Test 3 Flashcards
1
Q
Where loop diuretics exert their action
A
thick ascending loop
2
Q
most uncomplicated UTIs are caused by
A
E coli
3
Q
The kidney plays a central role in blood pressure regulation by
A
RAAS
4
Q
the functional unit of the kidney
A
nephron
5
Q
How do most infections of the urinary tract enter the body?
A
urethra
6
Q
Does the intracellular fluid compartment include the fluids found in the interstitial spaces?
A
No
7
Q
Is the sodium-potassium pump only found in blood cells?
A
No
8
Q
What is the major buffer system in the body?
A
Protein buffer system
9
Q
How does the protein buffer system work
A
Has lots of amino acids that pick up or release H ions
10
Q
How do you define edema?
A
fluid in interstitial space
11
Q
how would you determine if a patient has pulmonary edema?
A
Pink frothy sputum, dyspnea, crackles.
12
Q
many of the disorders of the GI tract are manifested by
A
anorexia, nausea, and vomitting
13
Q
the largest endocrine organ in the body
A
GI tract
14
Q
major hormones of the GI tract
A
Gastrin, histamine, secretin, somatostatin, CCK, pepsin, GRH, motilin
15
Q
the major hormones of the GI tract and from the
A
salivary, pancreatic and biliary tracts
16
Q
Three causes of jaundice include extrahepatic obstruction to bile such as _____ , intrahepatic obstruction such as ____ or _____, or excessive production of _____
A
gallstones; cirrhosis or hepatitis; bilirubin
17
Q
drug abuse and malignancy are a cause of
A
jaundice
18
Q
does the liver produce minerals and vitamins?
A
No it stores them
19
Q
The liver produces ____, it eliminates ____, it metabolizes drugs, steroids carbohydrates, fats and proteins, it synthesizes _____, and it synthesizes some plasma proteins.
A
bile salts; bilirubin; clotting factors
20
Q
What is the number one cause of failure to adequately control chronic pain?
A
undertreatment
21
Q
Diverticular disease is a condition in which the mucosal layer herniates through the _____
A
muscularis layer
22
Q
diverticular disease occurs in the
A
colon
23
Q
anemia is the deficiency of
A
RBCs
24
Q
Primary polycythemia exists when there is an ____ in circulating RBCs, WBCs and Platelets
A
increase
25
What is the end result of anemia?
hypoxia
26
What is the most significant consequence of hyperkalemia?
Depressed cardiac conductivity or cardiac arrest
27
If you infuse a hypotonic solution into a patient the fluid movement will be from...
vascular to interstitial
28
one notable characteristic of infectious mononucleosis
Downey cells
29
The ______ control renal blood flow and GFR.
juxtaglomerular apparatus (JGA)
30
As systemic BP increases, the afferent arterioles ____, preventing an increase in filtration pressure
constrict
31
Prevents wide fluctuations in systemic arterial pressure from being transmitted to the glomerular capillaries.
renal autoregulation
32
Should we normally see protein in the urine?
No
33
Glomerular hyperfilatration and increased glomerular capillary permeability lead to
proteinuria
34
Proteinuria contributes to _______ by accumulating in the interstitial space and activating complement proteins and other mediators and cells, such as macrophages, that promote inflammation and progressive fibrosis
tubulointersitial injury
35
Which is the most abundant protein in blood plasma?
albumin
36
Would a differential count of white blood cells include a reticulocyte count?
No
37
What are reticulocytes?
immature RBCs
38
How would you recognize reticulocytes in a blood smear?
they have a nucleus
39
When you would see retics
chronic, slow GI bleed
40
What does hematocrit measure?
% of RBCs
41
The most efficient phagocytes
neutrophils and monocytes
42
What is the principal disorder in pernicious anemia?
intrinsic factor deficiency
43
What are some characteristics of Hodgkin Lymphoma?
localized nodal involvement
44
causes of thrombocytopenia
Viral infections, drugs, chronic renal failure, aplastic anemia, radiation therapy, HIT
45
Does bilateral renal agenesis usually cause death?
