Pathophysiology Deck Flashcards
Elevated oxygen levels result in this condition
bronchopulmonary dysplasia (BPD)
The human body is composed of approximately ___% water
60% water
Three fluid compartments in the body
Intracellular fluid (ICF)
Extracellular fluid (ECF)
Interstitial fluid (ISF)
Two-thirds of the body’s water content is contained mainly within the ___ fluid
ICF - Intracellular fluid
High osmotic pressure in the bloodstream favors fluid movement from the _____ into _____
From ICF and ISF into the bloodstream (ECF)
Oncotic pressure, also called colloidal osmotic pressure, is a type of osmotic pressure exerted specifically by _____ in the bloodstream
Albumin
What is osmolality is based on?
1 mole (gram) of a substance dissolved in 1 kilogram of water
What is osmolarity based on?
The number of particles suspended in a solution.
A solution often used as a temporary replacement for blood
LR - lactated Ringers
Starling’s Law of Capillary Forces
Two major opposing forces at every capillary membrane: hydrostatic pressure + osmotic pressure (and oncotic pressure)
Stimulates the release of ADH
High plasma osmolarity
Blocking ACE in the RAAS prevents WHAT?
Angiotensin I from becoming angiotensin II. This prevents vasoconstriction and adrenal stimulation.
The net effect of the RAAS is…
Raise blood volume and increase blood pressure
Produced in response to fluid volume overload stretching the heart’s ventricles
BNP (B-type natriuretic peptide)
Both BNP and ANP promote what
Natriuresis - increasing glomerular filtration rate
Edema is excess fluid in what compartment(s)
ISF and ICF
Two causes of edema (types of pressures)
Elevated hydrostatic pressure in bloodstream or diminished osmotic force in bloodstream
What are the major solutes in the body?
Potassium, magnesium, phosphates, and protein
In the RAAS, adrenal gland produces _____ and _____
Aldosterone and ADH
Key cell type in blood vessels of the kidneys which are part of RAAS and are the first trigger for releasing renin
Juxtaglomerular (JG)
In a pt with pulmonary edema in respiratory acidosis, ___ is elevated because, as H+ moves inside of cells in an attempt to get it out of the bloodstream, ___ moves from cells into the bloodstream.
K+
In diabetic ketoacidosis, _____ is consumed by the additional keto acids present in the bloodstream. Because it is one of the measured anions, its consumption _____ the anion gap.
HCO3-
Increases
Two cations used to measure anion gap
Na+ and K+
Two anions used to measure anion gap
Cl- and HCO3-
Dialysis relies on _____ to remove solutes
diffusion
If a patient’s pH and PCO2 levels move in opposite directions, their disruption is _____ in nature. If a patient’s PCO2 is normal, or if it is moving in the same direction as pH, the patient’s disruption is _____ in nature.
respiratory, metabolic
Outer most part of your innate immunity
Skin and mucous membranes
Innate immunity also includes the _____ system - a set of protein that set to dice or break foreign cells.
complement (“That’s a nice virus you’ve got there, would be a shame if something happened to it!”)
Before a particular B or T cell is exposed to antigen, it is referred to as _____.
naive
B cells divide into ___ and ___ after attaching to an antigen.
Memory cells and antibodies
This makes phagocytic cells more likely to engulf pathogens (like salting peas - it makes them tastier)
Antigens
3 things that antibodies do
- Neutralize viruses
- Increase phagocytic cell activity against viruses
- Recruit the complement system (innate immunity)
Two types of T cells
Helper T cells and cytotoxic T cells
Selective (Helper) T cells divide into ___ and ___
Memory cells and de facto cells
Helper T cells produce proteins called ___
cytokines
Cytokines activate ___ and ___
B cells and cytotoxic T cells
_____ are what make secondary immune responses stronger and more prolonged than primary responses.
Memory cells
Eldery individuals have decreased population of ___ (in their immune systems)
naive T cells
Near skin surface, there are phagocytic cells called ___
dendritic cells
capillaries are made of ___ cells
endothelial cells
Skin cells release ___ to signal when there is an “invasion”
chemokines (chemical + kinetic)
Mast cells release ___ in response to a threat
histamine
Histamine acts on endothelial cells (capillaries) and causes ___ leading to ___
vasodilation, swelling
Neutrophils act on bacteria using ___
phagocytosis
A congenital abnormality is one that is ___.
present at birth
For two parents who are carriers of a recessive trait, what are the odds of producing offspring that have that condition? Odds of being carriers? Odds of no disease/not carrier?
1:4 Will get the condition (and receive both recessive genes)
2:4 (50/50) Will be a carrier
1:4 Will neither have the disease nor be a carrier
The four DNA nitrogen bases are ___.
adenine (A), thymine (T), guanine (G), and cytosine (C)
DNA base pairings
A+T and G+C
In RNA, ___ replaces ___ as a base.
uracil (U) replaces thymine (T)
RNA base pairings
A+U and G+C
The human genome is estimated to contain ___ genes.
