test 2 Flashcards
1
Q
Stomatitis
A
inflammation around the edges of the mouth
2
Q
Angular stomatitis
A
Inflammation in the corners of the mouth (edentulous-people with no teeth)
3
Q
Aphthous stomatitis
A
canker sore
4
Q
Ankyloglossia
A
tongue tied.
5
Q
Leukoplakia
A
white plaque (pre-cancerous lesions) that don’t scrape away.
6
Q
Koplik’s spots:
A
pearly white lesions that appear before the onset of measles
7
Q
Candidiasis
A
thrush, common in people who are immunocompromised or on antibiotics
8
Q
Palatoschisis
A
cleft pallet
9
Q
Dental caries:
A
cavities
10
Q
Gingivitis
A
inflammation of the gums. The gums with recede. (higher risk for cardiac problems)
11
Q
Malocclusion
A
Malocclusion
12
Q
Periodontal disease:
A
severe retraction of the gums. (higher risk for cardiac problems)
13
Q
Achalasia:
A
Lower end of esophagus doesn’t open up. Can lead to aspiration. May result from nerve damage or genetics.
14
Q
Gastroesophageal Reflux (GERD):
A
lower esophageal sphincter doesn’t close. Can lead to Barrett’s esophagus esophageal cancer.
15
Q
Esophageal sphincter:
A
symptoms narrowing of the esophagus.
16
Q
Acute gastritis
A
Inflammation of the gastric mucosa. Caused by irritants. May be asymptomatic. May complain of dyspepsia. Usually just treat the symptoms.
17
Q
Hiatal Hernia:
A
Congenital defect. Occurs as a result of a weakness at the diaphragm causing a portion of the stomach to form a pouch above the level of the diaphragm.
18
Q
Peptic Ulcer Disease (PUD
A
Ulcers that can be in the stomach, esophagus or duodenum. Duodenum ulcers are caused by hypersecretion of gastric acid from activation of the vagus nerve. Therefore, ulcers can be caused by stress.
19
Q
Sliding hiatal hernia:
A
slides up and down depending on whether or not the stomach is full. Can be surgically repaired.
20
Q
Paraesophageal (strangulated) hernia:
A
does not slide, stays in the mediastinum and can be strangulated or become ischemic due to strangulation by the diaphragm.
21
Q
Pyloric Stenosis:
A
Narrowing (stenosis) of the outlet of the stomach so that food cannot pass easily from it into the duodenum. Pyloric stenosis results in feeding problems and projectile vomiting in infants. Can be corrected with surgery.
22
Q
Dumping syndrome:
A
• Happens in people who have had gastric bypass surgery. Normally, the stomach empties in a slow and controlled manner.
• In post bypass surgery part of the stomach is removed and gastric contents get quickly dumped into duodenum.
• 2 things happen.
1. duodenal contents are hyperosmolar which draws water into the colon resulting in diarrhea.
2. blood sugar drops (hypoglycemia). BS goes up initially because of all the sugar being absorbed into the blood stream. Pancreas sees BS increase and releases insulin, dropping BS. Initially get cramping and bloating. Cold, clammy, sweaty, tachycardia, a couple of hours after eating.
23
Q
Gastroenteritis symptoms
A
- Acute inflammation of the mucosa of the stomach and small intestine.
- Nausea, vomiting, diarrhea, abdominal cramping, low grade fever
- Dehydration
24
Q
Causes of Acute Gastroenteritis
A
Viral: Norovirus: Rotavirus
o Bacterial: Salmonella enteritidis; Staphylococcus aureus, Enterohemorrhagic E. coli (0157:H7), Clostridium botulinum Clostridium difficile,
o Protozoan: Giardia intestinalis
25
Evaluation Gastroenteritis
stool for C&S; viral studies, O & P
26
Norovirus
* Member of a group of Caliciviridae (Cal·i·ci·vi·ri·dae)
* Transmission: person to person by direct contact or contact with fecally contaminated objects. May infect others up to 2 days after diarrhea has stopped. Common on cruise ships.
27
Rotavirus
* Member of a group of reoviridae
| * Transmission: fecal-oral route. Common in day cares.
28
Salmonellosis Transmission
• ingestion of food/water ; also via hands; humans may be asymptomatic carriers
poultry. Lives in the intestines of poultry.
feces of an infected animal.
reptiles and vegetables.
•
29
Salmonella will be destroyed
at high temperatures.
30
Once the salmonella gets into a person
it releases a toxin, that causes inflammation in the GI tract, resulting in diarrhea and vomiting.
