Term
| Only __% of the genome is actually genes? |
|
Definition
|
|
Term
Immunoglobulins:
__ is the first responder
After time, ___ levels go up and ___ goes down to zero
__ is important for protection against re-infection
__ is secretoyr |
|
Definition
|
|
Term
| Upon re-infection with a disease or after getting a booster vaccination, levels of ___ will go up |
|
Definition
|
|
Term
| There are ___ chromosomes |
|
Definition
|
|
Term
Innate Immune system:
Cellular components?
Humoral component?
The end-stage activated form of the humoral component is ___. |
|
Definition
macrophages
NK cells
Leukocytes
complement
MAC |
|
|
Term
Adaptive immune system:
Biggest player is ___. Types?
Humoral component? |
|
Definition
| Lymphocytes. Helper and killer T's (Cd4 & CD8) |
|
|
Term
| GABA/glycine and Glutamate - which is excitatory and which is inhibitory? |
|
Definition
Glutamate - excitatory
GABA - inhibitory |
|
|
Term
Which neurotransmitter?
Part of the extrapyramidal motor system
Deficiency leads to Parkinson's symptoms
In the limbic cortex, an excess of this leads to psychotic behavior. |
|
Definition
|
|
Term
Which neurotransmitter?
Is prominent in midbrain and brainstem, especially the pons.
Is involved with visceral control including sleep, temperature, appetite, and neuroendocrine fxns. |
|
Definition
|
|
Term
Which neurotransmitter?
Usually inhibits neuronal depolarization (makes neurotal discharge less likely)
Present in many areas of CNS. |
|
Definition
|
|
Term
|
Definition
phobias
global anxiety
panic attacks |
|
|
Term
|
Definition
obsessive compulsive
paranoid
psychopathic (sociopathic) |
|
|
Term
| 4 categories of mental illness |
|
Definition
neurosis
character disorders
affective (mood) disorders
psychosis |
|
|
Term
Chronic depression:
Suspected etiology/pathophysiology?
__% lifetime prevalence
__-__% lifetime suicide risk for those with it. |
|
Definition
"Amine hypothesis" - serotonin and NE too low
10%
10-15% |
|
|
Term
Key concepts of depression:
1. Exists in a full spectrum of ___
2. Commonly undiagnosed/untreated
3. Causes significant compromise of ___
4. Increases risk of ___ significantly |
|
Definition
severity
lifestyle
suicide/homicide |
|
|
Term
|
Definition
Reactive (secondary/exogenous) - adjustment disorder with depressed mood
Endogenous - major depressive disorder
Bipolar - manic depressive disorder
|
|
|
Term
| What are some OTC anti-depressant treatments? |
|
Definition
vitamins
minerals
St. John's Wort
Ginko extracts |
|
|
Term
| What are some Rx antidepressants? |
|
Definition
lithium
MAOIs
SSRIs
Serotonin/NE reuptake inhibitors
Tricyclics |
|
|
Term
| No psychotropic drugs are approved for use in ____ |
|
Definition
|
|
Term
___ are the first line drug for depression
Also used for? |
|
Definition
SSRI
also used for: eating disorders
OCD
panic attacks
PMS |
|
|
Term
SSRI's:
Lag time to full effect is __-__ wks
Essentially no risk of ____
Popular ones? |
|
Definition
2-6 wks
overdose
prozac, paxil, zoloft, lexapro, celexa |
|
|
Term
|
Definition
Sleep disturbance
appetite changes
sexual dysfunction |
|
|
Term
| What is a major side effect of all antidepressants? |
|
Definition
| increased risk of suicide, esp in first few months |
|
|
Term
| Cymbalta and effexor are two popular ___ drugs |
|
Definition
|
|
Term
|
Definition
| Same as depression plus lithium carbonate to prevent manic phase |
|
|
Term
| ___ is diminished capacity to recognize reality, characterized by delusions, hallucinations, and abnormal cognition (including genius) |
|
Definition
|
|
Term
| 2 general groups of psychosis |
|
Definition
schizophrenia
all others - temporary and secondary (due to drugs/CNS lesions, etc) |
|
|
Term
What disease?