20,000 - 25,000
An arrangement of three specific DNA bases is called a ___
codon
Common changes in DNA sequence are called ___
polymorphisms
A ___ occurs when a gene is damaged or changed in such a way that it alters the genetic code carried by that gene.
mutation
Each chromosome is divided into two sections, based on a point of narrowing of the linear chromosome, called the ___. The shorter segment, relative to the centromere, is known as the “___” arm, while the longer segment is known as the “___” arm.
centromere, P arm (short), Q arm (longer)
A ___ is an organized arrangement of all the chromosomes within a cell. The human one of these has ___ pairs of chromosomes.
karyotype, 23 pairs
DNA is copied to messenger RNA (mRNA) in the ___ in a process known as ___.
In the nucleus by transcription
mRNA moves to the ___ and then ___ occurs.
ribosomes, translation
Everyone has __ copies of each gene. Each individual gene is an ___ that is inherited from each parent.
2 copies, allele
T/F: Gene alleles must match
False - you can receive dominant and recessive alleles for each gene (i.e., no sickle cell, but are a carrier)
Genotype of Pp is called ___
heterozygous
Genotype of PP or pp is called ___
homozygous
CO2 mixes with water in the blood via a chemical reaction and forms ___.
bicarbonate (HCO3-) and a proton
What is the purpose of a buffer?
Prevents radical change in pH
Buffers are typically a ___ or a ___
weak acid or a conjugate base
The buffer that maintains the pH of human blood involves a ___ - ___ system.
carbonic acid (H2CO3) - bicarbonate ion (HCO3-)
When any acidic substance enters the bloodstream, the bicarbonate ions neutralize the hydronium ions forming ___
carbonic acid and water
When a basic substance enters the bloodstream, carbonic acid reacts with the hydroxide ions producing
bicarbonate ions and water
Third-spacing occurs due to decreased ___ pressure in the ___ space
oncotic, intravascular
If the anion gap is too high, your blood is more ___ than normal. If the anion gap is too low, your blood is more ___ than normal.
acidic, alkaline
In mild to moderate acidosis, treatment could be limited to supportive measures including ___ and ___.
IV fluids and respiratory support
Healthcare providers most commonly use anion gap to identify cases of ___.
metabolic acidosis
DKA occurs when glucose is unable to enter cells resulting in the ___ breaking down fat into ___.
liver, ketones
An elevated anion gap metabolic acidosis can be caused by ___ toxicity, ___, and ___ (MUDPILES). Non-Gap metabolic acidosis is due to GI loss of ___ or a failure of kidneys to ___.
elevated: salicylate toxicity, DKA, uremia
no-gap: bicarbonate (diarrhea), excrete acid
Normal PCO2
35-45 mmHg
Normal blood pH
7.35-7.45
Normal PaO2
75-100 mmHg
Normal HCO3-
22-26 mEq/L
Normal SaO2
(saturation) 95-100%
The central chemoreceptors, located on the ventral aspect of the medulla, are activated by an increase in ___ or ___.
CO2 or acidity
Kidneys compensate for hypercapnia by reabsorbing more ___ and excreting more ___
absorb HCO3-, excrete H+
The kidney compensates for respiratory alkalosis by reducing the amount of new ___ generated and by excreting ___. The process of renal compensation occurs within ___. The stimulus for the renal compensatory mechanism is ___ (not ___).
HCO3−/HCO3−
Occurs within 24 to 48 hours
Stimulus is PCO2, not pH
___ determines whether an acidosis is respiratory or metabolic in origin.
PCO2
Metabolic acidosis is due to alterations in ___, so the ___ is less than ___ since it _____ (is/is not) the cause of the primary acid-base disturbance
bicarbonate
pCO2 is less than 40
For a respiratory acidosis, the pCO2 is ___ due to ___.
greater than 40 to 45
decreased ventilation
How can hyperkalemia develop in metabolic acidosis?
H+ moves into the cells resulting in K+ moving into the extracellular fluid
A fall in pH is much LESS likely to raise the plasma potassium concentration in patients with ___ or ___
lactic acidosis
ketoacidosis
In metabolic alkalosis, PCO2 would ___. This is SECONDARY to ___.
PCO2 increases secondary to HCO3- increasing.
The kidneys can help combat alkalosis by ___. This process is slower than ___.
Increasing the excretion of bicarbonate ions through the urine. Slower than respiratory compensation.
A hereditary disease, presents as an enlarged heart chamber and decreased blood-pumping efficiency, leading to heart failure. ___ chance of passing on to children.
familial dilated cardiomyopathy, 50%
Where would you find gene locus 3p22.1
3 = Chromosome 3
p = P-arm (petit arm)
The standard number of chromosomes in a human cell is __
46 (23 pairs)
How many chromosomes would need to be in one ovum and one sperm to create the first cell of the embryo?