Yes, there's no kidneys
46
Respiratory alkalosis can be caused by
severe anxiety
47
mitochondria produces
ATP
48
The immune cells
T and B lymphocytes
49
What is the most common cause of an upper urinary tract obstruction?
renal colic
50
The nephrotic syndrome is not a specific disease, but a constellation of clinical findings that result from
increased glomerular permeability to the plasma proteins
51
What two compartments compose the extra-cellular fluid?
vascular and interstitial
52
the most abundant anion in the body
sodium, a cation
53
two things can cause an endocrine hormonal problem
overproduction and underproduction
54
The metabolic activities of the body require the precise regulation of the acid-base balance which is reflected in the
ph 7.35-7.45
55
What are some complications of peptic ulcer disease?
GI bleed, H pylori, perforation, anemia, nutritional problems
56
Gall bladder disease is a result of cholelithiasis and is usually treated with
cholecystectomy
57
hemolytic anemia can result in
jaundice
58
the sequence from the fastest-acting blood pH compensation to slowest-acting
blood, lungs, kidney
59
clinical manifestations of multiple myeloma
bone pain, M protein, fractures, and renal damage.
60
what anamatomical structure maintains a relatively high blood pressure in the glomerulus of the kidney?
the afferent arteriole is larger than the efferent arteriole
61
one function of the kidney is the elimination of
hydrogen ions
62
Hydrogen is secreted by the distal tubule and combines with nonbicarb buffers (ammonium and phosphate) for the elimination of ____ in the urine.
excess acids
63
can be responsible for acute tubular necrosis
nephrotoxins such as atbx
64
Which renal condition usually involves a history of recent infection with a group A beta-hemolytic strep?
nephrosis
65
tissue hypoxia causes the rate and depth of breathing to
increase
66
If a reticulocyte count was done on an individual with iron deficiency anemia because of chronic bleeding, would it be high or low?
high
67
What do the manifestations of leukemia include?
night sweats, petechial hemorrhage
68
Lymphocytes are described as
mononuclear immunocytes.
69
the primary lymphoid organ for B cells is
bone marrow
70
the primary lymphoid organ for T cells is
thymus
71
polycystic kidney disease is a
autosomal dominant disorder
72
IgG autoantibody and drug hypersensitivity can cause
thrombocytopenia
73
in hemolytic anemia, ____ destruction exceeds the liver's ability to conjugate and excrete _____
heme; bilirubin
74
Persons who have GERD have ___ resting tone of the ____ esophageal sphincter; the symptoms include heartburn & chronic ____.
decreased; lower; cough
75
The most common type of hiatal hernia is ___; this type ____ associated with GERD.
sliding, is
76
Acute obstruction high in the small intestine causes____ first, acute obstruction low in small intestine causes ____ first.
vomiting, constipation
77
With acute mesenteric ischemia, the damaged intestinal mucosa cannot produce enough mucus to protect itself from ____; bacteria invade the ____ intestinal wall, eventually causing ____.
digestive enzymes, necrotic, peritonitis
78
Neurons in the _____ nucleus play a major role in regulating appetite, food intake, & energy metabolism; hormones that circulate in the blood serve as _____ signals to this area when their concentrations increase or decrease in relation to _____.
arcuate, peripheral, body fat mass
79
_____ obesity is associated with a greater risk for metabolic syndrome, T2DM, & CV complications; resistance to _____& decreased production of _____ contribute to the insulin resistance in obesity.
Visceral, leptin, adiponectin
80
Cirrhosis & hepatitis can cause _____ portal hypertension; severe right-sided heart failure can cause ______ portal HTN.
intrahepatic; post-hepatic
81
The most accepted theory of ascites formation involves the combination of portal _____ & splanchic _____.
HTN; vasodilation
82
Ascites can be complicated by _____ peritonitis?