Peak onset in teens and 20's
characterized by social withdrawl, decline in hygiene, flight of ideas, autistic behavior, concrete thinking, delusions, hallucinations |
|
Definition
|
|
Term
| Psychosis/schizophrenia is sometimes thought to be due to an excess of ____, but it's probably more complicated than that. |
|
Definition
|
|
Term
| Giving too much 1st generation anti-psychotic drugs can induce ____ disorders |
|
Definition
parkinson-like
bc these drugs block dopamine receptors
Also, metabolic disorders (diabetes, obesity) |
|
|
Term
| What was the CATIE study? |
|
Definition
testing antipsychotic drugs
Olanzapine (Zyprexia) was best but all drugs were bad. only 26% of subjects finished trial.
Main conclusion: we need better drugs |
|
|
Term
Dermatology:
___ is like a burn
___ is a clogged sebaceous gland |
|
Definition
vesicle/bulla/blister
epidermal cyst |
|
|
Term
What disease?
Very common Chronic, relapsing inflammatory skin disorder
Equally common male/female
Itchy, pain, joint inflammation, depression
Creates plaque lesion |
|
Definition
|
|
Term
|
Definition
T-cell mediated autoimmune disease
Cytokine TNF alpha is esp important
high genetic rate |
|
|
Term
Psoriasis Pathophysiology:
Excessively rapid ___ of the epidermis |
|
Definition
| turnover rate: 3-4 days instead of 21-30 |
|
|
Term
| Bottom line of psoriasis treatment |
|
Definition
the most potent drugs are also the most toxic
Some drugs: corticosteroids, UVA/UVB, ciclosporin, methotrexate, retionoids |
|
|
Term
What disease?
Most common form of cancer
Due to UV light damage
Distant spread extremely rare but local destruction possible
very benign |
|
Definition
|
|
Term
|
Definition
| surgical excision or cryotherapy |
|
|
Term
What disease?
Caused by UV light exposure
EARLY TENDENCY TO ULCERATE - MOST IMPORTANT
rarely deadly in confined to skin |
|
Definition
|
|
Term
What disease?
Most deadly skin cancer - 55,000 cases/year, 8,000 deaths/year
Main risk factor is sun exposure
Incidence rising, mortality falling |
|
Definition
|
|
Term
| What is an "ugly duckling sign"? |
|
Definition
a mole that stands out from other moles/lesions
Positive ABCDE
indicative of melanoma |
|
|
Term
| How does immune therapy for melanoma work? |
|
Definition
| CD4 lymphocytes are extracted, cultured with melanoma antigens (NY-ESO-1) and then reinfused |
|
|
Term
Skin manifestations of Cardiovascular disease:
Pedal/pitting edema - suggestive of ??
Nail clubbing/cyanosis - suggestive of ??
Venous stasis ulcers - suggestive of ?? |
|
Definition
heart failure
inadequate O2
vascular insufficiency |
|
|
Term
| Petichiae and purpura are skin manifestations of ____ |
|
Definition
| coagulation issues/low platelet count/ |
|
|
Term
| Lupus - 2 types represented by two diff rashes |
|
Definition
Systemic - butterfly rash on cheeks
Discoid - rash on arms |
|
|
Term
___ is AKA hives. it is a skin manifestation of systemic rxn to medications
serpentine, puritic, itchy lesions |
|
Definition
|
|
Term
| ___ is a skin rxn to poison ivy, oak, or sumac |
|
Definition
|
|
Term
| Why are gastric ulcers rising while duodenal ulcers are not? |
|
Definition
|
|
Term
2 types of peptic ulcers:
1. ___: most common by 4:1 ratio. Most common in 30-55 y/o
2. ___: most common in 55-70 y/o |
|
Definition
|
|
Term
Peptic ulcer disease etiology:
Almost always due to ____
Other factors? |
|
Definition
H. pylori
NSAIDs (irritation, prostaglandin inhibition)
increased gastric acid production (smoking/stress)
Inadequate mucosal defense (smoking) |
|
|
Term
|
Definition
H. pylori eradication - most important - requires comination of drugs
reduce acid secretion
neutralize acid
enhance mucosal defense |
|
|
Term
| What are some ways gastric acid secretion is controlled? |
|
Definition
HCL via proton pump
parietal cells in the antrum and fundus
stimulated by gastrin, histamine, and acetylcholine
Supressed by Prostaglandin E2 and I2 |
|
|
Term
|
Definition
Pirenzepine blocks ACh receptor
Cimetidine blocks H2 receptor
Misoprostol stimulates prostaglandin receptor which inhibits proton pump
Omeprazole blocks proton pump
Bismuth (pepto bismol) - improves gastric mucosa defense and may treat H. pylori |
|
|
Term
What disease?
