Patho Midterm 2 final review

Secondary brain injury

Caused by effects of cerebral edema, hemorrhage, hematoma, cerebral vasospasm, infection and ischemia

Keratitis

Caused by herpes, causes cornea infection creating ulcers on the cornea

Tuberculosis/ cause

Caused by mycobacterium tuberculosis primarily effects the lungs

Unstable angina

Caused by reversible myocardial schema, an indication that an MI is likely

Lobar Pneumonia- caused by ...

Caused by streptococcus pneumoniae

Transient ischemic attacks

Caused by thrombotic particles which cause a temporary blockage of circulation to the brain

The most easily displaced matter in increased ICP is _______

Cerebrospinal Fluid

changes in the bronchi resulting from constant irritation from smoking or exposure to industrial pollution.

Chronic Bronchitis

The sayings pink puffer and blue bloater are associated with what

Emphysema - Bronchitis.

Group of disorders which makes up COPD

Emphysema, chronic bronchitis , chronic asthma

3 critical elements of endocarditis

Endocardium must be prepared for colonization, blood borne microorganisms, susceptible host

Adverse effects of Bulimia

Esophageal tears, constipation, diarrhea, electrolyte/nutritional imbalances and deficiencies

Asthma (Acute) Etiology , location is there sputum production ?

Etiology : Hypersensitivity type 1,/ hyperresponsive tissue Location: Small Bronchi, bronchioles Sputum production: Thick tenacious mucus

Anaerobic metabolism leads to accumulation of _______

Lactic acid

Chronic Bronchitis - Etiology, location , is there sputum production ?

Etiology : smoking, air pollution Location: Bronchi Sputum: frequent large amounts of sputum

Emphysema- Etiology, location, Is there sputum production ?

Etiology : smoking, genetic Location: primarily effects the alveoli Sputum production: minimal

In meningitis _____ forms that blocks the normal CSF flow

Exudate

true or false chlamydia may be a cause of aortic aneurysms

FALSE SYPHILIS can be the cause.

True or false Atelectasis commonly occurs as a direct result of the direct trauma associated with a flail chest.

FALSE atelecatasis often occurs has a secondary injury resulting from a broken rib puncturing the lung.

valvular incompetence

Failure of a valve to close completely allowing blood to regurgitate or leak backward.

true or false bronchiectasis is a primary lung disease

False it is often a secondary problem associated with cystic fibrosis , copd , - may result from aspiration childhood infection

Hyperopia

Far sightedness

Presbyopia

Far sightedness due to aging

what is the first sign of heart failure in children

Feeding difficulties other s/s: cough flarred nostrils, wheezing, grunting respirations

Generalized Anxiety Disorder

-excessive & persistent worries -restlessness, motor tension, irritability, fatigue, difficulty concentrating, sleep disturbance -depression, panic attacks are common

Endometrial Cancer (uterine) - etiology

-exogenous estrogen; infertility, oral contraceptives, obesity, diabetes mellitus, hypertension

Benign Prostatic Hypertrophy (BPH)

-hyperplasia of prostatic tissue -can compress the urethra and lead to urinary obstruction

Cushing's Reflex (triad)

-hypertension, bradycardia & irregular breathing (Cheyne Stokes respiration's)

Acute Complications of Diabetes

-hypoglycemia - lower plasma glucose level -symptoms are caused by activation of the sympathetic nervous system or from a sudden drop in the amount of glucose delivered to the brain -if the drop is rapid, get adrenergic signs, tachycardia

Dumping Syndrome - Signs & Symptoms

-hypovolemia causes dizziness, weakness, tachy, sweating, hypoglycemia, no food reserves in stomach

Retching

-if the upper esophageal sphincter stays closed, the chyme does not enter the mouth & it falls back down into the stomach

Benign Prostatic Hypertrophy (BPH) - pathophysiology

-imbalance between estrogen and testosterone caused by hormonal changes related to aging -no connection between BPH and prostatis carcinoma -enlarged gland with rectal exam -incomplete bladder emptying -leads to distended bladder, dilated ureters, hydronephrosis and possible renal damage -very common in older men; 50% of men, older than 65 yrs old

alexia

-impaired reading ability

agraphia

-impaired writing ability

macular degeneration - pathophysiology

-in both types the nutrients can no longer pass from the choroids to the retina -central vision with high acuity first becomes blurred, and then is lost -depth perception is affected, no pain & no peripheral vision loss

acute glaucoma

-in which there is a sudden marked increase in intraocular pressure

aphasia

-inability to comprehend or express language

Urinary Tract Infections (UTI) - signs & symptoms

-incontinence with incomplete emptying; urinary retention -anything that obstructs urine flow; pregnancy, scar tissue, renal calculi, immunosuppression, fecal incontinence

Peptic Ulcer - Causes

-increased acid-pepsin secretions, increased gastric secretion, increased vagal stimulation, alcohol, caffeine & spicy food in excess

Menorrhagia

-increased amount and duration of menstrual flow

Azotemia

-increased serum urea levels

Pyelonephritis

-infection in the kidney which involves the renal pelvis and medullary tissue -purulent exudate in the kidney, pelvis & calyces

Meningitis

-infection of the meninges of the CNS; usually bacterial -microorganisms reach the brain via the blood, from nearby tissue or through wounds -bacteria & other toxins are irritants; leads to an inflammatory response -exudate forms that blocks CSF flow; can lead to hydrocephalus & edema (increased ICP)

Urinary Tract Infections (UTI)

-infection of the urinary tract, cystitis, urethritis, pyelonephritis, most are ascending -occasionally can be caused by blood borne microorganisms

Dysphagia - causes

-infection, CVA, brain damage, achalasia -muscle impairment caused by muscular dystrophy -mechanical obstructions: congenital atresia, stenosis, esophageal diverticula, tumors

Burning Sensation

-inflammation & ulceration in the upper GI tract

Irritable Bowel Syndrome (IBS)

-a GI disorder with signs & symptoms of abdominal pain & changes in normal bowel habits -more common in young & middle age women

Alcoholic Hepatitis

-inflammation and cell necrosis occur -this leads to fibrous tissue; is an irreversible change -may be asymptomatic or mile symptoms

Crohn's Disease - Pathophysiology

-inflammation begins in the intestinal submucosa, spreads across and involves mucosa & serosa; skip lesions develop -fissures develop; typical lesion is a granuloma with cobblestone projections of inflamed tissue that are surrounded by ulcerated areas -the lumen can narrow and fistulae can form -the damaged wall impairs the ability to process, absorb food and stimulates motility -leads to hypoproteinemia, avitaminosis, malnutrition, steatorrhea

Cholangitis

-inflammation of the bile ducts, usually caused by infection

Cholecystitis

-inflammation of the gallbladder and cystic duct

Hepatitis

-inflammation of the liver; it may be idiopathic (fatty liver) or from a local infection (viral hepatitis) or from chemical/drug toxicity

Pancreatitis

-inflammation of the pancreas - caused by autodigestion -caused by premature activation of pancreatic enzymes -appears to be mainly related to the conversion of trypsinogen into trypsin -leads to widespread inflammation of the peritoneal membrane and chemical peritonitis -severe pain is caused by autodigestion of nerves

Prostatitis

-inflammation of the prostate -4 categories: 1) acute bacterial 2) chronic bacterial 3) nonbacterial 4) asymptomatic inflammatory prostatitis -an ascending infection or inflammation

conjunctivitis

-inflammation or infection involving the conjunctiva -allergens, bacteria, viruses or chemicals -redness, itching, excessive tear

Cholelithiasis

Formation of gallstones

Blebs

Formed by damaged alveoli that coalesce and make a large air space. - also can be called a bullae - can rupture and cause a pneumothorax

Embolic Stroke

Fragments break off a thrombus that formed outside the brain

Steatorrhea

Frequent bulky, greasy, loose stool with a foul door, characteristic of malabsorption syndromes

Histoplasmosis is a ..

Fungal infection , common in midwestern United States.

Infratentorial

If the problem is below the tantrum, damage is in the brain stem or spinal cord, widespread effects

Retching

If the upper esophageal sphincter stays closed, the chyme does not enter the mouth and it falls back down into the stomach

Mitral stenosis

Impaired blood flow from left atrium to the left ventricle, commonly caused by rheumatic fever or bacterial endocarditis

Myocardial Ischemia

Impaired blood flow to the myocardium so that needs for oxygen and nutrients are not met

Myocardial ischemia

Impaired blood flow to the myocardium so that needs for oxygen and nutrients are not met

Hypertension, _______ or weakening of arterial walls all contribute to arteriosclerosis

Impaired perfusion

Alexia

Impaired reading ability

Agraphia

Impaired writing ability

Cardiogenic Shock

Inability of the heart to pump the blood through the circulation.

Aphasia

Inability to comprehend or express language

Retention

Inability to empty the bladder, may be caused by anesthesia or spinal cord injury

Chronic venous insufficiency

Inadequate venous return over a long period, causes changes in blood vessels and supporting tissue due to ischema

Chronic venous insufficiency

Inadequate venous return over a long period, causes changes in blood vessels, skin and supporting tissue because of ischema

Auto regulation of brain

Increased Co2, decreased pH or decreased BP in the brain leads to immediate vasodilation

Chronic Bronchitis PAthophysiology

Increased mucus glands and secretion, inflammation and infection, obstruction.

Spastic paralysis

Increased muscle tone caused by a lack of moderating or inhibiting signals from the brain caused by damage to upper motor neurons

Pyelonephritis

Infection in the kidney which involves the renal pelvis and medullary tissue, purulent exudate can occur

Encephalitis

Infection of the connective tissue in the brain and spinal cord, basal ganglia is frequently affected

Meningitis

Infection of the meninges

Otitis Media

Inflamed tympanic membrane, causes fever, ear pain and irritability

Cystitis

Inflammation of the bladder

Infective endocarditis

Inflammation of the endocardium especially the valves

Infective endocarditis

Inflammation of the endocardium, especially the valves

Cholecystitis

Inflammation of the gallbladder and cystic duct

Croup

Inflammation of the larynx and subglottic area leads to obstruction and barking cough

Pericarditis

Inflammation of the pericardial membranes

Prostatitis

Inflammation of the prostate, an ascending infection

Urethritis

Inflammation of the urethra

Conjunctivitis

Inflammation or infection involving the conjunctiva causing redness, itching, and excessive teary

Asthma (acute) Pathophysiology

Inflammation, bronchoconstriction, increased mucus produced, obstruction , repeat attacks can lead to lung damage.

Syncope

Insufficient vasomotor compensation leading to decreased blood flow through the brain

______ do not allow for normal filling and emptying of the heart

Irregular contractions

Astigmatism

Irregular curvature in the cornea or lens

Asthma

Is a disease that involves periodic episodes of severe but reversible bronchial obstruction in persons with hypersensitive or hyper responsive airways.

Status Asthmaticus

Is a persistent and severe attack of asthma that does not respond to therapy. Often related to inadequate medical treatment.

Depression

-classified as an affective or mood disorder on the basis of characteristic disorganized emotions -it results from decreased activity by the excitatory neurotransmitters, norepinephrine and serotonin

Hematemesis

-coffee ground emesis, brown, granular material -caused by partial digested blood

Endometrial Cancer (uterine)

-common cancer, women older than 40 -most occur in 55-65 age range -vaginal bleeding is early indicator

Prostate Cancer - pathophysiology

-common in men over 50 yrs of age -second leading cause of death from cancer in men -many are androgen dependant -invasive to regional tissues; metastasizes to bone

Clostridium difficile (c-diff)

-common in people who have been on broad-spectrum antibiotics -causes severe illnesses

Breast Cancer

-common malignancy; occasionally occurs in males -incidence increases after age 20

Secondary Hypothyroidism

-conditions that cause either pituitary or hypothalamic failure

Mycobacterium

Is an acid fast , aerobic slow growing bacillus - Cause of TB ...:( - somewhat resistant to drying and many disenfectants.

Atherosclerosis

Is differentiated by the presence of ATHEROMAS, which are plaques consisting of lipids, cells , fibrin and cell debris.

Tetralogy of Fallot

Is the most cyanotic congenital heart condition. - is a cyanotic disorder.

Recurrent episodes of _______ may cause cells to adapt to periods of oxygen deprivation

Ischemia

Once blood is blocked cells will become _______ within 10 seconds

Ischemic

Genital Warts

-condylomata acuminate; caused by some types of HPV -linked to cervical cancer, incubation period may be up t0 6 months -pregnancy promotes the growth and spread of warts

Prostatitis - pathophysiology

-continuous mucosa with urinary tract promotes the spread of infection -causes of nonbacterial forms have not been established -leads to a tender, swollen gland - usually soft and boggy -large quantities of microorganisms, pus and leukocytes -the urinary tract is usually infected; leads to dysuria, frequency and urgency

Diarrhea

An increase in the frequency of defecation and in the fluidity, volume and weight of feces

Pneumonia

An infection of the lower respiratory tract, incidence and highest mortality occur in the elderly

Gastritis

An inflammatory disorder of the stomach, causes epithelial erosion

Bronchiolitis (RSV)

An inflammatory obstruction of the bronchioles, atelectasis can occur distal to the inflammation

Gastroenteritis

An inflammatory process involving the stomach and intestines

Glomerulonephritis

An inflammatory response occurs in the glomeruli of both kidneys, leads to increase permeability, leads to protein and RBCs enter the glomerular filtrate

Nystagmus

An involuntary abnormal moment of one or both eyes

Atherosclerosis can eventually lead to an _______

Aneurysm

True aneurysm

Aneurysm that involves all three layers of the wall

The _____ is susceptible for aneurysms because of constant stress

Aorta

Malformations most commonly effect....

Aortic and pulmonary valves.

Aortic stenosis

Aortic lumen size decreases, thus decreasing the amount of blood ejected into the aorta

Bronchogenic carcinoma

Arises from bronchial epithelium and is the most common malignant lung tumor.

Increased ICP leads to a decrease in _______ flow entering the brain

Arterial

Thrombotic stroke

Arterial occlusion caused by thumb have formed in arteries supplying the brain or in intracranial vessels

Prostatitis - signs & symptoms

-dysuria, frequency & urgency, fever & chills, low back pain or low abdo pain -may cause obstruction of urine flow, malaise, anorexia, muscle aching

Prostatitis - etiology

-e-coli most often but can be caused by pseudomonas, proteus or streptococcus faecalis -occurs in young people with UTI's -in older men with BPH; along with STI's (eg) gonorrhea -due to exposure to instruments such as during catheterization -sometimes spread through blood

Addison's Disease - Pathophysiology

-elevated ACTH levels with inadequate corticosteroid synthesis & release -more than 90% is destroyed before symptoms appear

Peptic Ulcer: Signs & Symptoms

-epigastric burning or aching pain; usually after 2-3 hours after meals and at night -relieved by eating or antacids, heartburn, nausea, vomiting, weight loss

Right heart failure

As pressure in the pulmonary circulation rises, the right ventricle can't compensate

Most common cause of Coronary artery disease is ________

Atherosclerosis

The most common cause of coronary artery disease is _______

Atherosclerosis

_______ is the leading contributor to coronary artery and cerebrovascular disease

Atherosclerosis

________ causes pooling of blood in the atria

Atrial fibrillation

Atrial flutter

Atrial heart rate 160 - 350 beats per minute

Atrial flutter

Atrial heart rate between 160-350

Atrial fibrillation

Atrial rate over 350 beats per minute

Chronic gastritis

Atrophy of the mucosa of the stomach leading to secretory glands being lost

_____ is the most common type of infective endocarditis

Bacterial

Epiglottitis cause

Bacterial infection H.Influenza type B.

Anthrax is a ...

Bacterial infection of the skin,respiratory tract or GI. Gram Positive bacillus

Otitis Externa

Bacterial infection, caused by prolonged exposure to moisture, inflammation with swelling and clear drainage of the ear

Atheromas are more likely to form at _______ due to turbulent blood flow

Bifurcations

Atherosclerosis are most likely to form at _______ due to turbulent blood flow

Bifurcations

Patent Ductus arteriosus

Blood bypasses the fetal lungs, from the pulmonary arteries to the descending aorta

Atrial septal defect

Blood is shunted from the left to the right atrium, usually asymptomatic

Varicose veins

Blood pooled in the veins causing them to be distended, tortuous and palpable

Varicose Veins

Blood pooling in the veins, being become distended, tortuous and palpable

Hemoptysis

Blood tinged bright red sputum, usually assosciated with pulmonary edema.

_______ decreases output to all tissues

Bradycardia

Herniation

Brain tissue moves from an area of greater pressure to an area of lesser pressure

Irreversible abnormal dilation or widening, primarily of the medium sized bronchi.

Bronchiectasis

If you saw a pt with theses S/s what would you expect ? - purulent sputum 1-2 cups per day , foul breath, chronic cough, dyspnea and hemoptysis

Bronchiectasis.

Steatorrhea

Bulky fatty foul stools, occurs in children first year of life and is a sign of cystic fibrosis

Dysarthria

Cannot articulate words clearly

Heart Rate and force of contraction are controlled by?

Cardiac control center in the medulla

Pink Eye

Caused by bacteria, highly contagious, spread by fingers or contaminated towels

Trachoma

Caused by chlamydia, follicles develop on the inner surface of the eyelids

Primary brain injury

Caused by direct injuries to the brain

where do atheromas primarily form

Large arteries, such as the aorta and iliac crest, the coronary arteries and the carotid arteries. * points of bifurcation where turbulent blood flow.

Polycystic ovarian syndrome

Large ovaries that contain cysts and are override with a thick capsule

Aortic regurgitation

Leads to a back flow into the left ventricle, causing volume overload and eventually hypertrophy

Tricuspid regurgitation

Leads to right ventricle overload

Mitral regurgitation

Left ventricle becomes dilated and hypertrophied, eventually leads to pulmonary hypertension and right ventricular failure

Intermittent Claudation

Leg pain associated with exercise due to muscle ischemia.

First indication of increased ICP is a decreasing ________

Level of consciousness

Reyes syndrome

Linked to viral infection in young children and treatment with ASA, causes changes in the brain and liver, and cerebral edema not caused by inflammation

Abscess

Localized infection that most often occurs in the frontal or temporal lobes

Apneusis

Long, gasping inspiratory phase followed by a short inadequate expiration.

2nd degree type 1

Longer delay periodically leads to a missed ventricular contraction

Anorexia

Loss of appetite, the lack of desire to eat despite physiologic stimuli that normally produces hunger

Right Hemisphere damage

Loss of appreciation of music and art, behavioural problems

Vegetative state

Loss of awareness and mental capabilities, caused by diffuse brain damage, sleep-wake cycle is present

Hypovolemic shock

Loss of circulating blood or plasma

Hypovolemic shock

Loss of circulating blood or plasma, hypotension is a sign of decompensation

Left Hemisphere damage

Loss of logical thinking, analytical skills, intellectual abilities, communication skills

Agnosia

Loss of recognition or association

Incontinence

Loss of voluntary control of the bladder

Level of consciousness is determined by the cerebral cortex and the _______

RAS

Epiglottitis onset

Rapid

Wilms tumor

Rare tumor which occurs in children

Hyperreflexia

Reflexes are increased

Bradycardia

Regular but slow heart rate, less than 60

Tachycardia

Regular rapid heart rate 100-160

causes of secondary hypertension

Renal, endocrine, pheochcromoytoma ,

Kernig sign

Resistance to leg extension when hips are flexed

Endocarditis is the most common problem of what heart disorder

Rheumatic fever.

cor pulmonale

Right sided CHF that occurs because of a pulmonary disorder

Tetralogy of fallout 1 - pulmonary valve stenosis 2 - ventral septal defect 3 - Dextroposition of the aorta 4 - ________

Right ventricular hypertrophy

Some plaques are prone to ______ - exposing underlying tissues leading to increased platelet adhesion and initiating the clotting cascade

Rupture

Silent Ischemia

Schema with no detectable symptoms

Abscesses are usually a _____ problem

Secondary

Endotoxic shock

Septic Shock s/s : fever, warm , dry flushed skin.