Bacterial
83
The _____ color of jaundice usually appears first in the ______.
yellow, sclera of the eye
84
Major cause of esophageal varices of cirrhosis: portal HTN or hepatocyte dysfunction?
portal htn
85
Major cause of jaundice in cirrhosis: portal HTN or hepatocyte dysfunction?
hepatocyte dysfunction
86
Major cause of hepatic encephalopathy in cirrhosis: portal HTN or hepatocyte dysfunction?
hepatocyte dysfunction
87
Major cause of hemorrhoids in cirrhosis: portal HTN or hepatocyte dysfunction?
portal htn
88
Major cause of splenomegaly in cirrhosis: portal HTN or hepatocyte dysfunction?
portal htn
89
Major cause of caput medusae in cirrhosis: portal HTN or hepatocyte dysfunction?
portal htn
90
Major cause of hypoalbuminemia in cirrhosis: portal HTN or hepatocyte dysfunction?
hepatocyte dysfunction
91
involves reflux of acid & pepsin from stomach to esophagus & causes esophagitis.
GERD
92
involves similar symptoms of GERD but no visible signs of erosion.
NERD
93
Caused by autoimmune damage primarily of gastric funds (leads to pernicious anemia)
Type A chronic gastritis
94
caused by non-immune mechanisms (H. pylori, chronic ETOH, NSAIDs) & primarily affects gastric antrum
Type B chronic gastritis
95
faulty chemical breakdown of nutrients, takes place in intestinal lumen or at brush border of intestinal mucosa of small intestine.
maldigestion
96
failure of intestinal mucosa to transport digested nutrients from intestine to blood or lymph.
malabsorption
97
body responds with glycogenolysis & gluconeogenesis with only a small amount of protein catabolism (LIKE WHEN FASTING FOR RITUALS, RELIGIOUS OBSERVATIONS, ETC.)
short term starvation (3-4 days)
98
body responds with lipolysis & eventually proteolysis, which can cause death (LIKE IN ANOREXIA NERVOSA)
Long-term starvation (+4 days)
99
type of cirrhosis where damage begins with hepatocytes
alcoholic cirrhosis
100
type of cirrhosis where damage begins in bile canaliculi & bile ducts
biliary cirrhosis
101
Disorder caused by absence of an enzyme causes bloating, crampy pain, diarrhea, & flatulence after ingesting milk.
Lactase deficiency
102
This is a functional gastrointestinal disorder characterized by abdl pain & altered bowel habits.
Irritable bowel syndrome
103
A disorder characterized by rapid gastric emptying of hypertonic chyme after bariatric surgery causing tachycardia, hypotension, pallor, diaphoresis, cramping, nausea, & diarrhea.
Dumping syndrome
104
This GI disorder manifests with asymptomatic presence of saclike outpouchings that are continuous with the GI tract lumen.
diverticulosis
105
most common in age 60+, those with decreased dietary fiber, increased intracolonic pressure like with constipation, abnormal neuromuscular function, & alterations in intestinal motility.
diverticulosis
106
This gastrin-secreting tumor causes gastric & duodenal ulcers, GERD with abdl pain & diarrhea
Zollinger-Ellison syndrome
107
Provision of nutrients after starvation should be done slowly and cautiously because this syndrome can occur when rapid provision of nutrients causes severe hypophosphatemia & other electrolyte imbalances that can be fatal.
Refeeding syndrome
108
This disease is progression from an asymptomatic form to a symptomatic form when saclike outpouchings of the continous GI tract lumen become inflamed
diverticulitis
109
This disorder is characterized by increased serum bilirubin levels, primarily conjugated, due to obstruction of common bile duct.
Cholestatic jaundice
110
This type of jaundice is when serum bilirubin levels, both conjugated & unconjugated, are a result of failure of liver cells to conjugate bilirubin & failure of bilirubin to pass from liver to intestine.
hepatocellular jaundice
111
Necrosis of liver cells without preexisting liver disease or cirrhosis is known as ______ ________ _______, often due to acetaminophen overdose.