31
Typhoid Fever
* Caused by Salmonella typhi
* Get’s into the GI tract from contaminated water or shellfish. Thrives in areas with a low pH (i.e. stomach).
* Peyer patches: Live in the colon and are linked to the lymphatics. Salmonella Typhi links to these and spreads to the lymphatics. They can also become inflamed and obstruct the bowel causing abdominal distension.
* If untreated by week 4, perforated bowel will kill the person
32
Staphylococcal Food Poisoning
* Pathogen: enterotoxin-producing strain of Staphylococcus aureus
* Reservoir: humans – skin, abscesses, nasal secretions
* Transmission: ingestion of S. aureus-contaminated food
* Can form toxins that inflame the GI tract.
* Comes from food, hand made sandwiches, creamy desserts, especially things made with mayonnaise.
* Food borne illnesses can also come from surfaces, such as cutting boards.
33
Enterohemorrhagic E. coli
* Pathogen: Escherichia coli 0157:H7
* Transmission: water and food contaminated by cattle manure; low infectious dose
* Caused by the run-off from farm lands (from animal poop). Common in hamburger, can also contaminate vegetables.
* E-coli naturally lives in the GI tract and prevents you from getting other GI infections.
* Bacteria gets into GI tract, releases toxins causing inflammation, causes disease. The toxins also affect the glomerulus of the kidneys. Arterioles running through the glomerulus become inflamed and get clogged up by platelets causing them to become occluded. RBC travelling through them, become damaged (hemolysis: damage to RBC). The individual becomes anemic and ends up with kidney failure. Clotting cascade gets set off, and the person begins to hemorrhage.
34
Listeriosis
* Pathogen: Listeria monocytogenes
* Lives everywhere. Ingest food after it’s been processed. Common in deli meats, don’t eat raw hotdogs. Can cause miscarriage in pregnant women. Can develop meningitis.
35
Botulism
* Pathogen: Clostridium botulinum
* Can be in canned food (forms in places where there’s no oxygen). Does not grow as well in sweet or acidic foods. Can thrive in things like carrots. Can also come from potatoes.
* Gets into the stomach and attacks the nervous system. Can cause blurred vision, paralysis, and die from respiratory failure.
36
C difficile associated diarrhea (CDAD)
* Pathogen: clostridium difficile
* Bad bacteria that takes over the good ones in the intestines. Like dandelion's taking over a garden.
* Can lead to pseudomembranous colitis. Bowel becomes so inflamed it develops necrosis.
37
Giardiasis
```
• Parasite Giardia intestinalis
o Giardia lamblia
o Giardia duodenalis
• Spread by
o Animal to person
o Person to person
• AKA: Beaver fever
• Cold temperatures put the parasite into a protective cyst. Once the cyst gets into the GI, the cysts break open and the trophozoites attach themselves to the colon and they multiply. The person sheds them through the feces, into the cold water, and they form cysts.
```
38
Staphylococcus comes primarily from
handmade sandwiches (mayonnaise) and cream filled desserts.
39
• Botulism comes from
home canning. Normally lives in soil and is anaerobic. Therefore, canned foods are excellent for them. The symptoms attack the nervous system, symptoms are neurologic, unlike the others that have GI symptoms.
40
C-Dif: nosocomial bacteria often contracted from
hospitals. Can lead to pseudomembranous colitis. Bowel becomes inflamed and develops areas of necrosis. Membrane forms over it that is old necrotic tissue. Inflamed piece of bowel that becomes necrotic (pseudo membrane).
41
Giardiasis: get it from
water. Commonly known as beaver fever.
42
Appendicitis • Clinical manifestations
: umbilical pain initially; pain over McBurney’s point
43
Appendicitis Complication:
perforation, peritonitis
44
Obstruction of appendiceal lumen results in
inflammation of appendix
45
Peritonitis
• The peritoneum keeps all our internal organs from floating around. It can become inflamed. It has a large surface area so absorbs toxins easily.
46
Peritonitis If it becomes infected
the person becomes septic and dies. If inflamed, causes less peristalsis in the bowel and can cause an obstruction.
• Causes nausea, vomiting, and a bunch of other very bad shit.
47
Intussusception
: One part of the bowel folds over another. Common in babies and they get a sudden onset of colicky pain and pass a stool that looks like red Jell-O. The red is from blood in the colon. It’s a surgical emergency. The bowel can become strangulated and ischemic.
48
Inguinal hernia
Loop of bowel slides down through the inguinal ring (weak spot in the abdominal wall from where the balls dropped down).