23 - one from each parent to total 46 in a cell
Distinguish between gene and allele
Genes are DNA sections that code for specific proteins or functional RNA, playing a crucial part in biological functions. Alleles, however, are variations of these genes, leading to diverse traits such as eye color.
A condition in which a baby is born with one or more extra fingers.
Polydactyly
If one biological parent carries the genetic code for polydactyly, their babies have a ___ chance of being born with polydactyly.
50% (some forms are dominant)
Why are males more likely to have x-linked traits?
The Y chromosome is the other half of the XY gene pair in the male. However, the Y chromosome doesn’t contain most of the genes of the X chromosome. Because of that, it doesn’t protect the male.
What is meant by sickle cell trait vs sickle cell genotype?
Sickle cell trait = carrier
Sickle cell genotype = has the disease
Red-green colorblindness is a ___ trait
x-linked recessive trait
What is genotype of red-green colorblind father?
XcY (c is recessive)
Genotype of mother who is homozygous at the colorblind locus
XcXc
What is aneuploidy
(AN-yoo-PLOY-dee) - The occurrence of one or more extra or missing chromosomes leading to an unbalanced chromosome complement, or any chromosome number that is not an exact multiple of the haploid number (i.e., 23)
3 types of down syndrome
Complete, mosaic, translocation
An error during the formation of the egg or the sperm results in either one having an extra chromosome. The resulting cells will also have three copies of chromosome 21. Constitutes almost all Down syndrome cases.
Complete trisomy 21
Type of down syndrome that occurs when an error in cell division takes place early in development but after a normal egg and sperm unite. It can also occur early in development when some cells lose an extra chromosome 21 that was present at conception. Symptoms vary based on number of affected cells.
Mosaic trisomy 21
Type of down syndrome that occurs when only part of an extra copy of chromosome 21 is in the cells and gets “stuck” to another chromosome and transmitted as cells divide. Presentation is the same as complete trisomy 21.
Translocation trisomy 21
Main cause of death in down syndrome
Congenital heart disease (CHD)
Congenital heart defects occur in approximately ___ of live-born infants with Down syndrome (DS).
50%
Most common heart condition that occurs with down syndrome.
Atrioventricular septal defect (AVSD) is the most common congenital heart disease
…followed by isolated tetralogy of Fallot (TOF), AVSD with TOF, and isolated ventricular septal defect
What does ND-PAE stand for
Neurobehavioral disorders associated with prenatal alcohol exposure (ND-PAE)
What are some common findings in children with neurobehavioral disorders associated with prenatal alcohol exposure (ND-PAE)
- Thinking and memory
- Behavior problems
- ADLs (playing with others, dressing, bathing, etc.)
Changes that have been observed in brains of those exposed to prenatal alcohol
Reduced brain volume
Altered cortical thickness
Altered white matter connectivity
Deficiency of this is thought to be a risk factor for spina bifida
Folic acid (B9)
Most severe form of spina bifida
Myelomeningocele is the most severe form of spina bifida. A portion of the spinal cord or nerves are exposed in a sac through an opening in the spine that may or may not be covered by the meninges.
Condition in which brain tissue extends into the spinal canal. (Congenital)
Arnold Chiari II malformation
Most common form of spina bifida. What does it affect?
Spina bifida occulta. Affects nerves, resulting in (possible) incontinence, constipation, back pain, muscle weakness.
Another name for vitamin B9
folate, folic acid
It is recommended that women take folic acid ___ pregnancy to help prevent ___
Before or during early pregnancy to help prevent spina bifida or other neural tube defects
Differentiate between a strain and a sprain.
A sprain is an injury to the ligaments and capsule of a joint in the body. A strain is an injury to muscles or tendons.
Differentiate between a spiral fracture and a transverse fracture.
Spiral Fracture: one part of the bone has been twisted at the break point. Transverse Fracture: the broken piece of bone is at a right angle to the bone’s axis.
How is PTH related to bone degeneration?
When dietary calcium intake is insufficient, PTH stimulates bone resorption.
An insufficient intake of dietary calcium can lead to what hormone being increased in the body? What other vitamin might be used to counter this?
PTH - parathyroid hormone. Hyperparathyroidism is countered with calcitriol (active vitamin D)
Differentiate between osteoblasts and osteoclasts
Osteoblasts form new bones (“BAM! New bones!”)
Osteoclasts dissolve old and damaged bone tissue
What is calcitriol?
Increases absorption of dietary calcium and phosphate from GI tract and promotes renal tubular reabsorption of calcium in the kidneys.
Opposes the action of parathyroid hormone.
Calcitonin (“Oh NO you don’t, calcium!”)
What condition might someone have if you are giving them calcitonin? Why?
Osteoporosis. It counteracts PTH, which breaks down bones.
