases of the:
○ A: kidneys ○ B: urinary bladder ○ C: prostate ○ D: urethra
○ A: kidneys
§ Urinary casts of Loop of Henle
□ KD rel UTI
§ UB- no urinary cast
• In nephrotic syndrome, all are present except:
○ A: proteinuria
○ B: edema
○ C: hematuria
○ D: hyperlipidemia
○ C: hematuria- (nephritic syndrome)
○ “O for PRO”
○ Nephrotic syndrome § Proteinuria (>3.5/24hrs) § Hypoproteinemia § Hyperlipidemia § Edema (d/t low oncotic pressure)
• Calcium containing urinary stones may be present in:
○ A: hyperparathyroidism ○ B: Repeated urinary tract infection ○ C: Increase intake of dietary calcium ○ D: gout
○ A: hyperparathyroidism
§ ↑PTH- Ca↑ d/t PTH stim breakdown of bones by osteoclasts
○ Rpt UTI- struvite/triple phosphate stones
○ Gout- ↑Uric acid- uric acid stones
• Pedal edema in patients w/ nephrotic syndrome is d/t:
○ A: lack of intravascular oncotic pressure
○ B: the KD disease that causes impairment of water excretion
○ C: there is HT disease
○ D: none of the above
○ A: lack of intravascular oncotic pressure
§ d/t severe proteinuria > hypoproteinemia
• What are the causes of acute pancreatitis?
○ GB disease
○ Alcohol
○ Trauma
○ Mumps
○ GB + Alcohol= 80%
• What are acute complications of Diabetes mellitus?
○ DKA
○ Hypoglycemia
○ Infection
• Pre-renal kidney failure results from:
○ A: obstruction ○ B: dehydration ○ C: Renal parenchymal problem ○ D: none of the above
○ B: dehydration
○ Pre-renal= dehydration
○ Post-renal= obstruction
• In hypocalcemia:
○ A: Trousseau's sign may be present ○ B: is caused by hyperparathyroidism ○ C: Is caused by hyperthyroidism ○ D: need not be corrected
○ A: Trousseau’s sign may be present
§ Sign of latent tetany observed in patients w/ low calcium- blood pressure cuff placed around arm and inflated to pressure greater than systolic blood pressure and held for 3 minutes-will occlude brachial artery-will induce spasm hand and forearm muscles-wrist and metacarpophalangeal joints flex, DIP and PIP joints extend, and the fingers adduct.
§ Or Chvostek- facial nerve tapped at angle of jaw (i.e. masseter muscle), facial muscles on same side face will contract
§ Hyperparathyroidism > hypercalcemia
§ Hyperthyroidism> no rel. calcium
• The differential diagnosis of a scrotal mass include:
○ A: inguinal hernia ○ B: cancer of the testicle ○ C: hydrocele ○ D: all of the above
○ D: all of the above
○ D/D scrotal mass: § Inguinal hernia § Hydrocele § Spermatocele § Hematoma/trauma § Orchitis § Epididymitis § Cancer
• Severe pain in the testicular area may be caused by:
○ A: hematoma of the testicle ○ B: torsion of the testicle ○ C: epididymitis ○ D: all of the above
○ D: all of the above
○ Testicular cancer usually painless
○ D/D Testicular pain: § Hematoma/trauma § Torsion of testicle (check @ 12) § Epididymitis § Hydrocele § Varicocle § Inguinal hernia
• If the blood sugar falls below 30 mg% there may be:
○ A: confusion ○ B: convulsion ○ C: coma ○ D: all of the above
○ D: all of the above
• Causes of hematuria include
○ A: Kidney stone ○ B: Cancer of the urinary bladder ○ C: cancer of the kidney ○ D: all of the above
○ D: all of the above
§ KD stone- hematuria + pain § UB cancer- no pain, only hematuria, normal CT § KD cancer- no pain, blood, + w/ CT
○ D/D hematuria: § Infection (UB/KD) § Stones § Cancer (no pain) § Trauma (pt. history) § Menstrual contamination
• In Klinefelter’s Syndrome, which one of the following is present:
○ A: cancer of the testicle ○ B: infertility ○ C: testicular enlargement ○ D: Increased levels of testosterone
○ B: infertility § XXY § male § Testicular shrinkage/atrophy § Gynecomastia § ↓testosterone § ↑FSH § ↑LH
• Melanoma ABC’s
○ A malignant tumor of melanocytes
§ Melanocytes= cells that produce melanin (give skin color)
§ Causes 75% deaths rel. skin cancer
§ ABC's: □ A: asymmetry □ B: borders (irregular) □ C: color (varigated) □ D: diameter (>6mm) □ E: evolving over time
• S/S Acute glomerular nephritis:
○ Hematuria
○ Proteinuria
○ Acute renal failure
○ Good prognosis
○ “hey people a cute girl”
• Repeated vaginal yeast infection may be d/t:
○ A: congenital problem ○ B: diabetes mellitus ○ C: herpes infection ○ D: chronic urine infection
○ B: diabetes mellitus
§ Acute complications D.M.