Renal failure

Significant loss of renal function

Spina bifida occulta

Spina bifida with no herniation

Pelvic inflammatory disease

Starts out as vaginitis or cervicitis, tubal wall are oedematous, exudate forms

Somatic Pain

Steady, intense well localized abdominal pain, usually related to involvement of the parietal peritoneum

2 classifications of valve problems

Stenosis or valvular incompetence.

Intrinsic Asthma

Stimuli causes target tissue in the airway causing an asthma attack. i.e cold air, stress, exercise

Scarlet fever S/S

Strawberry tongue, Fever, Chills, sore throat, Rash on chest neck and groin.

Cardiac Anomolies

Structural defects in the heart that develop during the first 8 weeks of embryonic life. - heart defects are the major cause of death in the first year of life.

s/s Acute endocarditis

Sudden onset fever and chills and drowsiness. Infections causes severe impairment to the heart. Oslers nodes are present.

Amblyopia

Suppression of vision by the brain (lazy eye)

3 elements of infective endocarditis 1 - endocardium must be prepared for colonization 2 - blood borne microorganisms 3 - ________

Susceptible host

Papilledema

Swelling of the blood vessels in the eye

Uremia

Syndrome of renal failure. Include increased blood urea and creatinine levels

Cushings reflex

Systemic vasoconstriction, increased BP, decreased pulse and decreased respirations

Anaphylactic shock

Systemic vasodilation and increased permeability owing to severe allergic reaction.

True or false TRANSUDATES are watery effusions that are synonymous with hydrothorax

TRUE

true or false low density lipoproteins have a high lipid content.

TRUE

true or false pleurisy is associated with lobar pneumonia

TRUE

_______ can prevent adequate filling and decrease cardiac output

Tachycardia

________ can prevent adequate filling and decrease cardiac output

Tachycardia

Sympathetic response to vomiting

Tachycardia, tachypnea and sweating

Coronary Artery Disease

The ability of the heart to pump is impaired because of oxygen and nutrient deprivation

Mitral valve prolapse

The anterior and posterior cusps prolapse into the atrium during systole

Patent ductus arteriosus

The ductus arterioles is a vessel that connects the pulmonary arteries to the descending aorta

Vomiting

The forceful emptying of stomach and intestinal contents through the mouth

Heart Failure

The heart is unable to pump enough blood to meet the body's needs

Locked in syndrome

The individual is aware and capable of thinking, paralyzed and unable to communicate

Chronic renal failure

The irreversible lose of renal function, progresses towards end stage renal disease

Endometriosis

The presence of endometrial tissue outside the uterus

Post trauma infarction

The progressive axonal changes and necrosis that develop after injury

Cirrhosis

The progressive destruction of liver tissue leading to liver failure

GERD

The reflux of chyme from the stomach to the esophagus, allows gastric contents to regurgitate into the esophagus

Anaphylactic shock

The result of a widespread hypersensitivity reaction, rapid release of large amounts of histamine

Dyspnea

The subjective sensation of uncomfortable breathing

cardiac output

The volume of blood ejected by a ventricle in one minute. - it depends on heart rate and stroke volume

Large volume diarrhea

The volume of feces is increases. Usually caused by excessive amounts of water or secretions or both in the intestine

Deep venous thrombosis

Thrombus in a vein with inflammation, occurs mainly in lower extremities

Stable angina

Transient substernal chest pain, usually relieved by rest or nitrates

_______ is the most specific indicators of an MI

Troponin

True or false pericarditis is commonly a secondary infection

True

true or false pericarditis can be chronic or acute ?

True

True or false most pulmonary emboli originate from the deep veins of the legs

True ... 90% of p.e come from deep veins.

true or false pulmonary embolus are a leading cause of death in hospitals

True more than 600 000 people in the usa have a pulmonary embolism each year resulting in over 60 000 deaths.

True or false Transudates result from increased hydrostatic pressure or decreased osmotic pressure in the blood vessels.

True these effusions commonly occur secondary to liver or kidney disease.

What cleaning supplies kill TB

Ultraviolent light, heat, alcohol, glutaraldehydea and fomaldehyde.

Expressive aphasia

Unable to speak or write fluently

Global aphasia

Unable to understand spoken or written word, unable to express self

Receptive aphasia

Unable to understand spoken word

Scarlet Fever

Upper respiratory infection caused by B-Hemolytic streptococcus .

Scarlet fever

Upper respiratory infection causing strawberry tongue due to exotoxins

Dialysis

Used to compensate for kidney failure, either to maintain life until problem is reversed or to prolong life

Right heart failure

Usually caused by left heart failure, as pressure in the pulmonary circulation rises it is difficult for the right ventricle to empty

irregular dilated and torturous areas of the superficial or deep veins

Varicosities.

Acidosis leads to _______ in the brain

Vasodilation

Contributing factors for DVT 1 - venous stasis 2 - _______ 3 - Hypercoagulable conditions

Venous endothelial damage

Contributing factors for DVT

Venous stasis, venous endothelial damage, hypercoagulable conditions

_______ is the most common type of congenital heart lesions

Ventricular septal defect

Mycoplasmal Pneumonia

Very small bacteria with no cell wall found normally in upper respiratory tract. - common in children and young adults not considered highly contagious

Influenza is viral or bacterial

Viral

The common cold is caused by ?

Viral infection of upper respiratory tract. Most often Rhinovirus. Can be up to 200 causative pathogens.

Deeper brown vomitus

Vomit containing contents from the lower intestine

Yellow or greenish vomitus

Vomit that contains bile

Hematemesis

Vomitus containing blood and is usually granular and dark in colour. ( Coffee ground emesis)

When does an MI occur

When a coronary artery is totally obstructed leading to prolonged ischemia and cell death

Countrecoup injury

When the brain bounces off the opposite side of the skull

when does angina occur

When there is a deficit of oxygen to the heart muscle.

UTI occur most often in ________

Women

Cafe Coronary

a cause of aspiration that occurs when adults are eating and talking at social events.

pleurisy

a condition in which the pleural membranes are inflamed, swollen and rough.

Phlebothrombosis

a thrombus forms spontaneously in a vein without prior inflammation. - clot is less firmly attached in this case and its development is asymptomatic or silent. ( less firmly attached than a clot caused by thrombophlebitis.)

Ventricular septal defect is also known as what

a whole in the heart - caused by a whole in the inter ventricular septum.

25. Lower respiratory tract infections a. are less serious than upper respiratory tract infections b. are the most common type c. occur more in the infirm, very young, or old d. none of the above

c. occur more in the infirm, very young, or old

4. If someone is said to have "coffee grounds" vomitus, it is called: a. hematemesis b. melena c. hematochezia d. occult bleeding

a. hematemesis

12. Skip lesions are typical of both ulcerative colitis and CrohnDisease. a. true b. false

b. false

14. Pericardial effusion occurs only in acute pericarditis. a. true b. false

b. false

2. Nystagmus is the double vision caused by a weak or hypertonic muscle. a. true b. false

b. false

20. Cholelithiasis is the term for inflammation of the gallbladder. a. true b. false

b. false

27. Children with cerebral palsy have motor dysfunction, but only rarely have other neurological disorders. a. true b. false

b. false

32. Attention-deficit disorders always involve hyperactivity. a. true b. false

b. false

19. Cirrhosis, which is the replacement of parenchymal tissue with scar tissue as a result of inflammation, can result from all of the following EXCEPT a. excessive consumption of alcohol b. high levels of LDL ("bad cholesterol") c. prolonged obstruction (partial or complete) of the common bile duct or its branches d. viral hepatitis e. autoimmune reactions f. metabolic defects g. drugs and toxins

b. high levels of LDL ("bad cholesterol")

9. Signs and symptoms of myxedema coma include all of the following EXCEPT a. hypothermia without shivering b. hyperventilation c. hypotension d. hypoglycemia e. lactic acidosis

b. hyperventilation

7. The term for reduced oxygenation of arterial blood is a. ischemia b. hypoxemia c. hypoxia d. hypocapnia

b. hypoxemia

21. In syndromes of hypersecretion of steroids by the adrenal cortex, a. Cushing disease is caused by excessive secretion of ACTH by the anterior pituitary. b. Cushing syndrome refers to chronically excessive levels of circulating cortisol. c. In some cases, the excess ACTH and/or CRH may be secreted by nonpituitary tumors. d. All of the above

d. All of the above

4. Which of the following can cause conjunctivitis? a. Bacteria b. Viruses c. Allergens d. All of the above

d. All of the above

6. Which of the following is a possible complication of otitis media? a. Brain abscess b. Meningitis c. Hearing loss d. All of the above

d. All of the above

7. Which of the following is a symptom of Meniere's syndrome? a. Vertigo b. Loss of balance c. Nausea d. All of the above

d. All of the above

15. Arteriovenous malformations and Berry aneurysms are similar in that a. Neither is life threatening. b. Neither requires medical attention. c. Both affect only venules. d. Both are due to congenital abnormalities

d. Both are due to congenital abnormalities

12. Type I diabetes mellitus is usually due to: a. a familial, single gene abnormality b. obesity c. an interaction between genes and environment d. hyperglycemia

c. an interaction between genes and environment

10. Which is NOT a risk factor for ischemic stroke? a. diabetes mellitus b. polycythemia and thrombocythemia c. anemia d. impaired cardiac function e. nonrheumatic atrial fibrillation

c. anemia

5. Hypercapnia may be a result of a. hyperventilation b. fast, deep breathing c. apnea d. hyperpnea

c. apnea

12. Where do atherosclerotic plaques tend to form in the cerebral circulation? a. in the venous sinuses b. in the large veins c. at branches and curves of arteries d. in the capillaries

c. at branches and curves of arteries

38. The primary problem in RDS of the newborn is a. consolidation b. pulmonary edema c. atelectasis d. bronchiolar plugging

c. atelectasis

12. Persistent abnormal dilation of the bronchi is called a. bronchiolitis b. bronchitis c. bronchiectasis d. chronic bronchitis

c. bronchiectasis

5. The most common type of renal stone is: a. struvite b. cystine c. calcium oxalate d. uric acid

c. calcium oxalate

49. In a typical acute asthma attack, major symptoms include all of the following EXCEPT a. cough b. wheeze c. chest pain d. shortness of breath

c. chest pain

20. An individual with diabetes mellitus is more prone to all of the following EXCEPT: a. stroke and coronary artery disease b. kidney failure c. chronic hypotension d. infection e. retinopathy

c. chronic hypotension

22. Right heart failure due to pulmonary problems is commonly called: a. congestive heart failure b. restrictive heart failure c. cor pulmonale d. all of the above

c. cor pulmonale

15. Which is indicated by vomiting, abdominal pain, dehydration, andan acetone odor on the breath? a. hypoglycemia b. Cushing's disease c. diabetic ketoacidosis (DKA) d. SIADH

c. diabetic ketoacidosis (DKA)

36. If suicidal ideation is present, the imminent risk increases with each of the following risk factors EXCEPT: a. prior suicide attempt b. level of intent and formulation of plan c. feeling (sense) of power d. greater preoccupation (e.g., frequency, intensity, and duration of thoughts) e. availability of lethal means for suicide (e.g., firearms or pills) f. presence of active mental illness (e.g., severe depression or psychosis g. presence of substance abuse h. family history of completed suicide

c. feeling (sense) of power

8. Pyelonephritis is caused by all of the following EXCEPT a. pregnancy b. kidney stones c. glomerulonephritis d. neurogenic bladder

c. glomerulonephritis

28. The final common pathway in all shock is a. cellular alterations in the heart and brain b. cellular alterations in the vasculature and kidneys c. impairment of cellular metabolism d. impairment of urine excretion

c. impairment of cellular metabolism

13. Anemia accompanies chronic renal failure because of a. blood loss via the urine b. renal insensitivity to vitamin D c. inadequate production of erythropoietin d. inadequate retention of serum iron

c. inadequate production of erythropoietin

32. The cause of croup is a. acute hyperventilation b. allergy c. infection d. foreign body aspiration

c. infection

16. Mitral stenosis results directly in the incomplete emptying of the a. right atrium b. right ventricle c. left atrium d. left ventricle

c. left atrium

8. Pulmonary edema may be caused by a. low capillary hydrostatic pressure b. high capillary oncotic pressure c. low interstitial oncotic pressure d. high capillary permeability

d. high capillary permeability

14. During gym class a male with Type I diabetes develops hunger, lightheadedness, tachycardia, pallor, headache and confusion. The most probable cause of these symptoms is a. hyperglycemia caused by incorrect insulinadministration b. hyperglycemia from eating a snack before bedtime c. hypoglycemia from insulin sensitivity d. hypoglycemia resulting from decreased insulin requirement due to increased exercise

d. hypoglycemia resulting from decreased insulin requirement due to increased exercise

8. Which is NOT a site for peptic ulcers? a. stomach b. esophagus c. duodenum d. ileum

d. ileum

33. Which is NOT characteristic of ADHD? a. impulsivity b. hyperactivity c. distractibility d. inhibition

d. inhibition

21. Asthma-induced bronchospasms are thought to be caused by a. imbalance of the central and parasympathetic nervous systems b. imbalance of the central and sympathetic nervous systems c. interaction of oral and inhaled medications d. interaction of genetic and environmental factors

d. interaction of genetic and environmental factors

13. The result of prolonged, unrelieved, severe ischemia of the myocardium is: a. stable angina b. unstable angina c. variant angina d. myocardial infarction

d. myocardial infarction

15. Cardiac tamponade occurs in a. acute myocardial infarct b. endocarditis c. dilated cardiomyopathy d. pericardial effusion

d. pericardial effusion

3. Epigastric or periumbilical pain in a patient with acute appendicitisis a. visceral pain b. parietal pain c. somatic pain d. referred

d. referred

48. In asthma, bronchospasm can be triggered by all of the following EXCEPT a. exposure to cold air b. exercise c. allergic reaction d. relaxation

d. relaxation

9. Which does NOT act to prevent urinary tract infections? a. frequent urination due to drinking 2 to 3 litres of water per day b. unobstructed urinary flow c. bactericidal effect of urea d. slightly alkaline urine

d. slightly alkaline urine

bradycardia

heart rate less than 60 - is regular

Acute endocarditis

heart valves are attacked by virulent pathogens. staphylococcus aureus.

what age group does rheumatic fever commonly effect.

5-15 years .

Bronchiectasis

- Abnormal dilation of the medium bronchi occur - frequent obstructions occur in the airway damaging elastic fibers in bronchial wall - causes fibrous adhesion's which pull the wall of bronchus out. pooling of fluid occurs and is infected with pathogens - additional infection causes further damage and fibrosis to the lungs

excess fluid in the alveolar tissue may develop when....

- Inflammation is present in the lungs ( increased capilary permeability - plasma protein levels are low - pulmonary hypertension develops - blocked lymphatic drainage

Tertalogy of Fallot 4 defects

- 4 defects are the pulmonary valve stenosis, Ventricular septal defect, dextroposition of the aorta, and right ventricular hypertrophy

Second degree heart block 2

- Intermittent non-conducted P waves without progressive prolongation of the PR interval - The PR interval in the conducted beats remains constant. -The P waves 'march through' at a constant rate. -The RR interval surrounding the dropped beat(s) is an exact multiple of the preceding RR interval (e.g. double the preceding RR interval for a single dropped beat, treble for two dropped beats, etc).

Precipitating factors of asthma

- family hx of hay fever, recent upper airway viral infection, sedentary lifestyle, exposure to known allergens, extreme cold.

Bronchopneumonia - site of occurence, S/s , Onset

- has multiple cuases occurs has a diffuse pattern of infection in both lungs . More often in lower lobes. - Insidious onset. S/s : moderate fever, productive cough , (yellow or green)

chronic glaucoma

-(also called wide-angle or open-angle) is a common degenerative disorder in older persons

Pancreatitis - etiology

-2 major causes: gallstones and alcohol abuse -alcohol stimulates increased enzyme secretion and contraction of the sphincter of Oddi which blocks the flow

Prostate Cancer - etiology

-5-10% are caused by inherited mutations -high androgen levels -increased insulin-like growth factor -recurrent prostatitis -common in north America and northern Europe -higher in African-American population -testosterone receptors present on tumor

Chlamydia: Males

-: infection evident several weeks after exposure -urethritis and epididymitis; dysuria, itching, whitish discharge from penis -swollen inguinal lymph nodes; proctitis with anal intercourse

Urinary Tract Obstruction

-a blockage of urine flow within the urinary tracts -this may be caused by an anatomic problem or a function problem -the result is urinary stasis, dilated structures, increased risk of infection and compromised function -long term or permanent impairment can be caused by prolonged obstruction

Peptic Ulcer Disease

-a break in the mucosal lining of the lower esophagus, stomach or duodenum (most common) -usually single, small, round cavities with smooth margins -penetrate the submucosa; may erode into the muscularis and eventually perforate the wall

Myasthenia Gravis

-a chronic autoimmune disease -anti-acetylcholine receptor antibodies affect the neuromuscular junction -skeletal muscle weakness, rapid fatigue -initially facial & ocular muscles are affected, then arm & trunk

Ulcerative Colitis

-a chronic inflammatory disease; ulceration of the mucosa of the colon (mucous secreting goblet cells) -risk factors: family hx & Jewish, Caucasian, less common in smokers

Renal Insufficiency

-a decline in renal function to about 25% of normal or a GFR of 25-30 ml/min -serum creatinine and urea are slightly elevated

Hasimoto's Thyroiditis

-a destructive autoimmune disorder

Meniere disease

-a disorder of the inner ear or labyrinth

Atherosclerosis

-a form of arteriosclerosis -atheromas forms inside the walls of large arteries

Spina Bifida

-a group of neural tube defest; failure of posterior spinous processes to fuse -lumbar area is most common place -3 kinds: 1) spina bifida occulta 2) meningocele 3) myelomeningocele

Cerebral Palsy

-a group of non-progressive syndromes that affect the brain & cause motor dysfunction -can occur prenatal, perinatal or postnatal

Cerebral Aneurysm

-a localized dilation in an artery; most are located at a bifurcation or near the circle of Willis -enlargement over time and usually no symptoms until it is large enough to compress the structures or ruptures -bleeding is in the subarachnoid space & CSF

Abscesses

-a localized infection; most often in the frontal or temporal lobes -necrosis of brain tissue & surrounding edema -usually caused by infection in ear, throat, lung or sinus infection -septic emboli from acute bacterial endocarditis -directly from injury or surgical site

autoregulation

-a mechanism by which increased CO2 levels or decreased pH in the in blood, or decreased BP, in an area of the brain results in immediate local vasodilation -this is to protect brain cells from systemic problems