VERY common - 30% of americans
Spread by fecal-oral route
More common in poor sanitation
Contaminated food (esp shellfish) is usual source
Disease is usually mild
Does NOT lead to chronic infection |
|
Definition
|
|
Term
| What is fulminant hepatitis? |
|
Definition
| 2 types of Hep infection together (A+D) |
|
|
Term
Hep A Symptoms:
1. ___ phase - averages 30 days. no symptoms. makes it hard to track infection
2. ___ phase - malaise, anorexia, fatigue, myalgia, RUQ pain
3. ___ phase - jaundice for 2-3 weeks from rise in bilirubin, typically first seen in sclera. worsening phase 2.
4. ___ phase - gradual return to normal with complete healing. results in long term immunity. |
|
Definition
incubation
prodrome
icteric
convalescnet |
|
|
Term
What disease?
5-6% of the world have had it
Known as "serum hepatitis"
Spread by blood transfusion, exchange of body fluids, and vertical transmission
Acute illness similar to hep A but chronic infection is possible
Can cause chronic liver failure and cancer |
|
Definition
|
|
Term
Chronic Hep B infection
__% of immunocompetent people get it after acute infection
__% risk in neonates
__% risk of cirrhosis with chronic infection!!! |
|
Definition
|
|
Term
What disease?
2.5-3 million carriers in US
Acute infection can be siliar but milder than Hep A and many are asymptomatic (anicteric)
Spread by blood transfusion, contaminated needles, anal intercourse
Chronic infection rate is 75-80% |
|
Definition
|
|
Term
| ___ is the most common cuase of cirrhosis in US |
|
Definition
|
|
Term
|
Definition
| Hep B immunoglobulin - prevents chronic disease or vertical transmission |
|
|
Term
What disease?
irreversible inflammatory disaese that disrupts liver fxn and structure
decreased hepatic fxn due to fibrosis and nodules
Biliary channels become obstructed and cause portal HTN, which can result in blood being shunted away from the liver and result in hypoxic necrosis |
|
Definition
|
|
Term
| ___ - all blood is filtered through liver first, so if it gets backed up, lots of other organs can be affected |
|
Definition
|
|
Term
Checking ___ level is a quick easy way to look at liver fxn
Elevated levels of this or liver enzymes implies ___ |
|
Definition
|
|
Term
|
Definition
blood storage
bacterial and foreign particle removal
synthesizes clotting factors
Produces bile to absorb fat-soluble vitamins
metabolizes fat
when liver fails, all these fxns are compromised |
|
|
Term
Types of liver failure:
1. ___ - oxidation damages hepatocytes
2. ___ - cirrhosis begins in bile canaliculi and ducts. Primary is autoimmune, secondary is obstruction (pancreatic cancer tht blocks off bile duct)
3. ___ - consequency of chronic disease such as hepatitis |
|
Definition
alcoholic cirrhosis
biliary cirrhosis
postnecrotic cirrhosis |
|
|
Term
|
Definition
chronic RUQ pain
jaundice
edema (due to decreased albumin)
portal HTN
esophageal varices
reduced coagulation
reduced drug metabolism
increase risk of liver cancer |
|
|
Term
What disease?
2nd leading cause of cancer death in US
Lifetime risk 6%
genetic background in 25% of cases
90% occurs after age 50 |
|
Definition
|
|
Term
colorectal cancer:
risk increases with ____
risk decreases with ___, ___, ___ |
|
Definition
high fat, low fiber diets and inflammatory bowel disease
screening
low dose aspirin
changing diet |
|
|
Term
| Colorectal cancer prognosis (5 year survival rate) |
|
Definition
Stage 1 > 90%
Stage 2 - 80%
Stage 3 - depends, anywhere from 30-65%
Stage 4 - 5% |
|
|
Term
what disease?