Back problem caused by overuse
Back strain
Back problem caused by an external force or shock
Back sprain
A back sprain is usually felt where
thumbs, wrists, knees, and ankles (joints)
A back strain is usually felt where
In the back, legs, feet, and arms
Type of back pain that develops over times is
Back strain
Most common etiology of bursitis
The most common etiology is prolonged pressure, whereby the bursa is stressed between a hard surface and bony prominence. (e.g., students who frequently rest their elbows on their desks and people who work on their knees without adequate padding)
Cells that play a role in the development of bursitis
Synovial cells
What is a “hip fracture”
A break in the upper quarter of the femur
Where is an intracapsular hip fracture?
The “neck” of the femur
Type of hip fracture that results from a traumatic hip dislocation
Head fracture
Where does a femoral neck fracture occur
1-2 inches from the hip joint
Oncotic pressure
Oncotic pressure is the osmotic pressure generated by large molecules (especially proteins) in solution (relevant to pressures at the capillaries and third spacing)
Most common cause of metabolic acidosis
Vomiting or NG suction (loss of stomach acids)
Diuretics (volume depletion, particularly potassium-wasting)
The movement of leukocytes out of the circulatory system and towards the site of tissue damage or infection
diapedesis/extravasation
A gene located on one of the numbered chromosomes
Autosomal
Joint degeneration of the hands is also called
osteoarthritis
Bouchard’s nodes
Enlargement of the proximal interphalangeal (PIP) (middle joints of the fingers)
Risk factors for Bouchard’s nodes
elderly, female, obesity, smoking (females only)
Bouchard’s nodes pathology
Loss of joint cartilage and inflammation causes excessive bone formation
Rickets
Softening and weakening of bones in children, usually because of an extreme and prolonged vitamin D deficiency. RESULTS FROM DEFICIENT MINERALIZATION AT THE CARTILAGE OF GROWTH PLATES.
Osteomalacia
“Bone softening” in adults that is usually due to prolonged deficiency of vitamin D. ABNORMAL OSTEOID MINERALIZATION.
Symptoms of degenerative disc disease
N/T in arms and legs, neck and back pain
Most common symptoms of Paget’s disease
Most people have no symptoms
Paget’s disease
Excessive bone breakdown and regrowth
How does the fascia impact compartment syndrome?
Fascia does not stretch, so any swelling or bleeding within a compartment can lead to compartment syndrome
Muscle damage in compartment syndrome can lead to what other condition
rhabdomyolysis
Fat embolism syndrome is most common in patients with
orthopedic trauma
Non-traumatic risk factors for fat embolism
acute/chronic pancreatitis, bone marrow transplant, liposuction
Two causes of albinism
lack of ability to produce melanin or a defective gene
Vitiligo is associated with (cause)
autoimmune disorders
Melasma is associated with (cause)
hormones from pregnancy or medications
Melasma causes
dark patches on the skin
Most common skin cancer
basal cell carcinoma
Typically presents as a shiny, pink- or flesh-colored papule or nodule with surface telangiectasia
basal cell carcinoma
Scaling, ulceration, crusting, or the presence of a cutaneous horn
squamous cell carcinoma
Typically manifests as a dark brown-to-black papule or dome-shaped nodule, which may ulcerate and bleed with minor trauma
melanoma
3 zones of a burn (from inner to outter)
coagulation, stasis, hyperemia
The tissue (zone) that was destroyed at the time of a burn injury
Zone of coagulation
The area immediately surrounding tissue destroyed during a burn
Zone of stasis
Outermost zone of a burn injury. Microvascular perfusion is impaired/not impaired.
Zone of hyperemia. Perfusion is NOT impaired.
Will eventually progress and become necrotic within the first 48 hours following a thermal injury.
zone of stasis
A severe burn injury can result in the body being in this state
hypermetabolism
Hypermetabolism results in increased ___ requirements and increased ___.
increased nutritional requirements and basal metabolic rate (BMR)
What is the Rule of Nines used for
estimate body surface area of a burn
Most commonly used burn surface area estimator tool
Lund and Browder chart (assessor shades in the burnt area)
This tool classifies burns as minor, moderate, and major based on depth and surface area
American Burn Association (ABA)
Skin condition that mainly affects the scalp
seborrheic dermatitis
Condition that causes dry, itchy, inflamed skin. Chronic and has flares.
eczema/atopic dermatitis
Autoimmune skin condition that develops into scaly areas
psoriasis
Chronic hives with unclear etiology
urticaria
Form of lupus that mainly affects your skin
Discoid lupus erythematosus (DLE) - Systemic lupus (SLE) can affect any part of the body
Thrombus vs embolus, which one forms in a vein?
A venous thrombus is a blood clot that forms in a vein. An embolus is anything that moves through the blood vessels until it reaches a vessel that is too small to let it pass.