Spinal Cord Trauma - Pathophysiology

-a pathologic cascade of secondary spinal cord injury begins within a few minutes after injury -microscopic hemorrhages increase in size -white matter develops edema which impairs circulation -the areas of microscopic hemorrhage & edema are worst at the level of injury and 2 cord segments above & below -within 4 hours, there is disruption of myelin, axonal degeneration & ischemic endothelial injury -chemical & metabolic changes increase ischemia, vascular damage & necrosis -cord swelling increases the degree of dysfunction

Anti-Social Disorder

-a pattern of socially irresponsible, exploitative, and guiltless behavior that reflects a disregard for the rights of others -they exploit and manipulate others for personal gain -usually have a general disregard for the law -more common in men and low socioeconomic classes

Sliding Hernia

-a portion of the stomach and gastroesophageal junction move above the diaphragm; especially when lying down

Testicular Torsion

-a rotation of the testis; which leads to twisted blood vessels in the spermatic cord -it causes pain and swelling

Vertigo

-a sensation of spinning that occurs with inflammation of the semicircular canals in the inner ear -the person may feel that they are moving or that the world is spinning -often causes a loss of balance -may be caused by labryinthitis, vestibular neuritis, acute toxic labryinthitis & Meniere's disease

Seizures

-a sudden, uncontrolled, excessive discharge of brain neurons -characterized by sudden, transient alteration in brain function -convulsions

Type I Diabetes - 2 types

-a) immune: the beta pancreatic cells are destroyed through a cell mediated response -b) non-immune: secondary to another disease (eg. Pancreatitis)

Irritable Bowel Syndrome (IBS) - pathophysiology

-abnormal GI motility and secretion; may be rapid transit or delayed -visceral hypersensitivity - increased sensitivity to visceral pain -overgrowth of flora; constipation and bloating due to methane gas production -food allergy or tolerance, psychosocial factors

Arteriosclerosis

-abnormal thickening & hardening of the artery walls -impairs the ability to change the lumen size; the lumen gradually narrows -contributing causes: changes in lipid, cholesterols & phospholipid metabolism

Portal Hypertension

-abnormally high blood pressure in the portal venous system -mainly caused by resistance to portal blood flow -caused by disorders that obstruct or restrict blood flow through any part of the portal venous system or vena cava; collateral vessels develop -long term complications: varices, splenomegaly, ascities and hepatic encephalopathy

Pyelonephritis - pathophysiology

-abscesses and necrosis can occur -can compress the renal artery and vein -obstruct urine flow, bilateral obstruction can cause acute renal failure -can lead to scar tissue in a calyx which leads to loss of function and possible hydronephrosis -can lead to chronic renal failure

Amenorrhea

-absence of menstruation

Hydrocephalus

-accumulation of excess CSF in the skull; compresses brain tissue & blood vessels -fontanels & sutures are still open in infants so their head enlarges to accommodate the extra fluid -CSF accumulates because production exceeds absorption due to obstruction

Acute Renal Failure - Pathophysiology

-acute bilateral kidney disease -severe hypotension eg) circulatory shock or heart failure -hemoglobin is toxic to tubule epithelium and causes inflammation and necrosis -myoglobin released by crushed skeletal tissue has the same effect -nephrotoxins - drugs, chemicals or toxins -mechanical obstruction - calculi, blood clots or tumors

Myxedema Coma

-acute hypothyroidism resulting in hypotension, hypoglycemia, hypothermia, and loss of consciousness, a life-threatening complication occurring in undiagnosed or untreated elderly patients

Hypothyroidism - signs & symptoms

-affects all body systems, insidious onset -decreased energy metabolism & heat production -low basal metabolic rate, cold intolerance & lethargy -tiredness

deep coma

-all reflexes are lost, fixed & dilated pupils; slow, irregular pulse & resps

Autonomic Dysflexia

-also called autonomic hyperreflexia; can occur at any time after spinal shock resolves -massive, uncompensated cardiovascular response to stimulation of the sympathetic nervous system -this is life threatening; most at risk are injuries at T6 or above

Guillian Barre Syndrome

-also called post-infectious polyneuritis -an inflammatory condition of the peripheral nervous system -cause is unknown but indicates an autoimmune response -local inflammation, accumulated lymphocytes, demyelination, axon destruction occurs -causes impaired nerve conduction

Thyrotoxic Crisis

-also called thyroid storm -is an acute situation in a patient with uncontrolled hyperthyroidism, usually precipitated by infection or surgery -most common in people with undiagnosed or partially treated hyperthyroidism who are exposed to excessive stress

Acute Renal Failure

-an abrupt decrease in renal function -usually associated with oliguria (urine output of less than 30 ml/hr or 400 ml/day) -sometimes urine output is normal or increased -BUN (blood urea nitrogen) and creatinine levels are increased -usually reversible if it is caught early

Stress Ulcers

-an acute form of peptic ulcers that tends to occur with the physiologic stress of severe illness, multisystem organ failure or major trauma -multiple sites of ulceration in the stomach or duodenum

Pelvic Inflammatory Disease (PID)

-an acute inflammation caused by infection of the reproductive tract - particularly the fallopian tubes and ovaries -includes cervicitis endometritis (uterus), salpingitis and oophoritis -may be acute or chronic -may lead to peritonitis and pelvic abscess

Bulimia

-an eating disorder involving over eating followed by induced vomiting, laxatives or starvation to avoid weight gain -considered to be a mental health disorder -damage to oral cavity, esophageal tears, constipation, diarrhea, electrolyte imbalances

Goiter

-an enlargement of the thyroid gland -caused by both hypo & hyper thyroid -can compress esophagus or trachea

Diarrhea

-an increase in frequency of defecation & in the fluidity, volume & weight of feces

CVA

-an infarction of brain tissue that results from lack of blood -a central area of necrosis develops, surrounded by an area of inflammation and function in this area is lost immediately -3 types of CVA's

Encephalitis

-an infection in the connective tissue in the brain & spinal cord -particularly the basal ganglia and meninges are affected -necrosis & inflammation develop; usually viral cause

Peritonitis

-an inflammation of the peritoneal membrane -chemical irritation; leads to bacterial peritonitis -3rd spacing occurs

Appendicitis

-an inflammation of the vermiform appendix -cause is controversial; could be related to obstruction of the lumen with stool, tumors or foreign bodies -gangrene can develop and then perforation

Atherosclerosis: Pathophysiology

-an inflammatory disease which begins with an injury to endothelial cells -causes of injury: smoking, hypertension, diabetes, increased LDL levels, decreased HDL levels -once injury occurs

Gastritis

-an inflammatory disorder of the stomach (gastric mucosa) -the surface epithelium is eroded

Gastroenteritis

-an inflammatory process involving the stomach and intestines -usually caused by infection, allergies, nausea, abdo cramps, fever, malaise

Glomerulonephritis

-an inflammatory response occurs in the glomeruli of both kidneys -this is caused by antigen-antibody complexes in the glomerular capillaries

Huntington's Disease

-an inherited disorder that does not manifest until midlife -maternal inheritance delays onset longer than inheritance from fathers

nystagmus

-an involuntary abnormal movement of one or both eyes -may have neurologic causes, inner ear or cerebellar disorders or drug toxicity -it may be back-and-forth rhythmic motion, jerky movement or a circular motion

Acute Gastritis - Signs & Symptoms

-anorexia, nausea, vomiting, hematemesis, epigastric pain, cramps, discomfort, fever, headache, diarrhea

Diabetic Ketoacidosis - pre. factors

-another illness, interruption in insulin administration, emotional factors & stress

Postnecrotic Cirrhosis

-chronic hepatitis or long term exposure to toxic materials

Peptic Ulcer

-area surrounded by an area of inflammation -bleeding will occur if the inflammation erodes a blood vessel -starts with the breakdown of the mucosal barrier -excess acid more common in duodenal ulcers -impaired mucous defences more common in gastric ulcers -H. pylori bacteria

Biliary Cirrhosis

-associated with immune disorders or disorders that cause blockages in bile flow

Carcinoma of the Cervix - signs & symptoms

-asymptomatic in early stage -slight bleeding or spotting; slight watery discharge -anemia, weight loss

Huntington's Disease - Sign's & Symptom's

-at the onset, mood swings and personality changes develop, as well as restlessness and choreiform (rapid, jerky) movements in the arms and face -also intellectual impairment such as difficulty learning new information, loss of problem solving skills, poor judgement, inability to concentrate and memory lapses -rigidity and akinesia develop, making movement difficult -personality changes, moodiness, and behavioral disturbances become more marked as dementia progresses

Chronic Gastritis

-atrophy of the mucosa of the stomach; secretory glands are lost -achlorhydria and lack of intrinsic factor -risk factors: chronic peptic ulcers, ETOH abuse, elderly; autoimmune disorders - pernicious anemia

Meniere disease - signs & symptoms

-attacks may last mins or hours -severe vertigo, tinnitus, unilateral hearing loss, loss of balance, falls, nausea & vomiting, sweating -inability to concentrate, nystagmus

Posticteric Stage (recovery)

-begins with resolution of jaundice -symptoms decrease -hepatitis A: acute stage 8-10 weeks -hepatitis B: acute stage 16 weeks

Tumors

-benign tumors are rare - most are malignant -usually occur after age 50; more common in males (3:2 ratio) -smoking is a major risk factor

Testicular Cancer

-benign tumors are very rare -most are malignant and develop from germ cells -occur in 1/300 men; mainly in 15-35 yrs old

Metrorrhagia

-bleeding between cycles

Ovarian Cancer - signs & symptoms

-bloating, feeling of fullness, indigestion, frequent urination, backache, pain with intercourse

decerebrate posturing

-both the upper and lower limbs are extended, as is the head and the body is arched

Coronary Artery Disease (CAD)

-can be caused by any disease process that narrows the coronary arteries -most common cause is atherosclerosis

Glomerulonephritis - pathophysiology

-can be caused by group A beta-hemolytic Strep or Staphylococcus -develops 10 days to 2 weeks after preceding infection -leads to increased capillary permeability and cell proliferation -this leads to protein and erythrocytes entering the glomerular filtrate -the increased congestion and cell proliferation interfere with filtration; leads to decreased GFR -leads to retention of fluids and wastes; may lead to acute renal failure -decreased blood flow leads to release of renin, this increases BP and edema; can cause scarring

Meniere disease - complications

-can lead to permanent damage to hair cells -leads to permanent loss of hearing & vertigo -may be related to stress or changes in barometric pressure

Intestinal Obstruction: etiology

-can occur after abdominal surgery, after spinal cord injury, inflammation, pancreatitis, peritonitis, abdominal cavity infection, due to hypokalemia, mesenteric thrombosis or toxemia -adhesions, hernias, strictures, intussusception, volvulus, Hirschsprung's disease

dysarthia

-cannot articulate words learly

Gonorrhea

-cause Neisseria gonorrhoeae -many strains are resistant to penicillin and tetracycline

Ulcerative Colitis - pathophysiology

-cause is unknown, dietary, infectious, genetic and immunologic factors are possible causes -primary lesions are continuous & only affect mucosa, epithelial barrier is impaired, most severe in rectum and sigmoid colon -mucosa can become hemorrhagic, small erosions form into ulcers, abscesses are common, lumen may narrow

Reye's Syndrome

-cause is unknown, linked to a viral infection in young children & treatment with ASA -signs appear 3-5 days after the onset of infection, major changes occur in liver & brain -severe impairment of brain function due to cerebral edema and increased ammonia levels (liver not functioning)

pink eye

-caused by bacteria - staphylococcus aureus -highly contagious -spread by fingers or contaminated towels

trachoma

-caused by chlamydia trachomatis -follicles develop on the inner surface of the eyelids -occurs when not enough water to wash face & eyes -flies can carry the microorganism -can lead to blindness due to scarring

Cushing's Disease

-caused by excessive anterior pituitary secretion of ACTH -occurs whenever there is excessive cortisol

keratitis

-caused by the herpes simplex virus -severe pain & photophobia -cornea infected - has many pain receptors -ulcers can erode the cornea

Cerebral Aneurysm - Signs & Symptoms

-causes an inflammatory response & irritates nerve roots -causes vasospasm in arteries which decreases perfusion & increases ischemia -headache, photophobia, confusion, slurred speech, weakness, nuchal rigidity (stiff neck) -massive tear = blinding headache, vomiting, seizures, LOC

Testicular Cancer - etiology

-change in chromosome 12 in some families -possible relationship to infection or trauma -cryptorchidism is a predisposing factor

Cramping or Diffuse Pain

-characteristic of inflammation, distention, or stretching of the intestines

Dumping Syndrome

-control of gastric dumping is lost; can be caused by gastric resection if the pyloric sphincter is removed -large quantities of food is dumped into the intestine in a short period of time -this eliminates the mixing, storage and digestion that occurs in the stomach

Cystitis & Urethritis

-cystitis: inflammation of the bladder wall -urethritis: inflammation of the urethra

Parkinson's Disease - Etiology

-damage mainly affects the substantia nigra -imbalance between excitation and inhibition in the basal nuclei -increased muscle tone and activity; resting tremors, muscular rigidity -difficulty starting movements; unstable posture

Addison's Disease - signs & symptoms

-decreased BGL, impaired stress response -fatigue, weight loss, frequent infections -hyponatremia, decreased blood volume, decreased blood pressure -hyperkalemia related to lack of aldosterone -this can lead to cardiac arrhythmias & failure -decreased body hair, hyperpigmentation in extremities, skin creases, buccal mucosa & tongue

Addison's Disease

-decreased levels of adrenocorticoids, glucocorticoids, mineralcorticoids and androgrens -most common cause is an autoimmune reaction -may be caused by hemorrhage with meningococcal infection or by viral, tubercular or histoplasmosis infections

Primary Hypothyroidism

-decreased synthesis due to autoimmune effects, thyroiditis, deficiency of iodine, anti-thyroid drugs, congenital, loss of thyroid tissue after treatment

CVA- Signs & Symptoms

-depend on the location of CVA -initially flaccid paralysis, coma, loss of consciousness, death

Hydrocephalus - Signs & Symptoms

-depends on age of onset -sunset sign, sluggish pupil response to light, lethargy, irritability, feeding difficulty, high pitched cry when moved

dry or atrophic macular degeneration

-deposits form in the retinal cells gradually destroying them -most common type

loss of consciousness

-determined by the cerebral cortex & the RAS in the brain stem -acute brain disorders lead to decreased LOC

Ovarian Cysts - pathophysiology

-develop unilaterally in ruptured or unruptured follicle -usually last 8-12 weeks and resolve -bleeding can cause peritoneal inflammation

Acute Renal Failure - signs & symptoms

-develops rapidly, elevated serum urea nitrogen & creatinine -metabolic acidosis, hyperkalemia

Diabetic Ketoacidosis

-develops when there is an absolute or relative deficiency of insulin and an increase in insulin counterregulatory hormones -hepatic glucose production increased -peripheral glucose use decreases -fat mobilization increases -leads to ketogenesis

strabismus

-deviation of one eye leading to diplopia

CVA - Risk Factors

-diabetes mellitus, hypertension, increased cholesterol, hyperlipidemia, atherosclerosis, hx of TIA's, increase in age, obstructive sleep apnea, heart disease, oral contraceptives & smoking

Meningitis - Etiology

-different organisms in different age groups -children & young adults: neisseria meningitidus or meningococcus; spread by resp. droplets -neonates: e-coli; usually occurs with neural tube defect, premature rupture of membranes or difficult delivery -young children: haemphilus influenzae; most freq in fall & winter -elderly & young children: streptococcus pneumoniae; may be secondary to other infections

Constipation

-difficult or infrequent defecation

Dysphagia

-difficulty in swallowing; inability to swallow solid material & liquids

Primary Brain Injury

-direct injuries such as laceration or crushing of the neurons, glial cells and blood vessels of brain

TIA - Signs & symptoms

-directly related to the location of the ischemia; short episodes of impaired function, muscle weakness, visual disturbances, numbness, transient aphasia, confusion -attack may last a few minutes or longer but rarely longer than 1-2 hours

diplopia

-double vision

Chronic Renal Failure - signs & symptoms (late)

-dry, pruritus and hyperpigmented skin, bruise easily -peripheral neuropathy; impotence and decreased libido -menstrual irregularities; encephalopathy, CHF, arrhythmias -hypocalcemia and hyperphosphatemia -osteodystrophy, osteoporosis and tetany -uremic frost, urine-like breath odor; systemic infections

Renal Carcinoma - signs & symptoms

-dull, aching flank pain, palpable mass -unexplained weight loss, anemia or erythrocytosis -if caught early, good prognosis

Carcinoma of the Cervix - pathophysiology

-dysplasia occurs first; increases in severity -carcinoma is non-invasive stage; followed by invasive stage -spreads in all directions -can invade the uterine wall and extend into the ligaments, bladder or rectum -metastases to lymph nodes or distant sites are rare; occur at late stage

Gonorrhea: Males

-dysuria and purulent urethral discharge, epididymitis -some are asymptomatic

Grave's disease - signs & symptoms

-exophthalmos; paralysis of the extraocular muscles -damage to the retina & optic nerve can lead to blindness -decreased visual acuity, papilledema -visual field impairment, exposure keratopathy, corneal ulceration

Cirrhosis - pathophysiology

-extensive diffuse fibrosis, loss of organization in lobes, interferes with the blood supply to the liver, bile may back up leading to inflammation -decreased removal of bilirubin & bile production, impaired digestion & nutrient absorption, decreased blood clotting factors, inadequate storage of iron and vitamin B12, decreased inactivation of hormones & removal of toxic substances, esophageal varices, ascities, splenomegaly

hyperopia

-far sightedness

presbyopia

-far sightedness due to aging

Anxiety Disorder

-fear & anxiety become too intense & affect patient's ability to function -they are the most common type of mental health disorder -anxiety & depression often occur together

Chronic Gastritis - Signs & Symptoms

-feeling of fullness, nausea, vomiting, epigastric discomfort, gastric bleeding, anorexia, intolerance to some food -increased risk for peptic ulcers and gastric carcinoma

Poliomyelitis - Signs & Symptoms

-fever, headache, vomiting, nuchal rigidity, pain & flaccid paralysis

Visceral Abdominal Pain

-fibers are connected to the autonomic nervous system -autonomic responses frequently occur: pallor, sweating, nausea, vomiting

signs & symptoms of Increased ICP

-first indication is decreased LOC, lethargy, severe headache, vomiting, papilledema (swelling around optic disc), fixed pupil, Cushing's reflex

Cholelithiasis

-formation of gallstones

Steatorrhea

-frequent bulky, greasy, loose stool with foul odor -characteristic in malabsorption syndrome -see with cystic fibrosis

Intestinal Obstruction - pathophysiology

-gases & fluids accumulate and distend the intestine; strong contractions occur in an effort to move the contents -increased pressure leads to more secretions and compresses veins in the wall; this impairs absorption -leads to persistent vomiting, loss of fluid & electrolytes -intestinal wall becomes ischemic & necrotic & permeable -bacteria move into the peritoneal cavity; leads to peritonitis -can also move into the blood vessels and cause septicemia

GERD

-gastroesophageal reflux disease -the reflux of chyme from the stomach to the esophagus -the L.E.S relaxes after 1-2 hours after eating which allows gastric contents to regurgitate into the esophagus