20,000 cases/yr in US
11,000 deaths/yr
2:1 men:women
Risk factors: chronic H. pylori infection, smoking, diet high in nitrates, low in vit c |
|
Definition
|
|
Term
| 60 y/o man presents with symptoms of iron deficiency anemia - what is a likely cause? |
|
Definition
| gastric adenocarcinoma due to bleeding |
|
|
Term
| ___ cancer is less common than other GI cancers but more difficult to diagnose and has much worse prognosis (stage 1 - 60%, stage 4 - 3%) |
|
Definition
|
|
Term
What disease?
4th leading cause of cancer deaths
Incidence is stable
overall prognosis very poor
symptoms: gnawing, visceral pain that may radiate to back
weight loss, jaundice |
|
Definition
|
|
Term
| Risk factors for pacreatic cancer |
|
Definition
smoking
chronic pancreatitis
obesity
long term diabetes |
|
|
Term
| What is the Whipple Procedure? |
|
Definition
| surgical resection of pancreas |
|
|
Term
|
Definition
ulcerative colitis
chron's disease |
|
|
Term
|
Definition
inappropriate response to normal micro-flora
possible autoimmune mechanisms |
|
|
Term
What diseases?
1. symptoms include diarrhea, cramping pain, rectal bleeding, passage of mucus
2. symptoms include recurrent episodes of RLQ pain, malabsorption, steatorrhea, bowel obstruction. |
|
Definition
ulcerative colitis
chron's disease |
|
|
Term
Endoscopy would be used to diagnose ____
Barium swallow would be used to diagnose ___ |
|
Definition
ulcerative colitis
chron's disease |
|
|
Term
Treatment for which disease?
symptomatic
diet
antibiotics
immunomodulating drugs (TNF-a inhibitors, methotrexate)
surgery (terminal ilium excision) |
|
Definition
|
|
Term
Treatment for which disease?
aminosalicylates (aspirin derivative)
corticosteroids
immunomodulating drugs
surgery (total colectomy with ileostomy) |
|
Definition
|
|
Term
Classifications of arthritis:
1. ___ - includes RA and SLE
2. ___ - degenerative joint disease. started by wear and tear. ongoing process is inflammatory.
3. ___ - includes gout
4. ___ |
|
Definition
auto-immune mediated
OA
crystal deposition
infectious |
|
|
Term
What disease?
Affects 1% of US population
Female: male = 3:1
80% develop it between 35-64
Genetic link via HLA DR4
Chronic and systemic infalmmation of synovial membranes in multiple joints |
|
Definition
|
|
Term
Random letters for RA = something about autoimmunity
CCP antibody
IgM is directed against Fc fragment of IgG
Elevated ESR common
Elevated gamma globulins (IgM and IgG) common |
|
Definition
|
|
Term
| What are pannus formations? |
|
Definition
| bony deformations due to overgrowth of synovium |
|
|
Term
| Typical presentaiton of RA |
|
Definition
begins iwth fatigue
malaise
general wekaness
vague joint complaints
then after weeks to months acute synovitis occurs |
|
|
Term
| What is the hallmark of ongiong RA inflammation? |
|
Definition
| early mornign stiffness lasting >1 hr |
|
|
Term
What concept?
In RA, autoimmune antibodies directed against tissues eventually decide to attack other parts of the body, leading to systemic manifestations of the disease. |
|
Definition
|
|
Term
|
Definition
NSAIDs
PT
glucocorticoids (steroids)
DMARDs including malaria drugs (quinones) |
|
|
Term
What disease?