Type of hematoma typically caused by a skull fracture
epidural hematoma
A chronic disease of the central nervous system where the immune system attacks myelin
multiple sclerosis
An autoimmune condition that causes muscle weakness that gets worse with activity and better with rest.
Myasthenia gravis
A disease of the inner ear that can cause a person to get dizzy and have trouble hearing. Most often begins between the ages of 40 and 60. Set off by a build-up of fluid.
Meniere’s disease
Three layers of a blood vessel (inner to outer)
Tunica intima, tunica media, tunica externa
These cells (layer) allow fluid to flow smoothly and are interspersed with valves that ensure the flow continues in one direction.
tunica intima
Typically the thickest layer of the veins. ___ muscle type. Innervated by ___ nervous system.
tunica media, smooth muscle, sympathetic nervous system
Layer of vein wall consisting of connective tissue and elastic fibers to provide strength. May be the thickest layer in ___ veins.
tunica externa
Laminar blood flow
Laminar flow occurs when blood moves in ordered, parallel layers through the arteries with no obstructions to agitate the layers.
Turbulent flow generates ___, creating ___.
sound, creates audible diagnostic clues
Cardiac output
Cardiac output is the amount of blood ejected from the left ventricle in one minute.
LaPlace’s Law tells us that the inward pressure that is exerted by the vessel wall on the blood is directly proportional to the tensional stress in the wall and inversely proportional to the radius of the wall. Thus ___.
Thus the smaller the vessel the larger the pressure it can apply on the blood.
Equation for cardiac output
Heart Rate x Stroke Volume
Three compounds of the RAAS
(R) renin, (A) angiotensin II, (A) aldosterone
Unstable atoms that can damage cells, causing illness and aging.
free radicals
Most cholesterol in the body comes from where?
Your liver makes all the cholesterol you need. The remainder of the cholesterol in your body comes from foods from animals. Only about 20% comes from animal-based foods.
Cholesterol is a fat-like, waxy substance that helps your body make what 3 things
cell membranes, hormones, and vitamin D
Lesions on the skin containing cholesterol and fats
xanthomas
Vegans are frequently lacking ___ which results in ___. This can also happen to their tongue.
B12 deficiency results in pernicious anemia, glossitis can develop (tongue inflamation)
Patients with ___ anemia often present with jaundice in addition to anemia.
hemolytic
The most common hemoglobin disorders are ___ and ___
sickle cell disease and thalassemia (less hgb)
An inherited blood disorder where the body doesn’t produce enough hemoglobin
thalassemia
___ thickening or hardening of the arteries caused by a buildup of plaque in the inner lining
atherosclerosis
___ is one of the key factors in atherosclerosis development in people with both types of diabetes mellitus.
chronic inflammation
The formation of ___ occurs when macrophages engulf an excess of many types of LDL which result in the death of the macrophages once they become oversaturated with the LDLs
foam cells
A cardiac cath can ___ or ___ heart problems
diagnose or TREAT (i.e., check pressures, functioning of valves, opening a narrowed artery, biopsy)
Most common cause of myocardial ischemia
atherosclerosis
___ coronary artery blockage ___% is associated with symptoms
severe blockage >70%
___ circulation provides protection against ischemic injury
collateral circulation
What is cTn lab test
troponin
Troponin is produced following
cardiac muscle damage
What is an older test that was used to check for MI?
CPK-MB
Type of MI that occurs in those with atherosclerotic plaque rupture and thrombosis
Type 1 MI
Type of MI that occurs from decreased oxygen supply from an acute illness causing tachyarrhythmia, hypoxia, or hypotension WITHOUT ATHEROTHROMBOSIS.
Type 2 MI
Stable angina
Stable angina (more common) – attacks have a trigger (such as stress or exercise) and stop within a few minutes of resting
Unstable angina
Unstable angina (more serious) – attacks are more unpredictable (they may not have a trigger) and can continue despite resting
An echocardiogram (echo) is used to diagnose what
problem with the heart VALVES
A fibrous sac that encloses the heart and great vessels
pericardium
Three stages of acute inflammation
vascular permeability, cellular chemotaxis, systemic responses
Hormones that begin vascular permeability stage of inflammation. pH ___
histamine and bradykinin. pH of surrounding fluid LOWERS and inhibits microbial growth
During cellular chemotaxis, ___ are released from ___ in a process known as ___. WBC also attract ___ and other WBC to the area.
WBC are released from bone marrow through leukocytosis. WBC attract platelets.
Why are lymph nodes involved with inflammatory process?
Due to systemic responses.
___ modulate the inflammatory reaction by amplifying or deactivating the process.
Cytokines
Elevation of this in the bloodstream indicates that active inflammation is occurring.