Appendicitis - signs & symptoms

-general periumbilical pain, nausea & vomiting, pain eventually increases in RLQ, pain at McBurney's point & decreases with rupture then reoccurs -low grade fever, leukocytosis

Absence (petite mal)

-generalized and more common in children than adults -lasts for 5-10 seconds and may occur many times during the day -there is a brief loss of awareness and sometimes transient facial movements, such as twitches of the eyelids or lip smacking or starring

Tonic-Clonic (grand mal)

-generalized that may occur spontaneously or after a simple seizure -there is a pattern for this type: -prodromal signs: occur in some individuals nausea, irritability, depression or muscle twitching hours before the seizure -an aura: such as a peculiar visual or auditory sensation, immediately preceded the loss of consciousness

ALS - Pathophysiology

-genetic factors, upper & lower motor neuron degeneration -no indication of inflammation -the number of large motor neurons is decreased; the remaining motor neurons degenerate

Polyol Pathway

-glucose is shunted to the polyol pathway in hyperglycemia -glucose is converted to sorbitol and then to fructose -this increases intracellular osmotic pressure -H2O moves into the cell, leading to injury -this is most noticeable in the lens of the eye & leads to swelling, visual changes & cataracts -in nerves, it interferes with ion pumps, damages Schwann cells & interferes with nerve conduction -RBC's become swollen & stiff and leads to decreased perfusion

HHNKS - signs & symptoms

-glycosuria, polyuria, increased serum osmolarity -severe volume depletion, intracellular dehydration -complications depend on severity

Thrombotic Stroke

-gradual onset, minimal ICP -localized effects -plaque build-up causing platelet & fibrin to stick to the wall -atherosclerosis & inflammatory diseases are major risk factors

Endometriosis - etiology

-grows during proliferation and secretory stages -degenerates, shed and bleeds during menstrual cycle -because there is no exit for bleeding, the blood remains in the pelvic cavity -blood irritates the surrounding tissues -leads to inflammation and pain; eventually leads to fibrotic tissue -can lead to adhesions and obstruction of structures; can lead to infertility

20. Infective endocarditis is most often caused by: a. bacteria b. viruses c. fungus d. rickettsia

A. Bacteria

Syphilis - pathophysiology

-gumma is the typical lesion - necrosis and fibrosis -occur in the bone, liver, cardiovascular system, and CNS -newborns can develop congenital syphilis if the fetus is infected after the 4th month -may die in utero or be born with active infection or multiple abnormalities -transmission: contact with exudate or body fluids during sexual contact

Prostate Cancer - signs & symptoms

-hard nodule in the periphery of the gland -most as related to obstruction which occurs later due to the peripheral location

Testicular Cancer - signs & symptoms

-hard, painless, usually unilateral masses -testes may be enlarged or feel heavy -dull, aching pain in lower abdomen -hydrocele or epididymitis can occur -gynecomastia may develop due to hormone secretion

Partial Seizures

-have a single foci or origin, often in the cerebral cortex and may or may not involve altered LOC -they are manifested by repeated motor activity such as jerking or turning the head or eye aside, jerky movement of the leg or by a sensation such as tingling that begins in one area and may spread -memory and consciousness remain, awareness is reduced

Generalized Seizures

-have multiple foci or origins in the deep structures of both cerebral hemispheres and the brain stem and cause loss of consciousness

Cushing's Ulcers

-head injury; increased acid secretion occurs due to vagal stimulation

otitis media - complications

-hearing loss, mastoiditis, brain abscess, meningitis, chronic otitis media -may affect speech, language & cognitive abilities

Hernia Signs & Symptoms

-heartburn, frequent belching, discomfort increases with lying down after eating, bending over & coughing -dysphagia; persistent, mild, sub-sternal chest pain after eating

GERD - Sign's & Symptoms

-heartburn, regurgitation of acidic chyme, upper abdo pain, symptoms increase when laying down

Bladder Cancer - signs & symptoms

-hematuria, dysuria, frequency, infection

Peptic Ulcer Complications

-hemorrhage due to erosion of blood vessels -perforation, chyme can enter the peritoneal cavity which leads to chemical peritonitis -obstruction can occur due to stricture (scar tissue)

Toxic or Non-viral Hepatitis

-hepatotoxins cause inflammation and necrosis in the liver -this may be a direct effect y the toxins or a hypersensitivity response -can also be related to cholestasis

Diverticulitis

-herniation of mucosa through the muscle layers of the colon wall -cause is unknown, associated with decreased dietary fiber and increased intracolonic pressure -most common in people over 60 in countries where refined foods make up the diet -most common site is left colon

Meningocele (S.B)

-herniation of the meninges occurs through the defect and the meninges and CSF form a sac on the surface -transillumination confirms the absence of nerve tissue in the sac

Myelomeningocele (S.B)

-herniation of the spinal cord and nevres along with the meninges and CSF occurs -the most serious form, often seen with hydrocephalus

Benign Prostatic Hypertrophy (BPH) - signs & symptoms

-hesitancy, dribbling, decreased force of urinary stream, frequency, nocturia, recurrent UTI's

Gallstones: Etiology

-higher incidence in women, people with high bile cholesterol levels, obesity, multiparity, oral contraceptives or estrogen supplements, high cholesterol intake

Ovarian Cysts - signs & symptoms

-hirsutism (excessive hairiness), amenorrhea (absence of menstruation), infertility

Type I Diabetes - signs & symptoms

-hyperglycemia -renal threshold for glucose is passed, leads to osmotic diuresis -polyuria, polydipsia, polyphagia & ketoacidosis -weight loss - body breaks down fat & protein for energy

HHNKS

-hyperosmolar hyperglycemic non-ketotic syndrome -insulin deficiency not as profound as in Diabetic ketoacidosis -increased fluid deficiency, decreased levels of free fatty acids -lack of ketosis -glucose levels are increased in HHNKS due to hypovolemia

Guillian Barre Syndrome - Signs & Symptoms

-initially affects the legs but ascends to involve the spinal nerves to the trunk and neck -critical period is when the paralysis involves the diaphragm & resp muscles -progressive muscle weakness and areflexia; may occur rapidly or over a few days -cardiac arrhythmias, fluctuating blood pressure (labile) or loss of sweating capabilities

Abscess - Signs & Symptoms

-insidious onset, neurologic deficits, increasing ICP

Type II Diabetes - pathophysiology

-insulin resistance in glucose & lipid metabolism - suboptimal response of insulin sensitive tissues to insulin -abnormality of the insulin molecule -increased amounts of insulin antagonists -down regulation of the insulin receptor; alteration of glucose transporter proteins -resistance increased by obesity, inactivity, illness, medications and age -type II also leads to decreased insulin secretion by beta cells -it also abnormal glucagon secretion -pancreatic changes are non-specific -in obesity, insulin has greater difficulty assisting glucose into the cell

Renal Colic

-intense spasms of pain in the flank area radiating into the groin -this continues until the stone is passed or removed -ureter is contracting to try to move the stone -nausea, vomiting; cool, moist skin, tachycardia, can occur along with severe pain

Gonorrhea: Females

-involves endocervical canal; frequently asymptomatic -may affect Skene's and Bartholin's gland -PID can occur; women are prone to bacteremia and gonococcal arthritis -oro-genital contact can lead to pharyngitis, tonsillitis or lymphadenopathy -newborn - opthalmia neonatorum - conjunctivitis

Acute Gastritis

-involves injury of the mucosal barrier; inflamed, red and edematous -may be ulcerated and bleeding; can be caused by microorganisms, allergies, spicy foods, ETOH intake, ASA, radiation, chemo

astigmatism

-irregular curvature in the cornea or lens

macular degeneration

-is a common cause of visual loss in older persons -it appears to arise from a combination of genetic factors and environmental exposure -degeneration occurs at the fovea centralis in the macula lutea, with its high density of cones, at the central point of the retina

central retinal artery occlusion

-is a disease of the eye where the flow of blood through the central retinal artery is blocked -there are several different causes, but most common is carotid artery atherosclerosis

Dementia

-is a progressive chronic disease in which cortical function is decreased impairing cognitive skills such as language and innumeracy, logical thinking and judgement, ability to learn new information, as well as motor coordination -memory loss occurs, behavioral and personality changes often occur

Amyotrophic Lateral Sclerosis (ALS)

-is a progressive degenerative disease affecting both upper motor neurons in the cerebral cortex and lower motor neurons in the brain stem and spinal cord -leads to progressive muscle weakness, leading to respiratory failure and death

retinal detachment

-is an acute problem that occurs when the retina tears away from the underlying choroid because of marked myopia, degeneration with aging, or scar tissue that creates tension on the retina -the tear allows vitreous humor to flow behind the loose retinal portion -as increased vitreous humor continues to seep behind the retina, an increasing portion of the retina is lifted away from the choroid

Grave's disease

-is an autoimmune disease, commonly in women -most common cause of hyperthyroidism -a multi-system syndrome including: hyperthyroidism, goiter, exophthalmos, hypermetabolism

Inappropriate Secretion of ADH (SIADH)

-is due to excess ADH, which causes retention of fluid -the additional ADH is temporary, triggered by stress, or may be secreted by an ectopic source -the signs are related to severe hyponatremia, which causes mental confusion and irritability -diuretics and sodium supplements are used to correct the problem, as well as investigating any underlying cause

infratentorial lesions

-is located in the brain stem, or below the tentorium cerebelli -a lesion in this location may affect many motor and sensory fibers, resulting in widespread impairment

Thyrotoxic Crisis - signs & symptoms

-it is life threatening because of the resulting hyperthermia, tachycardia and heart failure and delirium -agitation, nausea, vomiting, diarrhea

Poliomyelitis

-it reproduces in the lymphoid tissue in the oropharynx and digestive tract and then enters the blood stream and eventually the CNS -the virus attacks the motor neurons of the spinal cord and medulla, causing minor flulike effects in many cases, but paralysis and respiratory failure in other causes depending on the level of destruction

Reye's Syndrome - Signs & Symptoms

-jaundice is not present but liver enzymes are elevated -hypoglycemia, increased lactic acid in the blood, severity varies, lethargy, headache, vomiting, disorientation, hyperreflexia, hyperventilation, seizures, stupor, coma

Icteric Stage

-jaundice, stools are light in color, urine is darker, skin is pruritic, hepatomegaly, liver is tender (mild aching pain), clotting time may be prolonged, lasts longer with hep B

Polycystic Ovarian Syndrome

-large ovaries that contain cysts and are covered with a thick capsule -associated hormonal abnormalities include: -elevated androgen, estrogen, LH levels, decreased FSH levels, the usual changes in FSH and LH do not occur -ovulation does not occur -dysfunction in the hypothalamic-pituitary control system

Spastic Paralysis

-largest group, results from damage to the pyramidal tracts, motor cortex or general cortical damage -characterized by hyperreflexia, exaggerated deep tendon reflexes, rigidity of extremities (scissor gait), scoliosis & contractures

False aneurysm

An extravascular hematoma that tunnels into the vessel.

Endometrial Cancer (uterine) - pathophysiology

-leiomyosarcomas - arise from connective tissue or muscle -poor prognosis; lung metastases are usually present at diagnosis -adenocarcinomas - most common -arise from glandular epithelium -excessive estrogen stimulation is major factor; relatively slow-growing tumor -may infiltrate the uterine wall or spread into the endometrial cavity

Carcinoma of the Cervix - etiology

-linked to oncogenic STI's -high risk factors: multiple sexual partners, promiscuous partners, sex during teen years, history of STI, smoking

Oligomenorrhea

-long cycles of more than 6 weeks

Anorexia

-loss of appetite -lack of desire to eat despite physiologic stimuli that normally produces hunger -associated with nausea, abdominal pain, diarrhea & psychological distress

right hemisphere injury (damage)

-loss of appreciation of music & art, behavioral problems, spatial orientation, recognizing relationships, impaired mobility, contralateral side neglect

vegetative state

-loss of awareness & mental capabilities -brain stem function is maintained; sleep-wake cycle is present -person does not respond to external stimuli

left hemisphere injury (damage)

-loss of logical thinking, analytical skills, intellectual abilities, communication skills

agnosia

-loss of recognition or association

Irritable Bowel Syndrome (IBS) - signs & symptoms

-lower abdominal pain, diarrhea, constipation, alternating constipation & diarrhea, gas, bloating, nausea, fecal urgency, incomplete bowel emptying

Pelvic Inflammatory Disease (PID) - signs & symptoms

-lower abdominal pain, may be sudden and severe or gradually increase in intensity -stead pain which increases with walking -purulent discharge, dysuria, fever, leukocytosis, signs or peritonitis

Urinary Tract Obstruction - signs & symptoms

-lower tract obstruction affects the entire system -partial obstruction of the bladder outlet or urethra can lead to nerve damage and an overactive bladder -the person may be unable to completely empty their bladder; this increases the risk for UTI's -pyelonephritis can develop which in turn increases the risk for systemic sepsis and shock

Endometriosis - signs & symptoms

-main sign is dysmenorrhea -pain may persist through menses and usually increases in severity each month -may lead to dyspareunia

Peptic Ulcer - Etiology

-major risk factors: H. Pylori infection, more common in men & developed countries, genetic factor, type O blood, ASA & NSAID meds

Urolithiasis (renal stones)

-masses of crystals, proteins or other substances that form in the urinary tract -may cause a partial or total obstruction -due to excessive amount of relatively insoluble salts in the filtrate or when insufficient fluid intake leads to highly concentrated filtrate

Gallstones: Signs & Symptoms

-may be asymptomatic; sudden onset of severe pain in RUQ, epigastric area that radiates to the back and right shoulder -nausea, vomiting, jaundice may develop if the bile backs up into liver/blood, risk of rupture, fever, leukocytosis, vomiting

Multiple Sclerosis - Etiology

-may be autoimmune, complex origins -genetic, immunologic & environmental components -climate may play a role, viral infection or abnormal immune response -impulses are not conducted properly -all types of nerve fibers are involved

Cystitis & Urethritis - signs & symptoms

-may be mild and not particularly noticed, lower abdominal pain, dysuria, urgency, frequency, nocturia, systemic signs of infection, cloudy urine with odor, hematuria, bacteruria, pyuria

Testicular Cancer - pathophysiology

-may begin in one type of cell or several -some secrete HCG, others secrete AFP -often spread to an early stage -others stay localized longer -pattern of spread: common iliac and para-aortic lymph nodes, then mediastinal and supraclavicular lymph nodes -metastases spread through the blood to the lungs, liver, bone and brain

Gallstones

-may form in bile ducts, gallbladder or cystic duct -cholesterol stones are white or crystalline -bilirubin stones are black -small stones may be passes without noticing -large stones may block flow of bile

Spina Bifida - Signs & Symptoms

-meningocele & myelomeningocele are visible -level of defect determines effects; also status of nerve tissue -muscle weakness, paralysis, bowel & bladder control is impaired

Lacunar stroke

-micro-infarcts less than 1 cm in diameter -small perforating arteries; often in the basal ganglia, internal capsules or pons -associated causes are smoking, hypertension & diabetes mellitus -after injury the affects area will be come discolored & soften, necrosis & swelling occur -neuronal cell bodies change, myelin sheaths & axon fibers are affected -oligodendrocytes & astrocytes are lost

Micro & Macrovascular Disease

-microvascular disease: retinopathy, diabetic nephropathy -macrovascular disease: CAD, CVA, peripheral artery disease

Hepatitis A

-mode of transmission: fecal oral route -spreads easily in crowded, unsanitary conditions -incubation period is 2-6 weeks

Cushing's Disease - pathophysiology

-more common in elderly, age 30-50 yrs in adults -adrenal tumors are more common in kids -possible causes: adrenal adenoma, pituitary adenoma, ectopic carcinoma -iatrogenic causes: possibly oral glucocorticoids

Type II Diabetes

-more common, & in children -risk factors: obesity, increased BMI, family history, member of an ethnic minority, puberty, female -metabolic syndrome: obesity, cardiovascular changes, insulin resistance

Prostate Cancer

-most are adenocarcinomas that begin in tissue near the glands surface

Urolithiasis (renal stones) - etiology

-most are made of calcium salts, then uric acids or urates, struvite or cysteine -analysis is important; calcium stones form when urine calcium levels are high -alkaline urine decreases the solubility of calcium -inadequate fluid intake is a major contributing factor -vegetarian diets that are high in oxalate can increase risk of stones -uric acid stones occur with hyperuricemia - could be related to gout, high purine diets or chemotherapy -infection can lead to mixed stones

Chronic Renal Failure - pathophysiology

-most common causes are diabetes mellitus and hypertension -symptoms are not usually noticed until the person has less than 25% of normal kidney function -GFR is decreased (approx.. 20% of normal) and mild symptoms are noticed -the healthy nephrons are attempting to compensate but mild azotemia can occur with a normal diet -impaired urine concentration occurs due to decrease in tubule function -fluid, electrolytes and wastes are retained -all body systems are affected; oliguria or anuria occurs -dialysis or kidney transplant is required to maintain life

Hypothyroidism

-most common disorder, decreased thyroid hormone production

Hepatitis E

-most common in developing countries -transmitted through the fecal-oral route (usually contaminated water) -more common in Asia & Africa -causes fulminant hepatitis with a high mortality rate in pregnant women

Testicular Torsion - pathophysiology

-most common in neonates and pubertal adolescents, but can occur at any time -may be spontaneous or occur after physical exertion or trauma -the twisted vessels decreases or stops circulation to the testis -this leads to vascular engorgement and ischemia

Breast Cancer - pathophysiology

-most occur in the upper, outer quadrant -then the central area has next highest frequency -most are unilateral, most arise from cells of ductal epithelium -the tumor invades the surrounding tissue and adheres to the skin; this causes dimpling -tumor is fixed when it adheres to the muscle or fascia of the chest wall -spread occurs at an early stage - to nearby lymph nodes; then metastases to the lungs, brain, bone & liver

Breast Cancer - etiology

-most occur in women over 50 -genetic predisposition has been shown -hormones - exposure to high estrogen levels -fibrocystic disease with atypical hyperplasia, prior uterine cancer, cancer in the other breast and radiation exposure to chest -lack of exercise, smoking, high-fat diet

Pelvic Inflammatory Disease (PID) - etiology

-most start as an STI; there is often prior occurrence of vaginitis or cervicitis -infection is more likely during or after menses -may be caused by insertion or an IUD or other contaminated instruments -may be associated with abortion or childbirth -may be caused by a blood borne microorganism

Spina Bifida - Etiology

-multifactorial, combination of genetic & environmental factors -family history of spina bifida and defects -exposure to radiation, gestational diabetes, vitamin A & folic acid deficit

Ovarian Cysts

-multiple, small, fluid-filled sacs under the serosa that covers the ovary -may become large enough to cause pain, urinary retention or menstrual irregularities

Myasthenia Gravis - Signs & Symptoms

-muscular fatigue after exercise; recurring increased respiratory tract infections -muscles of eyes, ears, face, mouth, throat, neck are affected first -chewing & swallowing are difficult, head droops

Pyloric Stenosis

-narrowing and obstruction of the pyloric sphincter -may be congenital defect or acquired later in life -signs usually occur within a few weeks after birth; projectile vomiting immediately after feeding

myopia

-near sightedness

Brudzinski Sign

-neck flexion causes hip & knee flexion

wet or exudative macular degeneration

-neovascularization occurs, with the formation of abnormal, leaky blood vessels, rapidly destroying the retina