49
Volvulus
: A twist or kink in the bowel. Occurs when there is a weak spot.
50
Adhesions
Formed from scar tissue. Internal organs and pieces of bowel stick together.
51
Acute Mesenteric Arterial Insufficiency
• The mesenteric artery is the major feeder to the bowel. Inferior and superior branch. Sometimes a blood clot travels to the artery causing it to occlude and become necrotic. People with atrial fibrillation and prosthetic heart valves are at increased risk. Intense, extreme pain felt after eating due to the ischemic bowel.
52
• Ischemia damages the colon, by
by damaging the mucosa rendering it incapable of protecting itself. May have fever, blood diarrhea, and other complications. If not treated immediately can lead to rupture and peritonitis.
53
Diverticulosis
• Fecal matter may be pushed into the pouches that form in the colon and may cause them to bulge out from the colon wall. Such a condition is called diverticulosis
54
• Diverticulosis occurs in
5 to 10 percent of persons over 40 years of age; its cause is unknown, but weakness of the intestinal wall and increased pressure within the channel of the intestine are probably significant factors.
55
• Diverticulosis has no symptoms, but
but the feces-filled sacs may become infected or inflamed, progressing to a more serious condition called diverticulitis. Its symptoms are pain and tenderness in the lower left side of the abdomen, chills, and sometimes fever.
56
Inflammatory Bowel Disease
* Catch all for ulcerative colitis and Crohn’s disease.
* Ulcerative colitis affects only the inner lining of the colon, also called the large intestine. But in Crohn's disease, inflammation can appear anywhere in the digestive tract, from the mouth to the anus. And it generally affects all the layers of the bowel walls, not just the inner lining.
57
Celiac disease
gluten sensitivity. Microvilli normally project into colon to increase surface area for absorption. In CD shorter microvilli therefore, less absorption.
58
Pancreatitis
Causes include alcoholism, blockage with gallstones, causing enzymes to backup and auto digest the pancreas resulting in abscess and pseudocysts. Painful and takes awhile to treat. Blood tests are amylase and lipase.
59
Cystic fibrosis
: autosomal recessive disorder characterized by excessively thick tenacious mucous production. This clogs pancreatic duct, stopping enzymes from entering duodenum, so patients require enzyme supplements every time they eat. Also affects lungs by clogging all the ducts leading to resp. failure.
60
Cholecystitis, cholelithiasis
* lithiasis means stones. People can have stones without inflamed gallbladder. Sometimes they get stuck causing inflammation.
* Lithotripsy is the treatment.
* Risks include high fat diets. Cholesterol plays a big role.
* Pain in RUQ. S/S pain, jaundice, fatty stool (steatorrhea), nausea, vomiting
61
Hepatitis A
: fecal/oral, person does not become a carrier
62
Hep. B:
parenteral, sexual, mother –infant transmission, person becomes a carrier
63
Hep. C
parenteral (most cases of post transfusion hepatitis), person becomes a carrier
64
Hep. D
parenteral, sexual, person becomes a carrier
65
Hep. E
fecal-oral, person does not become a carrier ***A & E aren’t carriers***
66
7 Functions of the liver
1. Detoxifies drugs and other foreign substances (drug toxicity)
2. Process and store vitamins (vitamin k)
3. Regulation of -protein metabolism (hypoalbuminemia – edema)
• Store glucose glycogen (hypo/hyperglycemia)
• fat digestion secreting bile (steatorrhea – fat in the poop)
4. Synthesis of clotting factors (bleeding)
5. Removes bilirubin from bloodstream (jaundice)
6. Metabolizes hormones (androgens – sex hormones sexual dysfunction)
7. Synthesize urea (takes ammonia, converts it to urea, and excretes it via the kidneys excessive ammonia levels)
67
Portal Hypertension
* liver receives blood from hepatic artery which provides oxygen and portal vein which provides nutrients.
* When liver is scarred, blood backs up into liver leading to portal hypertension.
* Back up can result in splenomegaly, or esophageal verrucae’s (verrucous veins in the esophagus) dangerous because veins can rupture leading to GI bleeding and shock
68
Cirrhosis.
• Scarring of the liver. Cells can regenerate, but only to certain degree. Surface becomes bumpy and nodular causing malfunction. Resulting in S/S of liver disease.
69
Hepatic encephalopathy
* build up of ammonia.
* Is toxic to neurotransmission (brain tissue) end up with neurological issues such as ataxia, asterix (uncontrolled hand flapping). As it worsens, can have decline in cognition.