Acute liver failure
112
Functional dysphagia caused by loss of esophageal innervation is called?
achalasia
113
Protrusion of the upper part of the stomach through the diaphragm & into the thorax is called?
hiatal hernia (sliding hiatal hernia is the most common type)
114
Persons who have acute obstruction high in the small intestine are at risk for metabolic ___________, but those with acute obstruction low in the small intestine are at risk for metabolic _________.
alkalosis, acidosis
115
Acute gastritis often heals within a few ______, especially when injurious agents such as NSAIDs and alcohol are stopped.
days
116
Gastric & duodenal ulcers are both called ______ ulcers; risk factors include H. ________ and use of NSAIDs.
peptic, pylori
117
Although pancreatic insufficiency causes poor digestion of all nutrients, maldigestion of ______ due to lack of _______ is the chief problem.
fat, lipase
118
Divertula involve herniation of the_______ through the muscle layers; the most common location where diverticula develop is the ________.
mucosa; colon
119
Pain from appendicitis typically moves from the epigastric or ________ region to the ______ ______ _______.
periumbilical, RLQ
120
Obesity is defined as a BMI that exceeds _____kg/m2 & generally develops when caloric intake _______ caloric expenditure in genetically susceptible individuals.
30; exceeds
121
Cytokines & hormones secreted by adipose tissue are known as ______; in obesity, _______ that infiltrate adipose tissue secrete proinflammatory cytokines.
adipokenes, macrophages
122
Hepatitis ______ virus depends on hepatitis B virus in order to replicate.
D
123
Jaundice in viral hepatitis occurs during the _______ phase; when jaundice resolves, the ______ phase begins.
icteric; recovery
124
Cholecystitis occurs when a gallstone lodges in the _______ duct, the most common type of gallstone is made of _________.
cystic, cholesterol
125
The primary diagnostic marker for acute pancreatitis is elevated serum _______; chronic pancreatitis may be autoimmune or associated with chronic _______ abuse.
lipase, alcohol
126
Fatty liver is associated with chronic use of _______, or with ______ (including in children); although fatty liver is asymptomatic, persons who have it may develop steatohepatitis & may progress to ________, liver failure, or liver cancer.
alcohol, obesity; cirrhosis
127
difficulty swallowing
dysphage
128
accumulation of fluid in the peritoneal cavity
ascites
129
loss of appetite
anorexia
130
vomiting of blood
hematemesis
131
dark, tarry stools
melena
132
frank bleeding from the rectum
hematochezia
133
formation of gallstones
cholelithiasis
134
distended, torturous, collateral veins
varices
135
Hep A route of transmission
fecal-oral, parenteral, sexual
136
Hep B route of transmission
parenteral, sexual
137
Hep C route of transmission
parenteral
138
Hep D route of transmission
parenteral, fecal-oral, sexual
139
Hep E route of transmission
fecal-oral
140
Hepatitis that can be chronic
Hep B, C, and D
141
Hepatitis that has a carrier state
Hep B, C, and D
142
lesions are located in entire GI tract, with small and large intestines most common
Crohns
143
Lesions are located in rectum and colon; continuous lesions
ulcerative colitis
144
lesions involve mucosal layer only
ulcerative colitis
145
fistulas and abscesses common
Crohns
146
Lesions involve entire thickness of intestinal wall
Crohns
147
common in ulcerative colitis to have
blood in stools
148
in alcohol cirrhosis, alcohol damage triggers overgrowth of _____, which distorts the liver
connective tissue
149
Absence of a normal body opening or passageway.
Atresia
150
Twisting of loops of intestine on themselves, which obstructs the lumen
volvulous
151
Neonates who have a congenital anomaly should be examined for the presence of ______.
other anomalies
152
Children who have cleft ____ tend to have repeated sinus & middle ear infections should be evaluated for loss of _____.
palate, hearing
153
In children, CHRONIC hepatitis most often occurs from which type of hepatitis?
B & C - because of the immature immune system
154
Childhood chronic hepatitis usually has ____ symptoms.