C-reactive protein (CRP)
Prostaglandins are partially responsible for the ___ response of acute inflammation. This also causes swollen ___.
systemic response, swollen lymph nodes
Causes of chronic inflammation
Microorganisms that are difficult to eradicate (i.e., TB)
Hypersensitivity disorders - autoimmune diseases, MS, lupus
Prolonged exposure to toxic agents (coal dust)
Staph and strep are both caused by ___ that are part of ___
Bacteria that are part of the normal flora of the human body
Strep bacteria have ___ that resist ___
Capsules that resist WBC phagocytosis and secret substances that degrade tissue membranes
What are the vector and reservoir for Lyme disease bacteria?
Reservoir is deer and the vector is ticks
Lyme disease can spread to the facial nerve causing ___
Bell’s palsy
Type of bacteria involved in Lyme’s disease
bacterial parasites
What causes mono
Infectious mononucleosis is caused by the Epstein-Barr virus (EBV)
T-helper cells are also called
CD4 cells
Cytotoxic T cells are also called
CD8 cells
Systemic lupus (SLE) is more common in which gender? Which race?
Women, African Americans
What is a retrovirus?
A retrovirus has RNA as its genetic material and comes equipped with its own enzyme, called reverse transcriptase, that can convert its RNA into DNA so that the virus can give genetic instructions to the host cell.
What does HIV use CD4 cells for?
self-replication, then they are destroyed
Hemoglobin can attach to ___ oxygen molecules. Oxygen attaching to heme forms ___.
4 molecules, forms oxyhemoglobin
_____ is responsible for the stimulation of red blood cell (RBC) production, is secreted by ____ in response to _____
erythropoietin
the kidneys
low oxygen levels in the bloodstream
A fever typically causes oxygen saturation to ___
decrease
When both parents have Crohn’s, there is a ___ chance that their children will have the disease.
50%
Risk factors for Crohn’s include ___, ___, and ___.
genetics, ethnicity, cigarette smoking
The appendix is a ___ organ
vestigial organ (has lost all of its original function via evolution)
The ___ drains the venous circulation of the GI system.
portal vein
The intestine, spleen, pancreas, stomach, and esophagus have venous networks that drain into the ___, which empties into the ___
portal vein, inferior vena cava
How does CRRT differ from hemodialysis and when would it be used?
CRRT is a slower, continuous process used for patients who are hemodynamically unstable and fluid overloaded. It takes smaller volumes of blood from the patient and filters it through a dialyzer over 24 hours
Most common form of bladder cancer
transitional cell carcinoma (TCC)
Two hormones produced in the posterior pituitary
ADH (vasopressin) and oxytocin
___ feedback regulates each of the hypothalamic-pituitary-hormone axes
Negative feedback
Pituitary hormones act on receptors located on ___ to ___
endocrine glands to secrete hormones
Anterior pituitary hormones
- Thyrotropin, or TSH
- Gonadotropins, or FSH and LH
- Somatotropin, or GH
- Corticotropin, or ACTH
- Prolactin, or PRL
Diabetes insipidus occurs due to a lack of ___ being secreted by the ___
ADH, posterior pituitary
Thyroid hormones
T3 (triiodothyronine, T4 (thyroxine)
___ is the regulator of body metabolism
thyroxine (T4)
How does iodine affect TSH levels
If iodine levels are decreased in the body, thyroid hormone synthesis is diminished, which the pituitary senses and then attempts to compensate for by increasing TSH.
Patients on these medications should have thyroid hormone levels monitored
lithium, phenytoin, rifampin
___ is an autoimmune disorder causing hyperthyroidism.
Graves’ disease
Patients with hyperthyroidism can develop ___, which is life-threatening.
thyrotoxic crisis
Secreted from the adrenal cortex
corticosteroids/glucocorticoids, androgens, aldosterone (mineralcorticoids
Aldosterone is particularly active in ___. It causes reabsorption of ___ and ___, and secretion of ___.
RAAS, reabsorb Na+ and H2O, secrete K+
Secreted from the adrenal medulla
epi/nor-epi (catecholemines)
Adrenal insufficiency can be due to dysfunction of the adrenal gland or ___
Decreased ACTH (pituitary dysfunction)
___ is a hypofunction of the adrenal gland. More common in ___.
Addison’s disease, women (3:1)
___ is a disorder of adrenal overactivity.
Cushing’s syndrome
Muscle protein, triglycerides, and fat are broken down to assist with ___ in the liver.
gluconeogenesis
Hyperinsulinism
Pancreas attempts to compensate for insulin resistance by overworking, which leads to high levels of insulin. Able to compensate this way for many years.
Glucagon
Stimulates glycogen breakdown and gluconeogenesis
Opposes both insulin and glucagon. Keeps food from being absorbed too fast from GI tract.