Pyloric Stenosis - Pathophysiology

-no bile, stools are small & infrequent, failure to thrive, dehydration, hunger -acquired stenosis: persistent feeling of fullness, vomiting

Meningitis - Signs & Symptoms

-no focal signs because of generalized infection -systemic reaction (fever, tachy, chills, petechial rash) -increasing generalized throbbing headache, severe photophobia, nuchal rigidity -Kernig Sign & Brudzinski sign -vomiting, irritability, lethargy, stupor & seizures

Spina Bifida Occulta

-no herniation of spinal cord or meninges -watch for abnormal hair along the spinal cord, may be coarse or silky -a midline dimple, cutaneous angioma, subcutaneous mass

coma

-no response to verbal or pain stimuli, motionless; some reflexes present

Crohn's Disease - signs & symptoms

-no specific symptoms other than irritable bowel -abdominal pain, diarrhea, melena, pain & tenderness in RLQ -anorexia, weight loss, anemia, fatigue, delayed growth & sexual maturation in children

Type II Diabetes - signs & symptoms

-non-specific, onset is slow & insidious -typically, an individual has type II approximately 7 years before diagnosis -fatigue, puritis, recurrent infections, visual changes, paresthesias

Diabetic Ketoacidosis - signs & symptoms

-non-specific, polyuria & dehydration occur and are due to osmotic diuresis because of hyperglycemia -hyponatremia, hypophosphatemia & hypomagnesemia -hyponatremia is the most significant imbalance -Kussmaul respiration, postural dizziness, nervous system depression, ketonuria, abdominal pain, thirst, polyuria

Spinal Cord Trauma - Signs & Symptoms

-normal activity at or below injury stops -the complete loss of reflex function in all segments below the level of injury -impaired thermal control because sympathetic nervous system is damaged; pt. will assume environment temperatures -spinal shock duration varies, ave 7-20 days -C6 or above = quadriplegia or tetraplegia

End Stage Cirrhosis

-normal tissue is replaced by fibrotic tissue so normal liver function is almost non-existent -portal hypertension develops; impaired digestion and absorption

Carcinoma of the Cervix

-numbers have declined due to the pap smear -average age in 35 -invasive carcinoma - age 45 -1 in 65 diagnosed after age 65 -Hispanic-African women have twice the risk

Choledocholithiasis

-obstruction of the biliary tract by gallstones

supratentorial lesions

-occur in the cerebral hemispheres above the tentorium cerebelli -a lesion in this location leads to specific dysfunction or effects

Urinary Tract Infections (UTI) - etiology

-occur more often in women -older men with prostatic hypertrophy due to urinary retention -congenital abnormalities in children - especially if they obstruct flow or cause reflux -elderly - due to incomplete emptying, decreased fluid intake, impaired blood supply, immobility

Post-Polio Syndrome

-occurs 10-40 yrs after the original disease -progressive & debilitating fatigue -weakness, pain, muscle atrophy, severity related to severity of initial infection

PTSD

-occurs after exposure to serious trauma that involve intense fear, threat of death or helplessness -may develop shortly after the event of or after a prolonged period -recollections or flashbacks during the day & as persistent nightmares -sleeping difficulties, irritability, poor concentration, hypervigilance, exaggerated startle response

Hepatitis D

-occurs in people with hepatitis B -required the hep B virus to replicate and produce infection -usually increases the severity of hep B infection -transmitted through blood; high incidence in IV drug abusers

contre-coup injury

-occurs when an area of the brain contralateral to the site of direct damage is injured as the brain bounces off the skull

narrow-angle glaucoma

-occurs when the angle between the cornea and the iris in the anterior chamber is decreased by factors such as abnormal anterior insertion of the iris

cataract

-occurs when the normally clear lens becomes cloudy and interferes with light transmission -the changes may be caused by degeneration related to aging and metabolic abnormalities such as diabetes

Bilary Colic

-occurs when the stone blocks bile flow in the cystic or common duct -the strong muscle contractions occur to try and move the stone

Chlamydia: Females

-often asymptomatic until signs of PID -if any symptoms - urethritis, bartholinitis, cervicitis or salpingitis -newborns can develop conjunctivitis or pneumonia

ADD

-often linked with ADHD -a persistent pattern of inattention and/or hyperactivity; impulsivity that is more and severe than usually seen in people at a similar level of development -highly distractible, unable to filter or contain stimuli; excessive motor activity -random, impulsive movements

Cirrhosis - signs & symptoms

-often mild & vague at start, fatigue, weight loss, anemia, diarrhea, RUQ dull, aching pain, ascites, peripheral edema, bruising, esophageal varices, jaundice, encephalopathy, sex hormone imbalances, personality changes, memory lapse, frequent infections, pruritus

Colicky

-often severe pain results from recurrent smooth muscle spasm or contraction and occurs in response to severe inflammation or obstruction

Urolithiasis (renal stones) - pathophysiology

-once a nidus or solid mass starts to form other material is deposited on it -cell debris from an infection can start a nidus -immobility increases the risk of calculi due to urinary stasis -this leads to chemical changes in the urine -only cause signs and symptoms when urine flow is obstructed

Chlamydia

-one of the most common STI's -leading cause of PID; chlamydia trachomatis

E-Coli Infection

-onset is acute, watery diarrhea, cramps, lasting up to a week -leads to anemia, thrombocytopenia and also acute renal failure

Preicteric Stage

-onset may be insidious, fatigue & malaise, anorexia & nausea, general muscle aching, fever, headache, distaste for cigarettes, mild RUQ discomfot

Testicular Torsion - signs & symptoms

-pain is not relieved by scrotal elevation, rest or scrotal support -tender, high riding testis; thickened spermatic cord -it is surgical emergency; surgery must be done within 6 hours of the onset of symptoms to preserve function

Dysmenorrhea

-painful menstruation

Endometrial Cancer (uterine) - signs & symptoms

-painless vaginal bleeding or spotting, palpable mass, lower abdominal pressure or discomfort, bleeding after intercourse

Acute Complications of Diabetes - signs & symptoms

-palpitations, diaphoresis, tremors, pallor, anxiety, headache, dizziness, irritability, poor judgement, cool & clammy skin

Type I Diabetes

-pancreatic atrophy, loss of beta cells -increased rates in Caucasians, Finland, decreased in Japan -think it's a result of a genetic-environment interaction -diagnosed between 9 months and 12 years

ptosis

-paralysis of the upper eyelid

Autonomic Dysflexia - Signs & Symptoms

-paroxysmal hypertension (300 mmHg) -pounding headache, blurred vision, sweating above the lesion, flushed skin, nasal congestion, nausea, piloerection, bradycardia (30-40 bpm) -often associated with a distended bladder or rectum but can be caused by a sensory stimulation

Rolling or Paraesophageal Hernia

-part of the fundus of the stomach moves up -the blood vessels in the stomach wall may be compressed -food can lodge in the pouch and cause inflammation

Hiatal Hernia

-part of the stomach that protrudes through the opening in the diaphragm; ends up in the thoracic cavity -may lead to chronic esophagitis, fibrosis & stricture

Bile Pigment Stones

-people with hemolytic anemia, alcoholic cirrhosis or biliary tract infection

Ulcerative Colitis - signs & symptoms

-periods of remission & exacerbation; vary with severity & extent of disease, large volumes of watery diarrhea, bleeding can be severe, cramping pain, urge to defecate -severe forms: fever, tachycardia, freq. diarrhea, urgency, bloody stools, continuous cramping, dehydration, weight loss, anemia

Situational Disorders

-personality disorder, acute reaction to a specific situation -usually occur during unusual stress

Atheromas

-plaques made of lipids, cells, fibrin & cell debris -can have thrombi attached; rough elevated surface -more likely to form at bifurcations due to turbulent blood flow -leads to various ischemic syndromes -leading contributors to CAD & cerebrovascular disease

Chronic Renal Failure - signs & symptoms (early)

-polyuria, frequency & nocturia -anorexia, nausea, anemia, fatigue, weight loss, exercise intolerance -bone marrow depression and impaired cell function; increased BP

Cerebral Palsy - Pathophysiology

-prenatal cerebral hypoxia, low birth weight -hypoxia, malformation, mechanical trauma -hemorrhage, hypoglycemia, hyperbilirubinemia, infection -leads to necrosis, atrophy of brain tissue

Ovarian Cancer

-prognosis is favorable if diagnosed early -only 25% are diagnosed early; genetic factors are important -2/2 women over 55 years old -types: serous, mucinous, endometrioid

Huntington's Disease - Pathophysiology

-progressive atrophy of the brain occurs, with degeneration of neurons, particularly in the basal ganglia and the frontal cortex -the ventricles are dilated -there is depletion of GABA, an inhibitory neurotransmitter in the basal nuclei and substantia nigra -levels of Ach in the brain also decreased

Parkinson's Disease

-progressive degenerative disorder -affects motor function through loss of extrapyramidal activity -degeneration of the basal nuclei; affects the dopamine secreting path

Multiple Sclerosis

-progressive demyelination of neurons in the brain, spinal cord and cranial nerves -affects CNS myelin only, no PNS -periods of remission and exacerbation; each episode leads to increased damage

Cirrhosis

-progressive destruction of liver tissue leading to liver failure -may be classified by the related structural changes (micro or macronodular) or by the cause: -alcoholic liver disease -biliary cirrhosis -postnecrotic cirrhosis -metabolic

Hepatitis Signs & Symptoms

-ranges from none to rapid onset of liver failure & coma -3 stages: preicteric or prodromal, icteric or jaundice and posticteric or recovery stage

Wilm's Tumor

-rare tumor which occurs in children -genetic link - defect in tumor suppressing gene on chromosome 11 -usually occurs in 1 kidney; large encapsulated mass -usually diagnosed between age 3-4; may have high BP -pulmonary metastases are common

Syphilis

-rates fluctuate; increase in antibiotic resistance strains -caused by treponema pallidum; systemic infection - 4 stages

Signs of Spinal Shock Repairing

-reappearance of reflexes, hyperreflexia, spasticity & reflex emptying of the bladder -spinal neuron excitability returns slowly and depends on degree of damage

Frank Blood

-red, usually on surface of stool -usually related to lesions in the rectum or anal canal

How many types of influenza are there ?

3 main types A,B,C - A is most common.

SIADH - signs & symptom

-related to hyponatremia, neurologic damage, thirst, impaired taste, anorexia, dyspnea on exertion -fatigue, dulled sensorium, GI symptoms, confusion, irritability, lethargy, muscle twitching, convulsions

Chronic Complications of Diabetes

-related to microvascular & macrovascular disease -good blood sugar control decreases diabetes complications -glucose becomes irreversibly bound to collagen and other proteins in RBC, blood vessel walls & interstitial tissue -leads to thickening of the basement membrane or increased permeability in blood vessels & nerves -binds to cell receptors and leads to cellular division in the glomeruli, smooth muscle of blood vessels & collagen synthesis with fibrosis -loss of vasodilation -procoagulant changes on endothelial cells leads to platelet adhesion & decreased fibrinolysis

Kernig Sign

-resistance to leg extension when hips are flexed

decorticate posturing

-responses include rigid flexion in the upper limbs, with adducted arms and internal rotation of the hands; the lower limbs are extended

Ataxic Cerebral Palsy

-results from damage to the cerebellum -loss of balance & coordination

Diskinetic Disease

-results from damage to the extrapyramidal tract, basal nuclei, or cranial nerves -extreme difficulty in fine motor coordination and purposeful movement

glaucoma

-results from increased intraocular pressure caused by an excessive accumulation of aqueous humor -with gaining, the lens enlarges, pushing the iris more forward and to the side -this anatomic position may block the outflow of aqueous humor when the pupil is dilated and the thickened iris fills the narrow angle -pressure inside the eyeball can increase significantly within an hour of pupil dilation, blocking drainage of fluid

TIA

-results from temporary localized reduction of blood flow in the brain; recovery occurs within 24 hours -most likely caused by thrombotic particles with a temporary blockage; atherosclerosis

Secondary Brain Injury

-results from the additional effects of cerebral edema, hemorrhage hematoma, cerebral vasospasm, infection, and ischemia related to systemic factors

Brain Injuries - Signs & Symptoms

-seizures, cranial nerve impairment, otorrhea & rhinorrhea, otorrhagia, fever, stress ulcers

Intestinal Obstruction: signs & symptoms

-severe colicky abdominal pain, borborygmi, vomiting, abdominal distention, restlessness, diaphoresis, no bowel movements, dehydration, weakness, confusion, shock

Pancreatitis - signs & symptoms

-severe epigastric or abdominal pain which may radiate to back -signs of shock, low grade fever, once infection occurs fever will increase -abdominal distention, decreased bowel sounds

Encephalitis - Signs & Symptoms

-severe headache, nuchal rigidity, lethargy, vomiting, seizures, fever

Myxedema

-severe hypothyroidism in adults -the non-pitting edema manifested as facial puffiness and a thick tongue

Myasthenic Crisis

-severe muscle weakness causes quadriparesis or quadriplegia -respiratory insufficiency with SOB -decreased tidal volume & vital capacity -extreme difficult swallowing

Stress

-severe or prolonged stress can affect both mucosal barrier and acid production -decreased mucosal blood flow and motility; leads to chyme stasis -may lead to increased caffeine, smoking, ETOH, altered eating patterns

Polymenorrhea

-short cycles of less than 3 weeks

Renal Failure

-significant loss of renal function -may be acute or chronic

Pyelonephritis - signs & symptoms

-signs of cystitis because usually also present -flank or lower back pain - dull aching -systemic signs of infection

Breast Cancer - signs & symptoms

-single, small, hard, painless nodule -freely movable in early stage; later becomes fixed -skin dimpling, nipple discharge, change in breast contour

Grave's disease - pathophysiology

-slowly progressive; regular mechanisms are overridden -thyroid auto-antibodies or thyroid stimulating immunoglobins are very common -TSH & TRH are suppresses, increased iodine uptake, ocular effects -functional abnormalities that are caused by hyperactivity of the sympathetic nervous system -infiltrative changes of the orbital contents including enlargement of the ocular muscles

Occult Blood

-small, hidden amounts of blood, not visible to the eye

Urolithiasis (renal stones) - signs & symptoms

-sometimes asymptomatic; flank pain

Renal Carcinoma

-starts in the tubule epithelium in the renal cortex -asymptomatic early and has often metastasized to the liver, lings, bone or CNS by the time it is diagnosed -more common in men and smokers -initial sign is painless hematuria

Somatic Pain

-steady, intense, well localized abdominal pain -usually related to involvement of the parietal peritoneum -directly linked to spinal nerve -may cause guarding

Hemorrhagic Stroke

-sudden onset, increased ICP, systemic effects -affects large areas of the brain; effects are noticeable in both hemispheres -common causes: hypertension, ruptured aneurysms, vascular malformations, bleeding into a tumor, CAD, diabetes, illicit drug use

Embolic Stroke

-sudden onset, minimal ICP -localized effects -often obstructs small vessels at a bifurcation -common site is carotid artery or ascending aorta -risk factors: a-fib, MI, endocarditis, rheumatic heart disease, valvular prosthesis, atrial septal defects

Peritonitis - signs & symptoms

-sudden, severe, generalized abdominal pain with localized tenderness at site of the underlying problem -increases with movement, vomiting, dehydration, hypovolemia, fever, leukocytosis, abdominal distention, rigid abdo, decreased bowel sounds

amblyopia

-suppression by the brain

Bi-Polar Disorder

-swings between depression & mania -may occur over a short period or long period of time -some people will experience more depressive episodes and some more manic

SIADH - pathophysiology

-symptoms of water intoxication, hyponatremia (dilution), hypo-osmolarity, concentrated urine

Uremia

-syndrome of renal failure; it includes increased blood urea and creatinine levels -signs & symptoms: fatigue, anorexia, nausea, vomiting, pruritus & neurologic changes also occur -it is caused by the retention of toxic wastes, deficiency states and electrolyte disorders

Diabetic Ketoacidosis - pathophysiology

-the counterregulatory hormones antagonize insulin -leads to increased glucose production & decreased use of glucose -leads to decreased glucose uptake & increased release of fatty acids -accelerated gluconeogenesis & ketogenesis -glucagon levels increase; leads to another increase in activation of gluconeogenesis & ketogenesis -bicarbonate buffering does not occur & metabolic acidosis develops

Vomiting

-the forceful emptying of stomach (chyme) and intestinal contents through the mouth -controlled by the vomiting center in the medulla

glaucoma - pathophysiology

-the increased pressure compresses the blood flow to the retinal cells, causing ischemia and damage to the retinal cells -when observed through the pupil, the optic disc appears eroded or "cupped" as the optic nerve fibers are compressed -damage to the retina and optic nerve is irreversible and eventually blindness results

locked-in syndrome

-the individual is aware & capable of thinking -paralyzed & unable to communicate

Chronic Renal Failure

-the irreversible loss of renal function -it affects most organ systems -progresses towards end stage renal disease

Intestinal Obstruction

-the lack of movement of intestinal contents through the intestine -most common in the small intestine due to smaller size -may be an acute problem or develop gradually -mechanical obstruction: tumor, adhesions, hernias -functional: neurologic impairment, paralytic ileus

otitis media

-the most common infection of infants & children -ear pain, fever, irritability -inflamed tympanic membrane; fluid in the middle ear -otitis media with penicillin resistant microorganisms is becoming more prevalent

Acute Distress Disorder

-the person exposed to a traumatic event that involved actual or threatened death or serious injury, or a threat to the physical integrity of themselves or others and the response involved intense fear, helplessness or horror

Schizophrenia

-the person has a break in reality or a split between cognitive thought and emotions -positive symptoms - ones that are not present in a healthy individual -eg) hallucinations, delusions, disorganized speech & behavior -negative symptoms - ones that are typically present in a healthy individual but absent in the affected person -eg) flattened affect, anhedonia, alogia, avolition

Diverticulitis - Pathophysiology

-the pouches (diverticula) form at weak points in the colon wall; often where arteries penetrate through the muscle to the mucosa -abnormal colonic motility with intralumal hypertension may contribute to the disease

Endometriosis

-the presence of endometrial tissue outside the uterus -can occur on the ovaries, ligaments or colon -responds to cyclic hormone changes -cause is unknown

retinal detachment - pathophysiology

-the retinal cells cease to function as they are deprived of nutrients diffusing from the blood vessels of the choroid -this loss of function results in an area of blackness in the visual field -if separation continues, the retina is deprived of its source of nutrients in the choroid and dies

Urinary Tract Obstruction - pathophysiology

-the severity of an obstruction is based on: -the locations, the completeness of the blockage, involvement of one or both of the upper urinary tracts, duration, the cause -complete obstruction causes dilation to all structures above the obstruction -this can lead to irreversible kidney damage unless the cause is relieved

Large Volume Diarrhea

-the volume of feces is increased -usually caused by excessive amounts of H20 or secretions or both in the intestine

Alzheimer's Disease

-there is a progressive loss of intellectual function that eventually interferes with work, relationships and personal hygiene -personality changes, lack of initiative and repetitive behavior and impairments in judgement, abstract thinking and problem-solving abilities are characteristic

retinal detachment - signs & symptoms

-there is no pain, may see light or dark floating spots in the visual field, resulting from blood or exudate leaking from the tear -typically this has been described as a "dark curtain" drawn across the visual field