No
155
In intestinal malrotation ______ condition, the cecum & initial portion of the colon reside in the upper ____ quadrant of the abdomen.
congenital, right
156
Stenosis of a segment of bowel causes ____ of the lumen proximal to the obstruction and ____ distal to it.
dilation proximal, collapse distal
157
A child who falls below the ____ percentile on the growth curve is likely to have failure to thrive.
Third
158
Rotavirus is a leading cause of ______ in infants & young children.
Acute gastroenteritis
159
is imperforate anus congenital or acquired?
congenital
160
is esophageal atresia congenital or acquired?
congenital
161
is hep A congenital or acquired?
acquired
162
Is cleft lip congenital or acquired?
congenital
163
Is trachoesophageal fistula congenital or acquired?
congenital
164
Is intussusception congenital or acquired?
acquired
165
Is eosinophilic esophagitis congenital or acquired?
acquired
166
Is Hirschsprung disease congenital or acquired?
congenital
167
in esophageal atresia, the esophagus is a blind pouch and cannot swallow amniotic fluid; therefore, there is an increased amount of amniotic fluid leading to
maternal polyhydramnios
168
In ____ _____, air will enter the stomach and distend it, gastric secretions will regurgitate into trachea & enter lungs causing inflammation & damaging lung tissue.
tracheoesophageal fistula
169
severe acute malnutrition caused by deficiency of all nutrients.
Marasmus
170
severe acute malnutrition caused by deficiency of protein
Kwashiorkor
171
has a known pathophysiologic cause that results in insufficient nutrients becoming available for the body's needs.
organic failure to thrive
172
occurs in the absence of known physiologic causes & is associated with ineffective nurturing or neglect.
nonorganic failure to thrive
173
arises during the 2nd or 3rd day after birth for full term infants & 2-4 weeks after birth in premature infants.
Physiologic jaundice
174
arises after that time period or else within 24 hours after birth with high bilirubin levels.
pathologic jaundice
175
Risk factor for Cleft lip
maternal vitamin B deficiency
176
Risk factor for distal intestinal obstruction syndrome
cystic fibrosis
177
risk factor for pyloric stenosis
maternal hypersecretion of gastrin
178
risk factor for Hep B infection
frequent blood transfusions for hemophilia
179
risk factor for Hep A infection
daycare personnel who don't practice hand hygeine
180
Cleft palate arises during the third ______ of gestation, and cleft lip arises during the fourth ______ of gestation.
month; week
181
Wilson disease, also called __________ degeneration, is an autosomal __________ defect of _______ metabolism that damages the _______, brain, eyes, & kidneys.
hepatolenticular; recessive, copper, liver
182
In biliary atresia, some of the _____ ducts are absent or obstructed, which leads to development of portal _____ & cirrhosis.
bile; hypertension
183
Gluten-sensitive enteropathy, AKA _____ disease or _______ _______, is an autoimmune disease in which reactive ___ lymphocytes mediate damage to the intestinal _______.
celiac, celiac sprue, T-lymphocytes, epithelium
184
In kwashiorkor, generalized edema occurs because of decreased plasma _______; the liver accumulates ______ because of lack of amino acids to make lipoproteins.
proteins (albumin); fat
185
Children who have marasmus do not have the subcutaneous ____ seen with kwashiorkor, & their livers are not _________.
fat, enlarged
186
Brain damage caused by high bilirubin levels is known as
kernicterus
187
The immature mucosal barrier of a premature infant's GI tract is an important factor in the development of ________ ________, which can lead to abdl distention, ______ perforation, sepsis &________.
necrotizing enterocolitis; bowel perforation, & death
188
Many infants who have GE reflux develop _______ pneumonia; although children usually outgrow the reflux, if it persists in childhood, the child may develop chronic ______, hoarseness, & recurrent __________.
aspiration pneumonia, chronic cough, recurrent pneunomia
189
Cystic fibrosis is characterized by a deficiency of _______ enzymes, hypersecretion of respiratory _______, & ______ sodium & chloride in _______.
pancreatic enzymes, respiratory mucous, increased Na & Cl in sweat.