Somatostatin
Diagnostic criteria for DKA
BS >= 250 mg/dL
pH < 7.3
HCO3- < 15 mEq/L
ketonuria + ketonemia
Respiratory presentation of DKA
hyperventilating
Two risk factors for spina bifida
Obesity and diabetes
Individuals who have sickle cell anemia have normal copies of the gene for ___. Prompting this gene to make hemoglobin in adults with sickle cell anemia compensates for their faulty adult form of the gene.
the fetal form of hemoglobin
Rhabdomyolysis causes kidney failure in ___% of cases. This is due to ___ in the blood from injured muscle tissue.
15%, myoglobin
Type of hip fracture that would likely show bone fragments on xray
The visible fragments indicate that there are multiple fracture lines and are characteristic of a COMMINUTED fracture.
Ian rolled his ankle at basketball practice. He is limping and struggling to put weight on it. His ankle joint is visibly swollen and bruised.
What injury has Ian sustained?
Ian’s symptoms are more consistent with a grade II sprain since he has visible swelling and bruising, and, while he has not totally lost function of the joint, it is difficult for him to bear weight.
Acute phase of a burn injury begins ___ after the burn injury. It includes the start of ___ and ends with ___.
48–72 hours after, diuresis, closure of the burn wound
Rule of Nines
Vitiligo
Vitiligo is a pigmentation disorder in which areas of the skin lose melanin. It is characterized by irregular patches of white or pale skin, typically on the head, neck, axillae, and limbs.
Tinea ___ infection on the scalp is known as tinea capitis.
fungal
What condition is this: “I can see some things out of the corner of my eye, but when I look straight ahead, there is just a dark spot in the center.”
Macular degeneration
Chronic alcoholism results in nutritional deficiencies and demyelination of the nerves, causing ___.
peripheral neuropathy
A/an ___ is likely to occur following a fracture of the temporal bone due to the location of the middle meningeal artery.
epidural hematoma (this may involve losing consciousness)
Myasthenia gravis is characterized by (eye) ___, (vision) ___, and episodes of skeletal muscle weakness.
ptosis (drooping of the upper eyelid), diplopia (double vision)
When there is a partial fracture, and the intact part of the bone bends, it is a ___. These fractures are usually seen in ___, because ___.
greenstick fracture
These fractures are usually seen in children, whose bones are still relatively soft.
___ burns may be white and the surrounding area is edematous. Pain is minimal or absent due to ___.
Full thickness
Due to the damage to nerve endings
A transient ischemic attack occurs when ___
a clot forms in a blood vessel in the brain, but the body naturally dissolves it within 24 hours
___ is characterized by episodes of muscle weakness, numbness, blurred vision, and fatigue.
Multiple sclerosis
Name the condition: “I can see things in front of me okay, but I have to turn my head to see anything in the periphery of my vision.”
glaucoma
Hypertensive crisis: The patient’s systolic blood pressure >___ mmHg combined with ___ indicates hypertensive crisis.
> 180 mmHg, symptoms of organ damage (chest palpitations, a headache and blurred vision)
___ injury is the first step in the development of atherosclerosis. ___ formation is a second step in the development of atherosclerosis.
___ formation occurs after foam cell formation in the development of atherosclerosis.
Endothelial, Foam cell formation, Fatty streak formation
Like all T cells, CD4 cells mature with the ___.
thymus
A history of radiation exposure is a common risk for ___ and ___. Radiation affects DNA and may trigger cancerous changes in the bone marrow.
leukemias and lymphomas
___ anemia is caused by a failure of the bone marrow to produce adequate numbers of red blood cells.
Aplastic
What is this: Cancerous lymphoblasts crowd out healthy bone marrow tissue, making the bone marrow unable to produce adequate numbers of red blood cells or platelets.
lymphoblastic leukemia
Crackles are caused by ___ being present in the alveoli due to exudative edema.
additional fluid
Alcohol intoxication increases the risk for ___, placing the patient at higher risk for pneumonia.
aspiration
Is asthma a restrictive or an obstructive pulmonary disorder.
obstructive
Long-term consequence of uncontrolled asthma attacks
Asthma attacks trigger airway remodeling, leading to increasingly irreversible bronchoconstriction.
The free radicals introduced by smoking cause damage to the arterial endothelial cells, directly impairing ___ resulting in emphysema.
the alveoli
Pulmonary hypertension can lead to what heart condition
right-sided heart failure
Hepatitis C begins as an acute infection. Approximately __% will progress to a chronic infection.
70%
In cirrhosis, ___ cells overproduce collagenous fibrous tissue, which takes over the liver.
stellate
Pyelonephritis is an infection of the kidney and is most commonly caused by ___.
E. coli
Natriuresis develops as a result of ___.
the excretion of large amounts of sodium
An adult client who has hypervolemia reports a headache, muscle cramps, and vomiting. The nurse notices confusion. Which condition has the client developed?