Ulcerative Colitis - complications

-toxic megacolon, anal fissures, hemorrhoids, perirectal abscess, increased risk of colorectal carcinoma

Hepatitis C

-transmitted through blood and body fluids -most common type of hepatitis acquired through blood transfusions -co-infection with Hep B is common -increases the risk of hepatocellular carcinoma

Hepatitis B

-transmitted through contact with infected blood, body fluids or contaminated needles; a STD -mother-infant transmission can occur if the mother becomes infected during the 3rd trimester -incubation period is 2 months

Brain Injuries - Pathophysiology

-trauma causes loss of function in related area, inflammation, vasospasm occur, increased ICP, ischemia, dysfunction, some neurons recover after inflammation is decreased -central area becomes necrotic & develops scar tissue or cyst -hematoma can develop; epidural, subdural, subarachnoid or intracerebral may lead to herniation

Parkinson's Disease - Sign's & Symptoms

-tremors at rest, rigidity, akinesia, postural abnormalities -autonomic symptoms - inappropriate diaphoresis, orthostatic hypotension, gastric retention, constipation & urinary retention -cognitive - depression, dementia, disorientation, confusing memory loss, distractibility, difficulty with concept formation, abstraction, thinking, judgement, sleep disturbances

Dull, Aching Pain

-typical of stretching of the liver capsule caused by swelling

global aphasia

-unable to understand spoken or written word -unable to express self -major damage to Wernicke's area, Broca's area; as well as communicating fibers

receptive apahsia

-unable to understand spoken word

Multiple Sclerosis - Sign's & Symptoms

-unique to each person & area of demyelination -leg weakness, diplopia, paresthesia, burning, tingling, weakness, paralysis -loss of coordination, bladder, bowel, sexual function -chronic fatigue, depression, euphoria

Cretinism

-untreated congenital hypothyroidism, may be related to an iodine deficiency during pregnancy or may be a developmental delay

Glomerulonephritis - signs & symptoms

-urine will be dark and cloudy due to protein and RBC's -facial and periorbital edema at first -then generalized edema - due to loss of colloid osmotic pressure in the blood -sodium and water are retained; BP increases -flank or back pain; general signs of inflammation -oliguria - decreased urine output

otitis externa

-usually a bacterial infection, occasionally fungal cause -prolonged exposure to moisture -inflammation with swelling & clear drainage that progresses to purulent drainage with canal obstruction -external auditory canal & pinna are affected

Meniere disease - pathophysiology

-usually affects one ear; adults 30-50 yrs old -too much endolymph; intermittent problem -the endolymph stretches membranes and interferes with cochlear and vestibular hair cell function -the labyrinth membrane may rupture so perilymph mixes with endolymph

Genital Herpes

-usually caused by HSV-2

Gallstones: Pathophysiology

-usually form when a high concentration of cholesterol occurs or there is not enough bile salts -may also be related to inflammation or infection -causes inflammation and irritation in the gallbladder wall

Spinal Cord Trauma

-usually results from fracture or dislocation of the vertebrae, which compresses, stretches or tears the spinal cord -4 types of trauma: 1)simple fractures 2)compressed 3)wedge (displaced) 4)dislocation

Bladder Cancer

-usually start in the transitional epithelium in the trigone area -usually multiple tumors and tends to recur -diagnosed by malignant cells in urine & biopsy -invades bladder wall to adjacent structures -moves through blood to pelvic lymph nodes, liver and bone

Pelvic Inflammatory Disease (PID) - pathophysiology

-usually starts as vaginitis or cervicitis -polymicrobial; ascending infection -tubal walls are edematous, the lumen is blocked with purulent exudate -exudate drips out of the fimbriae on to the ovaries and surrounding tissue -peritonitis can develop; abscesses can form and need to be drained -can lead to septicemia, septic shock can cause death -adhesions and strictures commonly occur and lead to infertility or ectopic pregnancy -adhesions or scar tissue can affect surrounding tissue such as the colon

Metabolic

-usually storage disorders (eg) hemochromatosis

GERD - pathophysiology

-usually the L.E.S prevents reflux; has a lower than normal pressure -vomiting, coughing, lifting, bending, delayed gastric emptying -an inflammatory response develops in the esophageal wall

Diverticulitis - signs & symptoms

-vague or absent, mild discomfort, diarrhea, constipation, distention, flatulence, diverticula can become inflamed and abscesses can form - LLQ pain -nausea & vomiting, slight fever and leukocytosis

Cerebral Palsy - Signs & Symptoms

-varies with each type; 3 major groups -communication & speech problems, seizures, varying degrees of intellectual impairment -visual impairment

Referred Pain

-visceral pain felt at a distance away from the affected organ or diseased area -well localized; felt in the skin or deep tissue

hemianopia, diplopia

-visual loss; -double vision

Small Volume Diarrhea

-volume is not increased -usually related to inflammatory bowel disease -may contain pus, blood, mucous

ALS - Sign's & Symptoms

-weakness, paralysis, asymmetrical involvement -gradual involvement of all striated muscle except extra-ocular muscle and heart -progresses to paralysis; no remissions -spastic and flaccid paralysis may occur -no associated mental, sensory or autonomic symptoms

Cushing's Disease - signs & symptoms

-weight gain (accumulation of adipose tissue) -moon face, buffalo hump, glucose intolerance, develops into diabetes -protein wasting, muscle wasting, increased bone reabsorption -inhibiting bone formation, decreased GI calcium absorption -increased renal calcium excretion; all leads to osteoporosis -bone & back pain, kyphosis, decreased height, renal stones, thin -characteristic red streaks, easy bruising, thin, atrophied skin -vasoconstriction, hypertension, decreased immune system, irritability, depression, severe psychiatric disturbances -increased hair growth in women & acne

End-Stage Renal Failure

-when less than 10% of renal function is left

Autism

-withdrawal of a child into his/her self and into a fantasy world of their own -marked impaired development in social interaction & communication -elevated serotonin levels

Bladder Cancer - risk factors

-working with chemicals - dyes, rubber, aluminum -smoking, recurrent infections, heavy analgesic use

Brain Injuries - Etiology

-young adults: related to sports injuries & MVC -alcohol intake; delays onset of cerebral edema due to dehydrating effects -falls are a common cause

Hydrocephalus - 2 types

1) non-communicating or obstructive: flow through ventricles is blocked 2) communicating: absorption through the subarachnoid villi is impaired -if pressure is not relived then brain tissue is damaged -older children & adults develop more quickly

Syphilis - 4 stages

1) primary stage: chancre - painless, firm, ulcerated nodule at point of contact on the skin or mucosa about 3 weeks after contact -heals spontaneously 2) widespread symmetric rash on the skin and mucous membrane - palms of the hands, soles of the feet, tongue, palate -general signs of infection occur; disappear spontaneously 3) latent stage - can last or years, usually asymptomatic 4) tertiary syphilis - some never develop this stage

3 types of CVA's

1) thrombus: occlusion of an artery by an atheroma; most common 2) embolus: a sudden obstruction caused by an embolus lodging in a cerebral artery; thrombi may break off from an atheroma 3) hemorrhage: caused by a rupture of a cerebral artery in a patient with severe hypertension; most severe & destructive

how long is antibiotic therapy needed to treat endocarditis

4 weeks minimum

Etiology of UTI

Prostatic hypertrophy, congenital abnormalities, elderly

Decreased HR in cushings reflex causes an increase in ________

Pulse Pressure

Once blood is blocked myocardial cells will become ischemic within ______ seconds

10

predisposing factors to thrombus development

1st group factors involving stasis of blood - immobilization 2nd - endothelial injury caused by trauma, chemical injury, iv injection, inflammation. 3rd - increased blood coagulability, which may be caused by dehydration, cancer, pregnancy, increased platelet adhesion.

How long does it take for immunity to develop after the flu shot ?

2-3 weeks

Fibrous (nonfunctional tissue) in the heart is present around day ______ in an MI

7

Sinusitis

A bacterial infection secondary to a cold or allergy, involving one or more paranasal sinuses

Urinary tract Obstruction

A blockage of urine flow within the urinary tracts, may be caused by anatomic problem or a function problem

Peptic ulcer disease

A break in the mucosal lining of the lower esophagus, stomach or duodenum

Renal insufficiency

A decline in renal function to about 25% of normal or a GFR of 25 - 30 ml/min

Orthostatic hypotension

A decrease in both systolic and diastolic blood pressure on standing

Orthostatic hypotension

A decrease in both systolic and diastolic blood pressure on standing, systolic drop of 20 or diastolic drop of 10

Menieres syndrome

A disorder of the inner ear or labyrinth, related to over production of endolymph

Atherosclerosis

A form of arteriosclerosis

Spina Bifida

A group of neural tube defects

Aneurysm

A localized dilation fo a vessel wall or chamber of the heart

Cerebral Aneurysm

A localized dilation in an artery in the brain

Aneurysm

A localized dilation of a vessel wall or chamber of the heart

Parkinsons disease

A progressive degenerative disorder that affects motor function through the loss of extrapyramidal activity affecting dopamine secreting pathway

Testicular Torsion

A rotation of a testis, which leads to twisted blood vessels in the spermatic cord

Vertigo

A sensation of spinning that occurs with inflammation of the semicircular canals in the inner ear

Acute epiglottis

A severe life threatening rapidly progressive infection of the epiglottis and surrounding area

Nausea

A subjective experience that is associated with many different stimuli

Hypertension

A sustained elevation of systemic arterial blood pressure

Dissecting Aneurysm

A tear develops in the tunica intimate, blood flows between the layers of the vessel wall

Dissecting aneurysm

A tear develops in the tunica intimate, blood flows between the layers of the vessel wall

11. Coronary artery disease can diminish the myocardial blood supply enough to impair myocardial metabolism, which in some people causes the pain called a. angina b. ischemia c. infarction d. necrosis

A. Angina

pneumococcal pneumonia

AKA Lobar pneumonia

most common locations of aortic aneurysms

Abdominal and thoracic aorta.

Arteriosclerosis

Abnormal thickening and hardening of artery walls

Arteriosclerosis

Abnormal thickening and hardening of artery walls, impairs the ability to change the lumen size

Hydrocephalus

Accumulation of excess CSF in the skull that compresses brain tissue and blood vessels

Pericardial Effusion

Accumulation of fluid in the pericardial cavity, can lead to cardiac tamponade

Pericardial effusion

Accumulation of fluid in the pericardial cavity, occurs with pericarditis

4 categories of prostatitis

Acute bacteria, chronic bacterial, non bacterial, asymptomatic inflammatory prostatitis

Extrinsic Asthma

Acute episodes triggered by a type 1 hypersensitivity to an inhaled antigen. - more common in children and may stop occurring after adolescences

A fat emboli is distinguished by what signs and symptoms ?

Acute respiratory distress, PETECHIAL RASH and neurological dysfunction confusion, disorientation

Prostate cancer

Adenocarcinomas that begin in the tissue near the glands surface, metastasizes to bone

Transmural Infarction

All layers are affected from the endocardium through the epicardium

Transmural infarction

All layers of heart muscle are affected from the endocardium through the epicardium

Deep coma

All reflexes are lost, fixed and dilated pupils, slow and irregular pulse and respirations

Primary hypertension

Also called essential hypertension, most common type, no known cause

Sick Sinus syndrome

Alternating periods of bradycardia and tachycardia

Sick sinus syndrome

Alternating periods of bradycardia and tachycardia

what is the drug of choice to give a patient before a surgery to fight the scurge known has endocarditis

Amoxocillin

Ventricular septal defect

An abnormal opening between the right and left ventricle

Ventricular septal defect

An abnormal opening between the right and left ventricle, the most common type of congenital heart lesions

Atrial Septal Defect

An abnormal opening the atria, causing blood to be shunted from the left to right atrium

Bulimia

An eating disorder involving over eating followed by induced vomiting, laxatives or starvation to avoid weight gain

Fals Aneurysm

An extravascular hematoma that tunnels into the vessel

What disease is associated with these symptoms : - constant productive cough - tachypnea, SOB - Purulent cough with rhonchi - Cough is worse in the morning - LAte signs : wieght loss and peripheral edema /cor pulmonale

Chronic Bronhitis

Stable angina

Chronic coronary obstruction, transient, relieved at rest

What is the treatment for Anthrax

Ciprofloxacin

Cerebral aneurysms usually occur around the _______

Circle of Willis

Hematemesis

Coffee ground emesis, brown, granular material, caused by partial digestion of the protein in blood, upper GI bleed

Hematoma

Collection of blood from ruptured blood vessels

Bronchiolitis cause and age group

Common Viral infection caused by syncytial virus Common infection in young children 2-12 months of age.

Stroke volume is influenced by _______, preload and afterload

Contractility

Stroke volume is influenced by ________, preload and afterload

Contractility

Treatments for croup

Cool moisturized air

Varient angina

Coronary vasospasm which occurs at rest

Histoplasmosis S/S

Cough, marked fatigue , fever and ,night sweats

Intestinal pain

Cramping or diffuse pain caused by inflammation, distention to stretching

Laryngotracheobronchitis

Croup

Tetralogy of fallot

Cyanotic disorder, pulmonary valve stenosis, ventral septal defect, dextroposition of the aorta

Common inherited disorder in children, Mutation to the CFTR gene which is related to chloride ion transport in the cell membrane.

Cystic Fibrosis

Melena

Dark tarry took, caused by bleeding higher in the GI tract

S/S of glomerulonephritis

Dark urine, facial edema, generalized edema ,sodium and water retention, BP increases, flank pain, oliguria

Rhonchi

Deep harsh sounds resulting from thick mucus

ALS

Degenerative disorder affecting lower and upper motor neurons, leads to progressive muscle weakness

Emphysema- Pathophysiology

Destruction of the alveolar walls, loss of elasticity, impaired expiration, barrel chest, hyperinflation.

Ovarian cysts

Develop unilaterally in ruptured or enraptured follicle

Diabetes Ketoacidosis

Develops when there is an absolute or relative deficiency of insulin and an increase in insulin counter regulatory hormones

Strabismus

Deviation of one eye leading to diplopia (double vision)

Cardiac dysrhythmias

Deviations from the normal cardiac rate or rhythm, can be caused by damage to the conduction system or systemic problems

Constipation

Difficult or infrequent defecation

Dysphagia

Difficulty in swallowing

Bleeding in the brain leads to _______ effects

Diffuse

Cardiac tamponade

Distended neck veins, faint heart sounds, pulses paradoxus

Diplopia

Double vision

______ is characteristic of epiglottis

Drooling

Epiglottitis S/S

Drooling, Dysphagia , high fever , rapid respirations , tripod breathing

Liver pain

Dull, aching pain in RUQ

These S/S are related to what.... Hyperventilation, prolonged expiratory phase, use of accessory muscles, hyperinflation of the chest ( BARREL CHEST ), clubbed fingers, anorexia and fatigue

EMPHYSEMA

in this disease a pulmonary function test would indicate: increased residual volume and total lung capacity. As well as decreased forced expiratory volume.

Emphysema

Bronchiolitis, Onset, Pathology , S/s

Gradual onset, - Caused by inflammation of mucosa of the bronchioles leading to obstruction of small passageways. S/s : Wheezing , dyspnea, rapid shallow respiations , cough ,rales, fever and malaise

Legionnaires disease is caused by ..

Gram negative bacteria - Legionella pneumophilla

Legionnaires disease - general info

Hard to identify lives inside pulmonary macrophages, Thrives in warm moist enviroments ;) like Steves vagina If left untreated can cause severe damage and necrosis to the lungs

Cardiac output

Heart rate x stroke volume

Severe headaches are common of ______ strokes

Hemmorhagic

Increased ICP can be caused by deem, excess CSF or ______

Hemorrhage

Meningocele

Herniation of the meninges occurs, form sac on the surface of the skin

Poliomyelitis

Highly contagious, attacks motor neurons of the spinal cord and medulla

Croup S/s

Hoarse barking cough , inspiratory stridor, restlessness

Benign prostatic hypertrophy

Hyperplasia of prostatic tissue, that can compress the urethra and leads to urinary obstruction

Tuberculin test

Hypersensitivity test initiated by M. Tuberculosis. If a person is thought to have been exposed to TB they are later exposed to M. Tuberculosis. If the patient has been exposed than a large skin lesion will occur. Chest X-ray and sputum culture will determine if TB is present.

Secondary hypertension

Hypertension caused by another disease process

Malignant hypertension

Hypertension uncontrollable when treated with 3 or more drugs

Supratentorial

If the problem is above the tantrum cerebelli, very specific effects

Atherosclerosis pathophysiology 1 - cells become inflamed 2 - cytokines are released 3 - growth factors are released 4 - macrophages stick to injured epithelium 5 - ________

Macrophages oxidizes LDL causing more damage

Third hypertension

Malignant or resistant hypertension if uncontrollable when treated with 3 or more drugs

Urolithiasis (kidney stones)

Masses of crystals, proteins or other substances that form in the urinary tract

Autonomic Dysreflexia

Massive, uncompensated cardiovascular response to stimulation of the sympathetic nervous system

3 causes of abdominal pain

Mechanical, chemical (inflammation), or ischemic

Strokes are more common in _______ than in women

Men

Lacunar stroke

Micro infarcts less than 1cm in diameter

which valve of the heart is effected by verrucae associated with rheumatic fever

Mitral

second degree heart block type 1

Mobitz I heart block is characterized by progressive prolongation of the PR interval on the electrocardiogram (ECG) on consecutive beats followed by a blocked P wave (i.e., a 'dropped' QRS complex). After the dropped QRS complex, the PR interval resets and the cycle repeats.

Croup, age group, region of infection. s/s,

Most common 3 months- 3 years Viral infection , Upper respiratory condition Larynx and subglottic area become inflamed leading to seal barking cough and hoarse voice. Inspiratory Stridor

Epiglottitis

Most common 3-7 years. Infection causes swelling of the larynx, supraglottic area and epiglottis.

Chlamydia

Most common STI, leading cause of PID, causes dysuria, itching and whitish discharge

_______ is most common cause of decreased contractility

Myocardial Infarction

________ is most common cause of decreased contractility

Myocardial Infarction

Silent Ischemia

Myocardial schema without noticeable signs and symptoms

Pyloric Stenosis

Narrowing and obstruction of the pyloric sphincter, projectile vomiting occurs immediately after feeding

Myopia

Near sightedness

Brudzinski sign

Neck flexion causes hip and knee flexion

3rd degree block

No association between atrial and ventricular contractions

Small volume diarrhea

No increase in fecal matter, usually related to inflammatory bowel disease. May contain blood, mucous or pus

Flaccid

No motor tone caused by damage to the lower motor neurons in the anterior horns of the spinal cord

Coma

No response to verbal or pain stimuli, motionless, some reflexes are present

Postpolio syndrome

Occurs 10 to 40 years after the original illness, progressive and debilitating fatigue

Shock

Occurs when the cardiovascular system is unable to adequately perfuse tissues leading to impaired cellular metabolism

Congestive Heart Failure

Occurs when the heart is unable to pump sufficent blood to meet the metabolic needs of the body. - most often occurs as a result of a complication of another condition.