□ DKA
□ Hypoglycemia
□ Infection
• The hormone produced by the pancreas is:
○ A: glucagon ○ B: glycogen ○ C: gastrin ○ D: thyroxin
○ A: glucagon
○ Glycogen= stored form of glucose
○ Gastrin= ST secretion
○ Thyroxin= thyroid secretion
Many of the women of a village in South America are found to have large goiters. The conclusion that can be made from that observation is that:
○ A: the region is low in iodine
○ B: There is a carcinogen present resulting in a high incidence of thyroid cancer
○ C: No conclusions can be made w/o biopsy
○ D: all of the above
○ A: The region is low in iodine
Unlike ovulation in the female, testosterone production in men, can continue until age:
○ A: 50 ○ B: 60 ○ C: 70 ○ D: may continue indefinitely
○ D: may continue indefinitely
The commonest malignant testicular tumor is:
○ A: Seminoma ○ B: Teratoma ○ C: Leydig cell tumor ○ D: Lymphoma
○ A: Seminoma
○ Teratoma= ovarian malignancy forms from dermoid cyst
• In type 2 Diabetes Mellitus
○ A: there is no insulin
○ B: patients cannot utilize insulin properly
○ C: The insulin produced is biologically inactive
○ D: none of the above
○ B: patients cannot utilize insulin properly
Risk factors for the cancer of the urinary bladder include:
○ A: Undescended testicle ○ B: human papiloma virus infection ○ C: unclean personal hygiene ○ D: tobacco use
○ D: tobacco use
○ Tobacco related cancers: § Esophagus § Bladder § Mouth § Lung
The acute complications of Diabetes include all except:
○ A: DKA
○ B: Hypoglycemia
○ C: Acute pancreatitis
○ D: infections
○ C: acute pancreatitis
○ Acute complications of D.M.:
§ DKA
§ Hypoglycemia
§ Infections
Tertiary syphilis can lead to:
○ A: aneurysm of the aorta ○ B: Dementia ○ C: Tabes dorsalis ○ D: all of the above
○ D: all of the above
○ Primary syphilis:
§ Chancre (lesions)
○ Secondary:
§ Systemic s/s
○ Tertiary:
§ Dementia
§ Aortic aneurysm
§ Tabes dorsalis
RBC casts are seen in diseases of the:
○ A: Kidneys ○ B: Urinary Bladder ○ C: Prostate ○ D: Urethra
○ A: kidneys
§ From loop of henle
In nephrotic syndrome, all are present except:
○ A: proteinuria ○ B: edema ○ C: hematuria
D: hyperlipidemia
○ C: hematuria
○ Nephrotic syndrome (O for PRO) § Proteinuria >3.5g/24 hrs § Hypoproteinemia § Edema § Hyperlipidemia
Name the cancer of the kidney in infants:
○ Wilm’s tumor
Calcium containing urinary stones may be present in:
○ A: hyperparathyroidism ○ B: Repeated urinary tract infections ○ C: increase intake of dietary calcium ○ D: gout
○ A: hyperparathyroidism
§ ↑PTH goes to bone, stimulates osteoclasts- crush bone- release Ca
○ Repeat UTI> Struvite/Triple Phosphate
○ Gout> ↑Uric acid
• In hypocalcemia:
○ A: Trousseau's sign may be present ○ B: Is caused by hyperparathyroidism ○ C: Is caused by hyperthyroidism ○ D: Need not be corrected
○ A: Trousseau’s sign may be present
§ Also Chvolstek
Torsion of the testicle:
○ A: should be treated immediately
○ B: should not be treated immediately
○ C: wait and watch policy should be followed
○ D: if there is any doubt about the diagnosis,
re-evaluation should be made w/in 48 hrs
○ A: should be treated immediately
○ Def: spermatic cord twists causing ischemia (cut testicular blood supply)
Risk factors for the cancer of the penis include:
○ A: undescended testicle ○ B: HPV infection ○ C: unclean personal hygiene ○ D: Tobacco use
○ C: unclean personal hygiene
○ Phimosis- adherence of prepuce to head of penis d/t smegma collection
§ Phimosis–> cancer of penis
The differential diagnosis of a scrotal mass include:
○ A: Inguinal hernia ○ B: Cancer of the testicle ○ C: Hydrocele ○ D: all of the above
○ D: all of the above
○ D/D Scrotal mass: § Inguinal hernia § Epidiymitis § Orchitis § Hydrocele § Hematoma § Torsion of the testicle § Testicular cancer (seminoma= most common)
Severe pain in the testicular area may be caused by:
○ A: hematoma of the testicle ○ B: torsion of the testicle ○ C: epididymitis ○ D: all of the above
○ D: all of the above
○ No pain w/ cancer until progressed
During a 3 day starvation, the body continues to produce glucose from:
○ A: Fat ○ B: Protein ○ C: Carbohydrate ○ D: none of the above
○ B: Protein
§ 2 days glycogen store
§ The break down muscles for usable proteins
Which of the following is not a sexually transmitted disease:
○ A: Gonorrhea ○ B: Syphilis ○ C: Pyelonephritis ○ D: HIV infection
○ C: Pyelonephritis
§ KD disease
In Klinefelter’s Syndrome, which one of the following is present?