Autoimmune disease that can cause arthritis
90% of pts are women of child-bearing age
Antibodies initially directed aginst DNA protein complexes |
|
Definition
|
|
Term
|
Definition
initial onset similar to RA (fatige, malaise, weight loss, fever)
Later polyarthritis
70% will develop hemolytic anemia (loss of Hb, RBCs)
30-50% will ultimatley get renal disease |
|
|
Term
| ___ is the most common cause of disability in the US |
|
Definition
|
|
Term
|
Definition
protein changes in cartilage linked to cytokines (esp interleukins) -- inflammatory process
also due to wear and tear |
|
|
Term
|
Definition
pain wtih joint use
improves with rest
brief morning stiffness (<15 min) |
|
|
Term
|
Definition
anti-inflammatory, analgesic (NSAIDS, gluticorticoids)
stimulate cartilage repair (chondroitin, glucosamine)
surgery |
|
|
Term
| What kidn of diet causes gout? |
|
Definition
|
|
Term
| How is gout connected to chemotherapy? |
|
Definition
| nucleic acid breakdown causes uric acid metabolism disorder |
|
|
Term
| Everyone with gout has ___, but not everyone with ___ has gout |
|
Definition
|
|
Term
| ___: nodular deposit of urate monohydrate crystals |
|
Definition
|
|
Term
| What is a major health problem with gout? |
|
Definition
| crystal deposits in glomeruli in kidneys |
|
|
Term
|
Definition
Reduce uric acid production
Reduce inflammation (colchicine) - only works in gouty arthritis, no other kinds
enhance urinary excretion of uric acid |
|
|
Term
| typical causes of infectious arthritis |
|
Definition
neiseria gonnorrhea
step
staph
TB |
|
|
Term
What disease?
systemic infection, usually on in immunosuppressed pt
IV drug users
post-joint replacement |
|
Definition
| hematogenous septic arthritis |
|
|
Term
What disease?
Malignancy arising in bone marrow
Most common form of primary bone cancer
derived from a single plasma cell in the bone marrow
Produces large amoutns of antibodies
Usually seen in people around 70
Higher rates in blacks and males |
|
Definition
|
|
Term
| Most common symptom of ___ is bone pain that is worse with movmement and better at rest. typically in the back and ribs. |
|
Definition
|
|
Term
| Pt presents with anemia and plasma cell proliferation + high serum M components on bone marrow biopsy... think? |
|
Definition
|
|
Term
| Fx with minimal trauma and x-ray reveals punched out bone lesion... think |
|
Definition
|
|
Term
| Multiple myeloma death usually occurs from |
|
Definition
kidney failure due to antibody deposition
infection due to bone marrow compromise
complications from chemo |
|
|
Term
What disease?
2nd most common primary bone cancer but overall very rare
Is a cancer of the young
May show up in older pts with paget's disease
usually begins in a long bone
metastasizes early
associated wtih bone pain/pathologic fx |
|
Definition
|
|
Term
| Classic xray finding of osteosarcoma |
|
Definition
|
|
Term
|
Definition
without treatment - death in a few months
with treatment - 10 year survival of 60-80% |
|
|
Term
What disease?
Demineralization of bone
OSTEOCLASTIC ACTIVITY DOMINATES OVER OSTEOBLASTIC EFFORTS
bone matrix normal |
|
Definition
|
|
Term
| What is the most common cause of osteoporosis? |
|
Definition
| involutional - associated with aging |
|
|
Term
| Risk factors for osteoporosis |
|
Definition
smoking
genetics
poor Ca intake
early menopause
thin body |
|
|
Term
|
Definition
Selective estrogen receptor modulators
used for osteoporosis treatment bc they target estrogen receptors only in bone -- reduces risk of breast cancer |
|
|
Term
|
Definition
an SERM used for osteoporosis
May reduce risk of breast cancer
side effects = menopausal symptoms |
|
|
Term
| What are bisphonates used to treat? |
|
Definition
|
|
Term
What disease?
Chronic aching pain and stiffness
fatigue
sleep disorders
headaches
symptoms aggrevated by exercise
may have many muscle trigger points |
|
Definition
|
|
Term
What disease?
pain and stiffness of shoulder and pelvic muscles
Difficulty brushing hair or rising from chair due to PAIN, not weakness
malaise
low grade fever
weight loss
Always diagnosed after 50
Aytpical autoimmune disorder |
|
Definition
|
|
Term
| Polymyalgia rheumatic should respond within 72 hrs to _____ |
|
Definition
|
|
Term
What disease?
systemic panarteritis that can cause sudden blindness due to occlusive opthalmic arteritis. connection in 1/3 of pts iwth polymyalgia rheumatica |
|
Definition
| giant cell arteritis (GCA) |
|
|
Term
What disease?