Subendocardial MI

Only the myocardium directly beneath the endocardium is affected because the thrombus breaks up quickly

Lobar Pneumonia S/S and onset

Onset: Sudden S/S : High fever chills , productive cough with rusty sputum. Rales which progress to absent lun sounds in affected lobes

What the hell are oslers nodes

Painful red nodules on the fingers.

Hiatal Hernia

Part of the stomach protrudes through the opening in the diaphragm

2nd degree type 2

Period missed ventricular contraction (PRI does not increase)

Ataxic Breathing

Periods of apnea alternating irregularly with a series of shallow breaths of equal depth

Right heart failure leads to _________ and hepatosplenomegaly

Peripheral Edema

Atheroma

Plaques made of lipids, cells, fibrin and cell debris form inside the walls of large arteries

Atheromas

Plaques made of lipids, cells, fibrin and cell debris form inside the walls of large arteries

Atrial fibrillation causes _______

Pooling of blood

Common cold is spread by

Primarily by Respiratory droplets

S/s of primary TB

Primary TB is asymptomatic

1st degree AV block

Prolonged PR interval

Myocardial Infarction

Prolonged ischemia causes irreversible damage to the myocardium. A thrombus occludes an artery for a prolonged period

Myocardial Infarction

Prolonged ischemia that causes irreversible damage to the myocardium

2. Which of the following statements is true? a. Atherosclerosis is a form of arteriosclerosis. b. Arteriosclerosis is a form of atherosclerosis. c. Atherosclerosis increases with more high-density lipoproteins (HDLs). d. Arteriosclerosis decreases with more low density lipoproteins (LDLs).

a. Atherosclerosis is a form of arteriosclerosis.

3. Diminishing cognition, decreasing ability to pay attention, language problems, and difficulty with short- or long-term memory may be seenwith: a. Dementia b. TIAs c. drug intoxication d. extrapyramidal damage

a. Dementia

16. Which is FALSE regarding hyperosmolar hyperglycemic nonketotic syndrome (HHNKS) and DKA? a. Glucose levels are lower in HHNKS than in DKA. b. Insulin deficiency is greater in DKA than in HHNKS. c. Dehydration in HHNKS is much more severe than in DKA. d. HHNKS is more common in type II diabetes than in type I

a. Glucose levels are lower in HHNKS than in DKA

15. Which is FALSE regarding the presence of pus in the pleural space (pleural empyema)? a. It is a transudative effusion. b. It is a complication of respiratory infection, usually bacterial pneumonia. c. Symptoms include pleural pain, cough, fever, and tachycardia. d. Treatments include antibiotics and thoracocentesis

a. It is a transudative effusion

23. Which is FALSE regarding Addison disease? a. It is called secondary hypocortisolism. b. ACTH levels are elevated. c. Synthesis and output of cortical steroids are inadequate. d. The adrenal cortex itself is defective.

a. It is called secondary hypocortisolism

34. Which is FALSE regarding croup? a. It is most common in girls from 2 to 6 years of age. b. The pathophysiology is due primarily to subglottic edema. c. Obstruction is usually greatest in the subglottic area (around cricoid cartilage). d. Symptoms are barking cough, hoarseness, and inspiratory stridor

a. It is most common in girls from 2 to 6 years of age.

23. Which is FALSE regarding acute pancreatitis? a. It is usually caused by a streptococcus infection b. The primary symptom of acute pancreatitis is epigastric or midabdominal pain, which may radiate to the back. c. It can produce a wide variety of additional symptoms. d. The goal of treatment is to stop autodigestion and prevent systemic complications.

a. It is usually caused by a streptococcus infection

7. Which is FALSE regarding autonomic dysreflexia? a. It precedes the development of spinal shock. b. Normal sensory stimulation of areas innervated below the cord lesion activates hyperactive sympathetic reflexes. c. Sympathetic discharges produce massive vasoconstriction, resulting in dangerously high blood pressure. d. Brain produces signals to dampen sympathetic stimulation and raise parasympathetic stimulation, but they can't get through the lesion. e. Heart rate decreases because parasympathetic innervation to heart (cranial nerve X, the vagus) is intact.

a. It precedes the development of spinal shock.

3. Strenuous exercise or metabolic acidosis promotes a. Kussmaul respirations b. laboured breathing at normal rate c. Cheyne-stokes respiration d. all of the above

a. Kussmaul respirations

4. Which is characterized by alternating periods of deep and shallow breathing andis often due to central nervous system impairment above the brain stem? a. Kussmaul respirations b. laboured breathing c. Cheyne-Stokes respirations d. COPD

a. Kussmaul respirations

16. Which of the following is FALSE concerning appendicitis? a. Obstruction of the lumen causes a decrease in intraluminal pressure that may produce inflammation. b. It is the most common abdominal surgical emergency. c. Epigastric or periumbilical pain is often present, and frequently is the first pain. d. The inflammation may progress to gangrene.

a. Obstruction of the lumen causes a decrease in intraluminal pressure that may produce inflammation

31. What is croup? a. acute laryngotracheobronchitis b. acute epiglottitis c. acute tracheitis d. retropharyngeal abscess

a. acute laryngotracheobronchitis

18. Brain abscesses form: a. after open trauma and neurosurgery b. from contiguous infection sites (e.g. nasal areas, middle ear) c. through spread in the bloodstream d. independently of other infections e. through insect larvae in the scalp

a. after open trauma and neurosurgery b. from contiguous infection sites (e.g. nasal areas, middle ear) c. through spread in the bloodstream d. independently of other infections

36. Which is NOT a clinical manifestation of epiglottitis? a. apathy and calmness b. sudden development of high fever, sore throat, inspiratory stridor, and severe respiratory distress c. voice which sounds muffled d. drooling and inability to swallow

a. apathy and calmness

20. The best description of multiple sclerosis is a. autoimmune demyelination of neurons in the central nervous system b. diminished acetylcholine at the neurotransmitter junction as a resultof an autoimmune disorder c. depletion of dopamine in the CNS as a result of viral, vascular or metabolic factors d. a degenerative disorder of lower and upper motor neurons caused by viral immune factors

a. autoimmune demyelination of neurons in the central nervous system

40. Cystic Fibrosis is caused by a. autosomal recessive inheritance b. autosomal dominant inheritance c. infection d. malignancy

a. autosomal recessive inheritance

31. ADHD is a a. behavioural disorder b. mood disorder c. personality disorder d. psychosis e. anxiety disorder

a. behavioural disorder

18. Obstructive pulmonary disease is characterized by a. difficult expiration b. difficult inspiration c. fever d. use of only primary muscles of respiration

a. difficult expiration

30. Symptoms of schizophrenia which are termed negative symptoms include all of the following EXCEPT: a. disorganized speech and behaviour b. hallucinations c. delusions d. affective flattening, the almost complete lack of emotional or facial expression e. inability to have emotional experiences f. absence of spontaneous speech g. deficit in spontaneous or goal-directed activities

a. disorganized speech and behaviour b. hallucinations c. delusions

19. Diabetic neuropathy most commonly affects the a. extremities b. trunk c. head d. viscera

a. extremities

28. Which is typical of tuberculosis? a. formation of isolated granulomas b. killing of the tuberculosis bacilli by T cells c. ARDS d. atelectasis

a. formation of isolated granulomas

9. The most common cause of pulmonary edema is a. high hydrostatic pressure in pulmonary capillaries resulting from left ventricular failure b. right sided heart failure c. mitral valve prolapse d. aortic stenosis

a. high hydrostatic pressure in pulmonary

3. Graves disease is characterized by a. hypersecretion of thyroid hormone b. hyposecretion of thyroid hormone c. hypersecretion of thyroid-stimulating hormone (TSH) and thyroidreleasing hormone (TRH) d. production of auto-antibodies to thyroxine

a. hypersecretion of thyroid hormone

12. Which is NOT a risk factor for coronary artery disease? a. hypertension b. cigarette smoking c. diabetes mellitus d. moderate alcohol consumption (2-10 drinks per week) e. obesity f. dyslipidemia (excessive VLDLs and LDLs

a. hypertension

14. Intracranial aneurysms can result from all of the following EXCEPT: a. hypotension b. congenital anomalies of the vessel wall c. neurosurgery or angiography (iatrogenic causes) d. infection or inflammation e. arteriosclerosis

a. hypotension

8. Myxedema coma is associated with a. hypothyroidism b. hypoparathyroidsm c. hyperthyroidism d. thyroid storm

a. hypothyroidism

3. Obstruction along the urinary tract causes behind the obstruction. a. increased hydrostatic pressure and dilation b. decreased hydrostatic pressure and dilation c. increased hydrostatic pressure and constriction d. decreased hydrostatic pressure and constriction

a. increased hydrostatic pressure and dilation

17. Which is the most common cardiac valve disease in North America and is most prevalent in young women? a. mitral valve prolapse b. tricuspid stenosis c. tricuspid valve prolapse d. mitral valve stenosis

a. mitral valve prolapse

27. Shock can be classified by all of the following EXCEPT a. organ system involvement b. cause c. principal pathophysiologic process d. signs and symptoms

a. organ system involvement

4. Most cases of combined systolic and diastolic hypertension have no known cause and are therefore diagnosed as hypertension. a. primary ("essential") b. secondary c. congenital d. acquired

a. primary ("essential")

1. Risk factors for infective endocarditis include which of the following? a. prosthetic heart valves b. turbulent cardiac blood flow c. intravenous drug abuse d. all of the above

a. prosthetic heart valves

23. A patient is diagnosed with pulmonary disease and elevated pulmonary resistance. Which of the following heart failures may result from this condition? a. right heart failure b. left heart failure c. pericarditis d. cardiac tamponade

a. right heart failure

2. Kussmaul respiration may be characterized as a. slightly faster with large effortless tidal volumes and no expiratory pause b. very fast, laboured breathing c. very fast, shallow breathing d. alternating periods of deep and shallow breathing

a. slightly faster with large effortless tidal volumes and no expiratory pause

10. Emboli from venous thrombi are dangerous because they can lodge in the arteries serving the lungs. a. true b. false

a. true

11. By definition, in a true TIA all the neurologic deficits must havedisappeared completely within 24 hours. a. true b. false

a. true

11. Ulcerative colitis involves only the colon, but Crohn Disease can affect any area of the gastrointestinal tract. a. true b. false

a. true

2. Pelvic inflammatory disease develops from an ascendinginfection. a. true b. false

a. true

20. In asthma, in contrast to emphysema and chronic obstructive bronchitis, there is relatively little or no permanent obstructive change in lung tissue. a. true b. false

a. true

22. Both acute and chronic cholecystitis almost always result from obstruction of the cystic duct by a gallstone. a. true b. false

a. true

22. Most cases of emphysema are caused by smoking a. true b. false

a. true

24. Both spina bifida and spina bifida occulta involve a defect in formation of the vertebral column. a. true b. false

a. true

24. Unlike emphysema and pneumonia, which involve the respiratory zone,bronchitis involves only the conductive zone. a. true b. false

a. true

28. Cerebral palsy by definition is nonprogressive, but its signs and symptoms change with maturation and growth of the child. a. true b. false

a. true

4. Complete obstruction of a ureter will reduce the glomerular filtration rate to zero, resulting in failure of that kidney. a. true b. false

a. true

5. Contrecoup injuries are much more likely occur when objects strike the back of the head than when they strike the front. a. true b. false

a. true

6. Spinal shock, characterized by a complete loss of somatic and autonomic reflexes below the level of the lesion, can last from a few days to months. a. true b. false

a. true

9. Varicose veins and chronic venous insufficiency (CVI) can develop from damage to the one-way valves in the veins of the legs. a. true b. false

a. true

10. A patient has weight loss, abdominal pain, diarrhea, and bloody stools. The most likely diagnosis is: a. ulcerative colitis or Crohn Disease b. hiatal hernia c. pyloric obstruction d. achalasia

a. ulcerative colitis or Crohn Disease

6. Who is at LOWEST risk of developing a urinary tract infection a. young men b. sexually active young women c. elderly men and women d. prepubertal children

a. young men

CAD risk factors

advancing age, male gender or women after menopause, family hx, dyslipidemia, hypertension, cig. smoking, diabetes, obesity, sedentary lifestyle, oral contraceptives & smoking

pneumothorax

air in the pleural cavity.

Rheumatic fever

an acute systemic inflammatory condition that appears to result from an abnormal immune reaction to an untreated infection. - usually group A beta hemolytic streptococus

Crohn's Disease

an inflammatory disorder that can affect any part of the GI tract from the mouth to the anus -distal small intestine and proximal large colon are most commonly affected -risk factors: family hx, tobacco use, Jewish descent, urban residence

S/s early shock

anxiety , restlessness , thirst , tachycardia

11. Urinary tract infections are usually caused by chlamydia and viruses. a. true b. false

b. false

Pneumocystits carinii PCP

atypical pneumonia occurs in patients with immunodeficiency. AIDS patients. Also affects premature infants the microbe is considered a fungus

50. Sudden Infant Death Syndrome occurs most often between months of age. a. 1, 2 b. 2, 4 c. 4, 6 d. 6, 9

b. 2, 4

22. Which is FALSE regarding symptoms of hypercortisolism? a. Glucose intolerance and diabetes mellitus result from insulin resistance and increased gluconeogenesis. b. Alterations in mental status are rare. c. Weight gain is the most common feature of hypercortisolism. d. Truncal obesity, moon face, and buffalo hump are patterns of fat deposition. e. Muscles waste, bones become brittle, and skin thins because of catabolic effects on protein. f. Immune function is depressed

b. Alterations in mental status are rare

14. Skip lesions, granulomatous lesions with cobblestone appearance, longitudinal and transverse fissures in the intestinal wall, and fistulae are typical of a. ulcerative colitis b. Crohn Disease c. diverticulosis d. appendicitis

b. Crohn Disease

34. Post-traumatic stress disorder is another term for acute stress disorder. a. true b. False

b. False

7. Which is NOT associated with severe hypothyroidism? a. cretinism b. Graves c. myxedema d. Cushing's disease

b. Graves

9. Which of the following is NOT a risk factor for peptic ulcer disease? a. alcohol abuse b. H. Ducreyi infection c. chronic NSAID use d. smoking

b. H. Ducreyi infection

23. Which is FALSE regarding myasthenia gravis? a. It is a chronic autoimmune disease involving destruction of acetylcholine receptors on skeletal muscle fibres. b. It affects motor nerve roots. c. Treatments may result in cholinergic crisis. d. It causes muscle weakness and fatiguability.

b. It affects motor nerve roots.

47. Which is the most common cause of viral pneumonia in the pediatric patient? a. measles virus b. Respiratory Syncitial Virus (RSV) c. H. influenza d. staphylococcus pneumonia

b. Respiratory Syncitial Virus (RSV)

19. Which is FALSE regarding obstructive pulmonary disease? a. Asthma, emphysema, and chronic obstructive bronchitis are the most common forms. b. The primary problem is that stiffness and/or fibrosis decrease compliance, restricting expansion and producing tachypnea and small tidal volumes. c. Emptying of the lungs is slowed, and more force is required to expire a given volume of air. d. Dyspnea and wheezing occur in all forms.

b. The primary problem is that stiffness and/or fibrosis decrease compliance, restricting expansion and producing tachypnea and small tidal volumes.

13. Which is FALSE regarding bronchiectasis? a. It usually occurs with another respiratory pathology, but also isassociated with systemic disorders. b. The underlying cause of bronchiectasis is obvious in almost allcases. c. It is frequently associated with bronchitis and has similar symptoms. d. In permanent types of bronchial dilation, smaller bronchial divisionsare plugged with mucus or destroyed by fibrosis. e. Large amounts of purulent mucus are produced and hemoptysisis common. f. Hypoxemia can be severe enough to lead to cor pulmonale

b. The underlying cause of bronchiectasis is obvious in almost allcases

23. Which is NOT associated with emphysema? a. dyspnea upon exertion b. a productive cough c. thinness d. increased anterior to posterior chest diameter

b. a productive cough

18. Hepatitis A is characterized by: a. an incubation period of 60 - 180 days b. acute onset with fever c. a positive carrier state d. fecal-oral mode of transmission

b. acute onset with fever d. fecal-oral mode of transmission

21. Which is FALSE regarding amyotrophic lateral sclerosis? a. usually occurs after age 30 b. affects both smooth and skeletal muscle c. affects both upper and lower motor neurons d. is incurable at present

b. affects both smooth and skeletal muscle

25. Ventricular septal defect can be characterized by a. failure of the ductus arteriosus to close b. an abnormal opening in the interventricular septum c. an abnormal opening in the interatrial septum d. an abnormal opening in the pericardium

b. an abnormal opening in the interventricular septum

5. Reflux esophagitis can be defined as: a. a specific immune response to gastroesophageal reflux b. an inflammatory response to gastroesophageal reflux c. a congenital anomaly d. a secretory response to gastroesophageal reflux

b. an inflammatory response to gastroesophageal reflux

3. The fatty streak, the earliest pathological finding in , is a collection of foam cells (macrophages full of oxidized LDL) that does not obstruct the affected vessel. a. arteriosclerosis b. atherosclerosis c. aneurysms d. venous thrombosis

b. atherosclerosis

1. If an individual is said to show signs of dyspnea, he is a. hypocapnic b. attempting to increase respiratory effort c. uses only primary muscles of respiration d. easily getting enough air

b. attempting to increase respiratory effort

10. Pyelonephritis, an infection of the renal pelvis and interstitium, isusually caused by: a. viruses b. bacteria c. fungi d. all of the above

b. bacteria

27. Tuberculosis is caused by: a. virus b. bacteria c. fungus d. chlamidi

b. bacteria

17. A 55 year old obese patient complains of a blister on her foot that has not healed. She says it is dark and ugly and that she didn't realize it was present until she removed her shoe and found it was bloody. She also complains of blurred vision and "heaviness" in her chest. She most likely has a. diabetes mellitus Type I b. diabetes mellitus Type II c. SIADH d. impaired glucose tolerance

b. diabetes mellitus Type II

13. A 24-year old woman with a history of type 1 diabetes is found in a stuporous state. She is hypotensive and has cold clammy skin. What is the likely etiology of her condition? a. hyperglycemia b. insulin reaction c. renal failure d. peripheral neuropathy

b. insulin reaction

16. Which is NOT a symptom of bacterial meningitis? a. severe photophobia b. intention tremor c. severe throbbing headache d. nuchal rigidity e. Brudzinski and Kernig signs

b. intention tremor

26. Patent ductus arteriosus a. causes an intermittent murmur b. may be asymptomatic c. must be surgically repaired in the first six months of life d. Is part of a triad of congenital defects

b. may be asymptomatic

11. If not removed, an aspirated solid may cause all of the following EXCEPT a. chronic local inflammation b. pleurisy c. bronchiectasis d. recurrent infection

b. pleurisy

5. Which factor is NOT associated with primaryhypertension? a. cigarette smoking b. preeclampsia c. family history of hypertension d. black race

b. preeclampsia

39. The chief predisposing factor for Respiratory Distress Syndrome of the newbornis a. low birth weight b. premature birth c. alcohol consumption during pregnancy d. smoking during pregnancy

b. premature birth

13. Which is NOT a source of emboli in embolic stroke? a. thrombi formed in heart under conditions of atrial fibrillation, myocardial infarct, endocarditis, rheumatic heart disease, and valvularprostheses b. thrombi formed in deep veins of systemic circulation c. thrombi formed in carotids, aorta, or vertebral-basilar circulation d. fat emboli forming after fractures of long bones e. air emboli

b. thrombi formed in deep veins of systemic circulation

33. Which type of microbe is most commonly involved in the etiology of croup? a. bacterium b. virus c. fungus d. mycoplasma

b. virus

44. Bronchiolitis (inflammatory obstruction of the bronchioles) tends to occur duringthe first years of life and is most often caused by a. bacterium b. virus c. fungus d. mycoplasma

b. virus

2. Poorly localized, dull abdominal pain felt in the general area of the source organ (i.e. the damaged organ) itself, usually near the midline in the epigastrum, midabdomen, or lower abdomen is called: a. parietal pain b. visceral pain c. referred pain d. reactionary pain

b. visceral pain

1. The oral expulsion of chyme describes a. saliva discharge b. vomiting c. retching d. phlegm discharge

b. vomiting

Essential hypertension develops when ...

b/p is consistently above 140/90

why do septal defects occur

because the foramen ovale fails to close at birth.

large pulmonary embolisms

block more than 60 % of lung tissue, affect the cardiovascular system. cause right sided heart failure.

saccular shape aneurysms

bulging wall on one side.