70
Nevus:
congenital discoloration of a circumscribed area of the skin, commonly called mole or birthmark.
71
Hemangioma
: A soft vascular nevus, centrally present on the face or neck, occurring at birth or shortly afterward.
72
Mongolian Spot
a smooth, brown to grayish blue nevus consisting of an excess of melanocytes, typically found at birth in the sacral region in East Asians, Blacks, American Indians, and many southern Europeans; it usually disappears during childhood.
73
Petechiae
Minute hemorrhagic spots, of pinpoint to pinhead size, in the skin, which are not blanched by pressure.
74
Ecchymosis
Discoloration of the skin (bruise) caused by escape of blood into the tissues.
75
Impetigo
: Bacterial infection on the surface of the skin (epidermis and upper layers of the dermis) outbreaks in crowded living areas.
76
Cellulitis
Bacterial infection in the deeper layers (dermis). Often happens in cases of poor circulation.
77
Necrotizing fasciitis
starts as a skin infection and spreads to the muscle
78
Paronychia
: infection of the cuticle. Often caused when people bite their nails
79
Abscess
: Bacterial infection. Liquefactive necrosis – all dead WBCs (puss)
80
Verrucae
warts.
81
Herpes simplex
: cold sore
82
Varicella zoster
chicken pox – spread by droplet
83
Herpes zoster
shingles. Happens in people who have already had chicken pox. The chicken pox go dormant, quietly live in a nerve route, when the persons immune system is weakened, the chicken pox virus reactivates and shingles result. Does not spread by droplet, but by touching the fluid filled blisters.
84
Candidiasis
yeast infection.
85
Onycholysis
: toe nail infection
86
Tinea corporis
ring worm. Not actually a worm, but a fungal infection. Anybody can get it, it is highly contagious through contact.
87
Tinea caputus
ringworm of the scalp.
88
Tinea pedis
Athlete’s foot. Can get it from public pools, hotel rooms
89
Tinea cruris
Jock itch
90
Scabies
the mite burrows under the skin (under epidermis) and lays eggs. Is very contagious, eggs mature. Bumpy rash. Does not cure on its own, must be cured with a special shampoo and body wash.
91
Lice
surface dwellers. Thrive by living off of a host. Life starts as a nit (egg) attaches itself to the shaft of the hair (close to the scalp), a week later, the egg hatches and a nymph is born. A week later, the nymph becomes an adult. Adult lice can live off something non-living for about three days.
92
Stab wound
deeper than it is wide
93
Puncture wound
deeper than it is long. Made by a pointed object. Sides are smooth
94
Blow
when somebody is struck by something that is moving (i.e. someone’s fist)
95
Impact:
person is moving and hit a stationary object. (i.e. hit a pole while riding bike)
96
Contusion
swollen bruise. Normally associated with an injury.
97
Avulsion:
something is torn from it’s point of attachment.
98
Irritant contact dermatitis
skin reactions ranging from erythema and scaling to necrotic burns resulting from nonimmunologic damage by chemicals in contact with the skin immediately or repeatedly
99
Allergic contact dermatitis
: involves the immune system. Involves the T lymphocytes. They think the body is under attack and mounts a counter attack, showing up as a rash.
100
Rhus contact dermatitis
: Urushiol is the oil in poison ivy that irritates the skin. Don’t burn poison ivy and inhale the smoke because the urushiol will cause respiratory distress.
101
Psoriasis:
Typically, our skin regenerates in about a month, in psoriasis, it regenerates much faster. Causing the epidermis to become thick and patchy. Not contagious.
102
Myopia
: the eyeball is too long or the cornea is too steep, so the light focuses in front of the retina. The person is near sighted.
103
Hyperopia
light from close objects sits behind the retina. Anything close looks blurry, the person is far sighted.
104
Floaters:
happens because vitreous humour. It’s like Jell-O and over time little areas of liquid develop and look like little dark spots. Especially after looking at bright light, look away, you see dark spots.
105
Conjunctivitis
pink eye. Streptococcus infection of the eye.
106
Blepharitis
: inflammation of the eye lash follicles. Oil glands at the base of the follicle becomes inflamed. Eyelids look greasy because of inflamed oil glands.
107
Sty:
: appears at the base of the eyelash. Localized inflammation of the oil gland that has become clogged. Starts off itchy and red and becomes painful. Warm compresses help it come to a head and it pops on its own.
108
Chalazion
Under the eye lid in the Meibomian glands that help lubricate our tears. They become clogged and form a cyst. This needs to be surgically removed.