Hyponatremia - Headache, confusion, vomiting, muscle cramps, and lethargy aresome of the symptoms of delusional hyponatremia in the presence of hypervolemia
The nurse is caring for a client who has been diagnosed with renal failure. Which mechanism of compensation for the acid-base disturbance does the nurse recognize in the client?
hyperventilation to reduce CO2
Prions are a type of ___
protein (infectious)
Predominant immunoglobulin after being exposed to an antigen
IgG
Treatment for grade II ankle sprain
Protect, rest, ice, compression, and elevation (PRICE)
The nurse is providing care for a client diagnosed with Pott’s disease. Which possible complication does the nurse associate with the diagnosis?
Spinal deformity with instability - Feedback: A complication of M. tuberculosis is an advanced infection, and destruction of the vertebrae can lead to spinal deformity with instability, vertebral collapse
Which birthmarks are characterized by pink, patchlike lesions that occur from permanent blood vessel abnormalities?
port wine stains
___ is critical for language comprehension and is connected to Broca’s area. Dysfunction of this area causes receptive aphasia.
Wernicke’s area
___ refers to twisting and writhing movements and is associated with ___ disease.
Athetosis, Huntington’s
The nurse is teaching a family member about providing home care for a client with a T1 spinal cord injury. The nurse stresses bowel and bladder management to avoid ___.
autonomic dysreflexia
The nurse is performing a physical assessment on a new client. The nurse notes diminished pulses, palpable coolness, and pallor in the lower extremities. The client reports numbness, tingling, and pain with ambulation. Which question by the nurse helps identify a possible serious complication?
Do you have pain when you rest your legs? Feedback: Determining if the client has pain when resting is an important question that can identify possible complications. Clients with this manifestation usually have critical limb ischemia, which can lead to necessary surgical amputation
A client is experiencing chest pain. On examination, a scratchy sound is heard through the stethoscope. Which intervention does the nurse think will help reduce the scratchy sound?
glucocorticoids - this is likely myocarditis and is a viral infection
Clients with current or prior symptoms of heart failure associated with underlying structural heart disease are classified under stage ___ heart failure.
stage C
Dobutamine is used to ___
augment cardiac output
The client has developed anemia. The mean corpuscular volume of the client is less than the normal value of 80 to 100, which is an indication of ___ anemia. Tachycardia and pale color are symptoms of this condition.
microcytic hypochromic anemia (micro hypo kidneys)
Almost one-third of platelets reside in the ___
spleen
Dumping syndrome is the gastrointestinal disorder that occurs due to ___
the removal of part of the stomach
Which part of the gastrointestinal (GI) tract is involved in the production of protective mucus
goblet cells
Radioactive iodine scan is used for detecting ___
hyperactivity of the thyroid gland
A female client with a ___ gland disorder may experience the absence of a menstrual cycle, which is known as amenorrhea
thyroid
___ stimulates the Leydig cells of the testes to secrete testosterone.
Luteinizing hormone
A pregnant mother with chlamydia can cause her baby to be born with ___
conjuntivitis
After exposure to HIV, PEP must be started within ___ to be effective
72 hours
With the development of ___, the symptoms of fatigue, weakness, fever, and malaise are often mistaken as a viral illness.
polymyalgia rheumatica
Proprioception is the awareness of one’s body and body parts in space and in relation to each other. The ___ lobe regions of the cerebrum are responsible for governing proprioception.
parietal
___ is a condition that is seen in clients with injuries at the sixth thoracic vertebra or above. It results in the lack of normal sympathetic outflow from the T1-L2 region of the spinal cord, causing bradycardia and low blood pressure (hypotension).
Neurogenic shock
Lymphoma cells specifically arise from proliferation of ___
B or T lymphocytes
Secondary polycythemia is characterized by an elevated ___ level
erythropoietin
Frequent cause of a lung abscess
Staphylococcal endocarditis usually occurs initially, followed by the development of septic emboli, which travels to the lung and forms the abscess
___ helps stimulate clotting factors
Vitamin K
The kidneys are responsible for the ___ of insulin.
degradation
HLA-DR2 can cause someone to develop ___ in the kidney and lungs
Goodpasture’s syndrome
Clients with spinal cord injuries are particularly vulnerable to the formation of ___ stones.
struvite
Hypospadias is the most common congenital disorder that occurs in newborns. In this condition ___
the position of the urethral surface of the penis is abnormal
___ is the collection of serous fluid in the scrotum that causes swelling and a feeling of heaviness.
Hydrocele - It is caused due to a traumatic injury or infection in the testis.
Inflammation and damage to the filtering part of the kidneys
glomerulonephritis
A condition where one or both kidneys become stretched and swollen as the result of a build-up of urine inside them
hydronephrosis
Chlamydia causes ___ in males
epididymitis
Type of cancer treated via cryotherapy
prostate cancer
Found mainly in blood and lymph fluid, this is the FIRST antibody the body makes when it fights a new infection
IgM (Must hurry)
Characterized by the development of binucleate Reed-Sternberg cells?
Hodgkin’s lymphoma