1. Which is FALSE regarding locked-in syndrome? a. Cognitive function is intact. b. Person is fully conscious. c. Afferent pathways are disrupted. d. Due to loss of motor function, person is unable to communicate except through blinking and vertical eye movements

c. Afferent pathways are disrupted.

12. Which of the following statements concerning chronic renal failure is FALSE? a. Plasma creatinine level increases. b. Sodium excretion increases. c. Alkalosis develops. d. Potassium is retained.

c. Alkalosis develops.

42. Which is FALSE regarding respiratory problems in CF? a. Typical lung features are mucus plugging, chronic inflammation, and infection. b. Bronchial arteries are unaffected and hemoptysis does notoccur. c. Amount of available and functional lung tissue progressivelydecreases. d. Respiratory failure is almost always the cause of death

c. Amount of available and functional lung tissue progressivelydecreases.

4. Which is FALSE regarding thyrotoxic crisis (thyroid storm)? a. is often fatal without early intervention b. involves increases in beta-adrenergic receptors and catecholamines c. Is associated with Hashimoto's thyroiditis d. occurs in severe hyperthyroidism under increased stress

c. Is associated with Hashimoto's thyroiditis

17. Tests which stretch the meninges can be used to assess for Meningitis or infection of the meninges. These tests are called: a. Yeoman and Ely tests b. Chvostek sign c. Kernig and Brudzinski signs d. lumbar puncture

c. Kernig and Brudzinski signs

5. The condition which causes loss of central vision and preserves peripheral vision is ____________. a. Presbyopia b. Glaucoma c. Macular degeneration d. Detached retina

c. Macular degeneration

10. Polyuria and polydipsia are symptoms of all of the following EXCEPT a. Type 1 diabetes mellitus b. Type 2 diabetes mellitus c. SIADH d. HHNKS

c. SIADH

26. Which is NOT true of congenital hydrocephalus? a. There is an increased volume of CSF. b. It is caused by a blockage of flow in the ventricular system, an imbalance in production of CSF, or a reduced reabsorption of CSF. c. The intraventricular pressure is lower than normal. d. Brain tissue is compressed against the skull.

c. The intraventricular pressure is lower than normal.

21. Which of the following is necessary for the formation of gallbladder stones? a. female gender b. obesity c. production of bile that is supersaturated with cholesterol d. prior biliary infection

c. production of bile that is supersaturated with cholesterol

17. Increased capillary permeability in ARDS causes a. immediate hyaline membrane formation b. consolidation c. pulmonary edema d. none of the above; capillary permeability decreases in ARDS

c. pulmonary edema

6. is the narrowing of the opening between the stomach and the duodenum. a. iliocecal obstruction b. hiatal hernia c. pyloric stenosis d. hiatal obstruction

c. pyloric stenosis

8. Intravascular activation of the coagulation cascade will result most directly in a. histamine release b. influx of phagocytes c. thrombus formation d. plaque formation

c. thrombus formation

1. Viral conjunctivitis is caused by . a. secondary bacterial infection b. Staphylococcus aureus c. virus d. allergens

c. virus

Arteriosclerosis

can be used as a general term for all types of arterial changes. It is best applied to degenerative changes in the small arteries and arterioles. -elasticity is lost, walls become thick and lumen gradually narrows.

most ------ can be detected by a murmor

cardiac defects

large amount of fluid that accumulates in the pericardium and compresses the heart

cardiac tamponade

pneumoconioses

chronic restrictive diseases resulting from long term exposure to irritating particles such as asbestos, mining, farmers lung, silicosis( stone cutting like the simpsons )

Fusiform shape aneurysms

circumferential dilation along a section of the artery.

1. Which is true regarding torsion of the testis? a. It occurs most commonly in men over 50. b. Onset is always preceded by physical exertion ortrauma. c. It is another term for epididymitis. d. Circulation to the testis is reduced or stopped because the arteries and veins in the spermatic cord are twisted

d. Circulation to the testis is reduced or stopped because the arteries and veins in the spermatic cord are twisted

2. Which is FALSE regarding vegetative states? a. Cerebral function is lost, but brain stem reflexes are intact. b. Grunting, yawning, eye opening, and random movements of trunk and head may occur. c. Sleep-wake cycles occur. d. Person can produce comprehensible words and follow commands

d. Person can produce comprehensible words and follow commands

3. The loss of visual accommodation related to aging is called ________. a. Myopia b. Glaucoma c. Astigmatism d. Presbyopia

d. Presbyopia

26. Which is FALSE regarding pneumonia? a. Organisms responsible for community-acquired pneumonia include bacterium, virus, mycoplasma, and chlamydia. b. Damage can be produced both by immune mechanisms and by toxins from certain microorganisms. c. Most cases of pneumonia are preceded by an upper respiratory tract infection. d. Regardless of which organism causes it, all pneumonia presents thesame symptoms and signs

d. Regardless of which organism causes it, all pneumonia presents thesame symptoms and signs

1. Water intoxication and hyponatremia are consequences and important features of a. diabetes mellitus b. neurogenic diabetes insipidus c. nephrogenic diabetes insipidus d. SIADH

d. SIADH

6. Which is true regarding primary and secondary hypertension? a. Primary always preceeds secondary. b. Primary occurs as a result of a disease process. c. Secondary is most common. d. Secondary is due to altered hemodynamics associated with another disease.

d. Secondary is due to altered hemodynamics associated with another disease.

7. Localized dilation or outpouching of a vessel wall or cardiac chamber is called: a. aneurysm b. thrombus c. embolus d. thromboembolus

d. Secondary is due to altered hemodynamics associated with another disease.

41. Which is FALSE regarding Cystic Fibrosis? a. CF results from an autosomal recessive mutation which produces defects in chloride ion transport in epithelium. b. Diagnostic test is for elevated levels of chloride in sweat. c. Mucus secretion is elevated. d. The mucus is less viscous.

d. The mucus is less viscous.

7. Urinary frequency, dysuria, suprapubic pain, lower back pain, hematuria, cloudy urine and possibly flank pain are all symptoms of: a. pyelonephritis b. cystitis c. renal failure d. a and b

d. a and b

35. Which of the following is the most apt to be fatal? a. acute tracheitis b. viral croup c. acute laryngotracheobronchitis d. acute epiglottitis

d. acute epiglottitis

10. Which would be dangerous to aspirate even in small quantities? a. fresh water from a lake b. salt water from the ocean c. gastric contents d. all of the above

d. all of the above

24. Ventricular septal defects a. are left-to-right shunts b. account for about 30% of all congenital defects c. can lead to left ventricular hypertrophy d. all of the above

d. all of the above

29. Genetic factors appear to play a large role in a. schizophrenia b. mood disorders c. panic disorder d. all of the above

d. all of the above

6. Which may result in hypoxemia? a. hypoventilation b. decreased oxygen content of inspired gas c. depressed respiratory centre from drugs d. all of the above

d. all of the above

8. Which of the following are types of cerebrovascular disease? a. lesions of vessel wall b. occlusion of vessel c. rupture of vessel d. all of the above

d. all of the above

29. Pulmonary embolism is occlusion of a portion of the pulmonary vascular bed byan embolus of a. fat b. blood clot c. air d. any of the above

d. any of the above

18. Hypoxia and ischemia occur as a complication of chronic diabetes mellitus. This happens because: a. elevated blood sugars plug capillaries b. smooth muscles of vessels contract c. diabetic neuropathy causes the blood vessels to close d. capillary basement membranes thicken

d. capillary basement membranes thicken

37. Homicidal ideation becomes a higher risk factor for harm to others in the presence of all of the following factors EXCEPT a. past history of violent behaviors b. presence of active psychosis c. severely agitated, aggressive, threatening or hostile behaviour d. chocolate

d. chocolate

1. Arteriosclerosis raises the systolic pressure by: a. increasing arterial distensibility and lumendiameter b. increasing arterial distensibility and decreasing lumen diameter c. decreasing arterial distensibility and increasing lumen diameter d. decreasing arterial distensibility and lumendiameter

d. decreasing arterial distensibility and lumendiameter

11. A 12 year old boy is admitted with Type I diabetes mellitus. Which of the following pathophysiologic changes has occurred? a. calcification of the islets of Langerhans b. decreased insulin receptors on the target organs c. fatty pancreatic change d. destruction of the beta cells of the pancreas

d. destruction of the beta cells of the pancreas

19. Which is NOT characteristic of Parkinson Disease? a. death of dopaminergic cells of the substantia nigra b. cogwheel rigidity c. resting tremor d. development of total invalidism within 3 years of diagnosis

d. development of total invalidism within 3 years of diagnosis

7. Which of the following is NOT a cause of intestinal obstruction? a. paralytic ileus b. volvulus c. intussusception d. duodenal ulcer

d. duodenal ulcer

37. Which is NOT a predisposing factor for RDS of the newborn? a. premature birth b. aspiration c. hypovolemia d. female gender

d. female gender

46. Which of the following is NOT associated with bronchiolitis? a. winter and spring seasons b. low socioeconomic status c. age under one year d. gender

d. gender

6. If a person has hypothyroidism secondary to iodine deficiency, the levelsof thyroid releasing hormone are likely to be a. zero b. low c. normal d. high

d. high

16. In pleural effusion, the fluid is watery and diffuses out of the capillaries as a result of increased blood pressure or decreased capillary oncotic pressure. a. exudative b. purulent c. hemothorax d. transudative

d. transudative

13. The development of colon cancer is most common in patients with chronic a. anorexia nervosa b. Crohn Disease c. peptic ulcer disease d. ulcerative colitis

d. ulcerative colitis

19. Which of the following is NOT affected by acute rheumatic fever? a. nervous system b. skin c. gastrointestinal tract d. various structures of heart

d. various structures of heart

Sub acute Endocarditis

defective heart valves are invaded by organisms of low virulence( streptococcus viridans)

15. Which is FALSE regarding diverticular disease? a. Diverticulosis is the presence of outpouching of mucosa through the muscle layers of the colon wall. b. Diverticulitis is inflammation of thediverticula. c. Abscess formation and peritonitis can result from diverticulitis. d. Diverticulosis is usuallyasymptomatic. e. Diverticular disease is a result of eating a high fibre diet.

e. Diverticular disease is a result of eating a high fibre diet

35. For a diagnosis of acute stress disorder, all of the following must be true EXCEPT: a. The initial traumatic event must have involved actual or threatened physical bodily harm or death to someone. b. The person must have been afraid or horrified or felt helpless. c. During or immediately after the event the person must have undergone dissociative symptoms such as numbing, detachment, depersonalization, or amnesia. d. During the post-stress period being evaluated, the person must have thoughts, dreams, or flashbacks of the event and avoid stimuli which remind him of the event. e. During the post-stress period being evaluated, the person must have periods of amnesia for the stressful event. f. During the post-stress period being evaluated, the person must have symptoms of anxiety and be significantly impaired in at least one essential area of function

e. During the post-stress period being evaluated, the person must have periods of amnesia for the stressful event.

14. Which is FALSE regarding tension pneumothorax? a. Air can enter the pleural space during inhalation but cannot leave during expiration b. Air pressure in the pleural space becomes greater than atmospheric pressure. c. Compression atelectasis occurs. d. The heart and great vessels may be compressed and displaced. e. It is uncomfortable but not dangerous

e. It is uncomfortable but not dangerous

25. An underlying condition of spina bifida is suggested by a. abnormal growth of hair along the spine b. a midline dimple posterior to the vertebral column c. a cutaneous angioma d. a subcutaneous mass e. all of the above

e. all of the above

9. Stroke is more common in a. people over 65 years of age b. women c. smokers d. people with arterial hypertension e. all of the above

e. all of the above

17. Long term portal hypertension may result in a. hepatic encephalopathy b. splenomegaly c. ascites d. varices e. any of the above

e. any of the above

43. Cystic fibrosis affects primarily the respiratory system and a. peripheral nervous system b. muscles c. gastrointestinal system, especially pancreatic secretion d. reproductive tract e. c and d

e. c and d

22. Which is FALSE regarding Guillain-Barre syndrome? a. Is frequently preceded by a viral infection b. Is an autoimmune attack on peripheral myelin c. results in symmetric weakness or paralysis d. can include paresthesias, pain, and autonomicdysfunction e. has a slow onset, usually over weeks

e. has a slow onset, usually over weeks

2. Which is NOT a manifestation of hyperthyroidism? a. heat intolerance and excessive sweating b. weight loss c. wakefulness and irritability d. symptoms of sympathetic activation due to increased sensitivity e. myxedema coma

e. myxedema coma

4. Which of the following will NOT cause increased intracranial pressure? a. edema b. intracranial hemorrhage c. tumor d. excess cerebrospinal fluid e. systemic hypertension

e. systemic hypertension

45. Which is NOT part of the pathophysiology and symptoms of bronchiolitis? a. virally caused destruction of bronchial epithelium including ciliated cells b. immune response inciting inflammation c. narrowing and plugging of bronchioles due to edema of thebronchiolar wall and accumulation of mucus, fibrin, and cellular debris d. increased work of breathing due to decreased compliance and increased airway resistance e. underexpansion of lungs and thoracic cage

e. underexpansion of lungs and thoracic cage

an increase in arteriolar vasoconstriction, which is attributed to increased stimulation

essential hypertension

5. Systemic symptoms of thyroid storm include a. nausea, vomiting, or diarrhea b. hyperthermia c. tachycardia, especially atrial d. heart failure e. agitation or delirium f. all of the above

f. all of the above

51. Risk factors associated with Sudden Infant Death Syndrome include all of the following EXCEPT a. poverty of mothers b. mothers younger than 20 years of age c. maternal use of illicit drugs d. siblings of previous SIDS victims e. low birth weight or preterm delivery f. sleeping in supine position g. exposure of baby to secondhand cigarette smoke

f. sleeping in supine position

large pulmonary embolisms cause left sided heart failure true or false

false they lead to s/s of right sided heart failure.

occupational diseases that lead to "restrictive lung disease"

farmers lung, asbestos's, silicosis

2 groups of restrictive lung disease

first group: abnormality of chest wall limits expansion i.e kyphosis second group: diseases effecting the tissue providing the supportive framework of the lungs. i.e farmers lung *** not airway obstruction or alveolar destruction***

High density lipoproteins

good lipoprotein , it has a low lipid content and is used to transport cholesterol away from cells.

Croup onset

gradual

restrictive lung diseases

group of diseases in which lung expansion is impaired and total lung capacity is reduced.

alpha1-antitrypsin

inhibits the activity of proteases- the destructive enzymes of neutrophils during the inflammatory response. A genetic deficency is often found in pt's who develop emphysema early in life.

s/s of anthrax

initially appears has flu like symptoms. 3-5 days later acute shortness of breath with widening of the mediastinum on x-ray. - shock follows quickly from toxin release

S/S of subacute infective endocarditis.

insidious onset, manifesting only as an intermittent low grade fever or fatigue. Anorexia, splenamegaly and oslers nodes

pulmonary embolism

is a blood clot or mass of other material that obstructs the pulmonary artery or a branch of it, blocking the flow of blood through the lung tissue.

Aortic Aneurysms

is a localized dilation and weakening of the arterial wall.

what would you associate with these s/s : crushing chest pain , low b/p , rapid weak pulse, and decrease loc. - the pt has been on a long plane ride

large P.E

Left Sided heart failure

left ventricle fails to pump blood into the systemic circulation. Pulmonary circulation increases and capillary pressure rises. Pulmonary edema occurs.

S/S progressive shock

lethargy , weakness , cool , moist , pale skin, low b/p , tachycardia , weak thready pulse, tachypnea Oliguria, metabolic acidosis

Rales

light bubbly or crackling sounds associated with serous secretions

Aschoff bodies

localized lesions in the heart muscle that may interfere with the hearts conduction. - associated with myocarditis caused by rheumatic fever.

Hypovolemic Shock

loss of circulating blood volume.

s/s of rheumatic fever

low grade fever , leukocytosis, malaise, anorexia, tachycardia ( at rest) , epistaxis and abdominal pain.

Croup is more severe during the day or at night ?

night

are the effects of acute endocarditis worse than subacute ?

no the basic effects are the same. ( Duhhhh)

Obstructive sleep apnea causpe ?

occurs when pharyngeal tissues collapse during sleep. Leading to repeated and monetary cessation of breathing.

Homan's Sign

pain in the calf muscle when the foot is dorsiflexed. - sign of DVT/Thrombus.

excessive fluid in the pleural cavity

pleural effusion

1st degree heart block

prolonged pr-interval

fluid collecting in the alveoli and interstitial area

pulmonary edema

Unstable angina

refers to prolonged pain at rest and of recent onset, may be caused by a break in an atheroma.

Thrombophlebitis

refers to the development of a thrombus in a vein in which inflammation is present.

preload

refers to the mechanical state of the heart at the end of diastole with the ventricles at their maximum volume.

Tachycardia

regular rapid heart rate 100-160

Shock

results from a decreased circulation blood volume, leading to decreased tissue perfusion and general hypoxia.

cor pulmonale

right sided congestive heart failure due to lung disease.

chronic low grade but damaging inflammation of the lungs over a long period of time.

second group of restrictive lung disease.

S/S decompensated

stupor, confusion , arrythmias , weak , slow pulse - Metabolic acidosis , Acute respiratory distress syndrome, - multiple thrombi Organ failure : liver , renal , paralytic ileus, GI hemorrhage.

Pulsus Paradoxus

systolic b/p drops 10mmhg during inspiration.

afterload

the force required to eject blood from the ventricles. - it is determined by peripheral resistance to the opening of the pulmonary semilunar valves.

malignant hypertension

the third type of hypertension - uncontrollable when treated with 3 or more drugs. - Diastolic Pressure is often very high.

how do dissecting aneurysms form

through a tear in the intima

expressive aphasia

unable to speak or write fluently

Sinusitis

usually a secondary bacterial infection to a cold or allergy. Causes obstructed drainage of the paranasal sinus.

flail chest

usually results from fractures of 3-6 ribs in two or more places. OR sternum fracture and a number of consecutive ribs.

Right sided Heart Failure

ventricle can't maintain it's output so less blood proceeds to the left side of the heart and systemic circulation. ( Forward effect.)

Do emphysema patients get frequent infections

very little compared/ some