190
s/s are enlarged spleen, bloody emesis or melena, & ascites
portal htn
191
s/s are jaundice, enlarged liver, clay-colored feces, failure to gain weight
biliary atresia
192
s/s are chronic constipation, poor weight gain, & progressive abdominal dissension; may develop small volume diarrhea
Hirschsprung disease
193
infant who previously fed well & gained weight develops repeated projectile vomiting & wants to eat again soon after each vomiting episode
pyloric stenosis
194
Outpouching of all layers of the small intestine caused by failure of the fibrous band that connects the small intestine to the umbilicus.
Meckel diverticulum
195
a condition in which one portion of the bowel telescopes or invaginates into another, most commonly at the ileocecal junction, sometimes a result of rotavirus vaccine.
Intussusception
196
What is the most common cause of acquired intestinal obstruction in infants?
Intussusception
197
What is the most common cause of acute diarrhea in children?
Bacterial or viral enterocolitis.
198
What is the length of time for diarrhea to be considered chronic?
Diarrhea lasting 4 weeks or longer.
199
What is the most common cause the need of a liver transplant in children?
biliary atresia
200
What is the most common form of childhood hepatitis?
hep A
201
What is the most common cause of portal hypertension in children?
splenomegaly
202
What is the most common sign of portal hypertension in children?
thrombus of portal vei
203
What are the three most common metabolic disorders that cause liver damage in children?
galactosemia, fructosemia, & Wilson disease
204
no symptoms ine arly stages; hematuria, dull flank pain, weight loss, anemia in late stages
renal cancer
205
sudden onset of hematuria, red blood cell casts, mild proteinuria, plus edema, htn, and oliguria if severe; may be asymptomatic
acute glomerulonephritis
206
severe colicky flank pain radiating to the groin, nausea and vomiting, some hematuria
calculus lodged in ureter
207
urgency, with or without incontinence, associated with frequency and nocturia; no bacteria in urine
overactive bladder
208
frequency, urgency, dysuria, suprapubic and low back pain, cloudy urine
acute cystitis
209
massive proetinuria, hypoproteinuria, hyperlipidemia, edema
nephrotic syndrome
210
sudden onset of oliguria with elevated plasma BUN and plasma creat levels
acute kidney injury
211
uremic syndrome causes
azotemia
212
A man was confused and incontinent until the nurse put a picture of a toilet on the bathroom door, and he became continent
functional incontinecne
213
A woman with bladder infection and has sudden strong need to urinate that cuase her to become incontinent
urge incontinence
214
A women loses a small amount of urine when sneezing
stress incontinence
215
A man with MS became incontinent when his caregiver was late and was not available to assist with am catherization
overflow incontinence
216
A process that regulates sodium and water blaance by reabsorption of a constant fraction of the sodium load filtered at the glomerulus
glomerulotubular balance
217
A process that regulates renal blood flow and GFR to keep them constant by altering the amount of vasoconstriction of afferent arterioles in response to changes in their circumference
myogenic mechanism
218
A process that regulates renal blood flow and GFR to keep them constant by altering the amount of vasoconstriction of afferent arterioles in response to changes in the concentration of filtered sodium
tubuloglomeruluar feedback
219
the filtration fraction is the ratio of the GFR to
renal plasma flow
220
has larger mitochondria and thus is more suited for active transport of solutes
thick ascending loop of Henle
221
reabsorption of large amounts of sodium, water, glucose, amino acids; net reabsorption of bicarb; secretion of H+, organic acids, and many meds
proximal tubule
222
reabsorption of sodium, chloride, and potassium but not much water
thick ascending limb of loop of henle
223
secretion of potassium, ammonia, and H+; site of action of aldosterone and ADH
distal tubule and collecting duct
224
ultrafiltration
glomerulus
225
reabsorption of water
descending limp of loop of Henle