109
Otitis media
: inflammation in the middle ear. Happens commonly in children and infants. The auditory tube (Eustachian tube) connects the middle ear to the nose and throat. In children it is shorter and straighter. Sinus or throat infection can spread to the ear causing the middle ear to become painful and inflamed. If left untreated, the tympanic membrane can burst, causing scarring. Often kids with otitis media require tubes.
110
Myringotomy
Tubes in the ears.
111
Externia ototitis
swimmers ear from lake water which contains pseudomonas
112
Depth of Burn
| 1st degree
* Partial thickness
* Destruction of epidermis only
* Erythema, pain, blistering may occur after first 24 hours
* Heals within 3 – 5 days; no scarring
* Skin function – intact
113
2nd degree
Superficial partial thickness
• Destruction of epidermis and some of the dermis
• Fluid filled blisters appear within minutes of injury
• Healing time 21 – 28 days
• Skin function absent
• Pain sensors intact
114
2nd degree – Deep partial thickness
* Destruction of entire dermis leaving skin appendages
* Mottled with areas of waxy white, dry surface
* Absent skin function
* Diminished pain and tactile sensation
* Diminished sensation
* Healing time > 30 days
115
3rd degree – Full thickness
* Involves entire epidermis, dermis, may extend to SQ tissue
* White, cherry red or black dry, leathery surface
* Skin function, tactile and pain sensors absent
* Secondary healing in small wounds, otherwise requires skin grafting
116
4th degree
• Goes all the way to the bone
117
• Zone of necrosis
the middle of the burn. Dead tissue that has been burnt away
118
• Zone of stasis
vulnerable tissue surrounding necrosis. May or may not return to normal
119
• Zone of hyperemia
: Increase in blood flow to the site. Redness around the burn. Trying to salvage the zone of stasis
120
Response to injury
| Body goes through 5 stages when burnt.
1. Burn shock: body loses fluid because skin contains a lot of water. When skin is gone, water is gone. Water is even lost from skin that is not burned
2. Cellular changes: Swelling. sodium and water shift inside the cell because the potassium pump stops working. Can result in airway occlusion from swelling
3. Metabolic changes: Increased HR, increase BP, Cortisol and epinephrine and norepinephrine activated from adrenal glands resulting in a state of metabolism.
4. Immune Response: opsonization is when the body prepares the bacteria to be destroyed. Bacterial translocation, bacteria from GI tract moves to the blood stream, to the abdominal cavity, putting the patient at risk for sepsis.
5. Organ dysfunction: heart, kidney, respiratory tract all start to shut down. Myocardium becomes depresses, less able to maintain cardiac output. Respiratory system fails due to laryngeal edema. Kidney fails due to decreased blood flow.
121
Injury due to cold
* Frostbite is categorized by 1st, 2nd, 3rd. Person can have hypothermia without frostbite.
* If body temp. drops below 35 degrees, they’re hypothermic.
122
Cataracts
* Happens because over time, the lenses become opaque
| * Opacity of the lens
123
risk of cateracts
o Age, smoking, ETOL, UV rays, DM, family history, drugs
124
Open Angle glaucoma
* Most common
* Drain structure in the eye looks normal, but fluid does not flow the way it should causing pressure
* Trabecular meshwork is blocked
* Happens slowly
125
Closed angle glaucoma
* Fluid does not drain right because the angle is to narrow between the cornea and iris – Ciliary body
* Since the iris is in the way, fluid buildup occurs
126
Macular Degeneration
• the small central portion of the retina, known as the macula, deteriorates which causes central blindness
127
Otosclerosis
* Hereditary disease that affects the three ossicles of the middle ear.
* The stapes is the bone against the oval window.
* These bones, especially the stapes, go through excessive remodeling.
* otospongiotic phase - Early in the disease, the stapes is the one particularly affected, it becomes spongy.
* otosclerotic phase - The spongy bone than becomes replaced with thick sclerotic bone that does not vibrate as well
* Stapedectomy: remove the stapes bone and replace it with a prosthesis.
128
Presbycusis
* Gradual loss of hearing. Occurs commonly in seniors. Can result from damage to nerves of the ear or can be conductive (problem with the conductivity in the ear). 50% of adults over age 75 have some form of this.
* Can be sensorineural or conductive
129
Meniere Disease
• Characterized by excessive endolymph
130
Helicobacter pylori:
a bacterium that likes acidic places.
131
Metaplasia
normal cells are replaced with abnormal cells. May be corrected or turn precancerous