○ A: Cancer of the breast ○ B: Infertility ○ C: Testicular enlargement ○ D: increased levels testosterone
○ B: infertility
§ XXY § Male § Gynecomastia § Testicular atrophy § ↓Testosterone § ↑LH
Pre-renal kidney failure results from:
○ A: obstruction ○ B: dehydration ○ C: Renal parenchymal problem ○ D: none of the above=
○ B: dehydration
○ Post-renal= obstruction
What stimulates the Graafian (ovarian) follicle?
○ FSH (Follicle stimulating hormone)
§ From anterior pituitary
What causes ovulation?
○ LH surge
What is the name of the follicle after ovulation and the ova is gone?
○ Corpus luteum
When is maximum fertility?
○ 14-21
○ Ovulation = +/- day 14
What is measured when doing a pregnancy test?
○ HCG (Human chorionic gonadotropin)
§ Urine
§ Blood- more accurate & shows earlier
What is the test for menopause?
○ FSH↑
§ (b/c estrogen↓)
What are the hormones produced by the corpus luteum?
○ Progesterone
○ Estrogen
What stops sperm production and how does it work?
○ Inhibin
§ Hormone produced by the gonads that inhibit FSH production by the pituitary gland
§ Is a negative feedback system
Give some examples of common vaginal infections:
○ Gardnerella vaginalis (g. vaginalis) ○ Candida ○ Trichomonas vaginalis ○ Herpes simplex ○ Gonorrhea ○ Chlamydia ○ Syphilis ○ Human papiloma virus (HPV)
What test would you use for a suspected UTI?
○ Urine dip stick
○ UTI if nitrites +/or WBC present
○ If no, but burning/pain/discomfort- could be other infection (Chlamydia, etc.)
What joint disease is related to a bacterial infection such as Chlamydia? What are the signs and symptoms associated?
○ Reiter’s Syndrome aka Reactive Arthritis
§ w/ Chlamydia infection
○ Category: spondyloarthropathy
○ S/S: § Urethritis § Conjunctivitis § Scaling skin heels & palms § Joint discomfort
On which day of the menstrual cycle is a woman most fertile?
○ Day 14-21
A 36 year old para 1 gravida 1 female comes in with a singular complaint of breast milk secretion. Her last menstruation was six months ago. What is your diagnosis and what tests will you order?
○ Prolactinoma
○ Tests:
§ HCG/Pregnancy
§ Prolactin
§ CT Scan (tumor of Ant. Pituitary)
○ Para= pregnancy
○ Gravida/grava= baby birthed
○ Gen presentation in men:
§ impotence
• What are the risk factors for:
○ A: Cancer of the cervix ○ B: Cancer of the uterus ○ C: Cancer of the testicle ○ D: Cancer of the penis ○ E: Cancer of the urinary bladder
○ A: Cervix: § Intercourse began @ early age § Multiple sexual partners § HPV infection § Other venereal diseases
○ B: uterus:
§ Unopposed estrogen
§ Nulliparity
○ C: testicle:
§ Undescended testicle
○ D: penis:
§ Poor hygiene
□ Smegma collection–> phimosis–> cancer
○ E: UB:
§ Smoking tobacco
What is genotype?
○ Genetic constitution or type
What are three different origins of ovarian neoplasm? From which one does a teratoma arise?
○ Types:
§ Primarily cystic
□ Ex: mucinous cystadenoma
§ primarily solid □ Ex: fibroma § Mixed □ Ex: dermoid (teratoma)
○ Surface epithelium affected
germ cell (ova)- teratoma arise from germ cell
What is placenta previa?
Placenta grown in front of baby b/c fertilized ovum doesn’t attach to sticky surface of uterus
What are causes of hematuria?
○ Infection (KD/UB) ○ Stones (KD/UB) ○ Cancer (no pain) ○ Trauma ○ Menstrual contamination