Chronic and episodic disease with no known cure
4-5% of population
1-3% of all office visits
Overall rate has doubled over past 50 years
5,000 fatalities/year
Leading pediatric admission diagnosis |
|
Definition
|
|
Term
| Pathophysiology of asthma |
|
Definition
| AIRWAY INFLAMMATION (reduction of airway diameter) |
|
|
Term
| Why are kids raised on farms less likely to get asthma? |
|
Definition
| early exposure to bacteria may lead to formation of IgG instead of IgE |
|
|
Term
|
Definition
Anti-inflammatory approach is critical!!
Bronchodilators for acute episodes (albuterol)
Anti-inflammatory agents for prevention (glucocorticoids, beta-2 inhaler, leukotriene modulators) |
|
|
Term
Asthma drugs
1. ___ - leukotriene modulator
2. __ - bronchodilator
3. ___ - glucocorticoid
4. ___ - long acting |
|
Definition
Advair
Albuterol
flovent
servent |
|
|
Term
What disease?
A chronic and gradually progressive pulmonary disrder
hallmark is airflow obstruction and gradual alveolar dilation and fibrosis
2 forms: chronic bronchitis and emphysema |
|
Definition
|
|
Term
| Most common cause of COPD? |
|
Definition
|
|
Term
2 types of COPD:
1. ___ - "blue bloater" - airway obstruction > alveolar loss.
chronic productive cough. SOB mild until late in disease. Low pO2. Patients often overweight wtih peripheral edema
___ - "pink puffer" - alveolar loss > airway obstruction. SOB even at rest. cough is rare. no cyanosis. appear uncomfortable, breathe rapidly, cannot get enough air due to loss of absorptive surface. |
|
Definition
chronic bronchitis
emphysema |
|
|
Term
|
Definition
1. Prevent - stop smoking. prevent other causes of damage
2. Improvement - prevent new damage, improve airways
3. Support - airway support, supplemental O2 |
|
|
Term
|
Definition
BAD
40% will survive 1 year
15% will survive 5 years
2 year survival for small cell: 3-20%
Overall 5 year survival for non-small cell: 16%
death toll greather than breast, prostate, colorectal, and pancreatic cancer |
|
|
Term
|
Definition
1. Small cell carcinoma (15%)
2. Non-small cell: squamous carcinoma, large cell carcinoma, adenocarcinoma (85%) |
|
|
Term
|
Definition
Most are symptomatic at time of diagnosis
Weight loss
Cough
hemoptysis
pain |
|
|
Term
| Lung cancer is famous for spreading to waht three organs? |
|
Definition
|
|
Term
What diesese?
Infection caused by mycobacterium
"Acid fast bacillus"
Initially either pulmonary or GI
In late stages can affect every organ system |
|
Definition
|
|
Term
| __ - __% of the worlds population has been exposed to TB |
|
Definition
|
|
Term
|
Definition
aerosol droplets
but also infected milk |
|
|
Term
The key pathologic feature of TB is a ____
The immune system usually contains but does not elimiante the bacteria |
|
Definition
| caseating granuloma (cheesy looking) |
|
|
Term
IN most pts, the immune system keeps the TB infection ___
In some pts (5-10%) the infection becomes ___ |
|
Definition
latent - still pos skin test
progressive (active) TB |
|
|
Term
| Symptoms of progressive TB |
|
Definition
intermittent fever (night sweats)
weight loss
cough, hemoptysis
fatigue, malaise
very infectious |
|
|
Term
|
Definition
100% cure rate with treatment as long as pt is compliant and no drug resistance
Without treatment: 30-35% die in one year
65% die in 5 years |
|
|
Term
What form of TB?
Most common in infants, elderly, immunocompromised/starving people
very lethal
multiple, widespread foci of lesions |
|
Definition
|
|
Term
|
Definition
|
|
Term
__-__% of all strains of TB become resistant to one or more first line drugs
mortality in drug-resistant cases similar to that of untreated active TB |
|
Definition
|
|
Term
| ___ is the most common neurologic disorder in the US |
|
Definition
| Cerebrovascular accident (stroke) |
|
|
Term
|
Definition
Same as cardiovascular disease
HTN
diabetes
obesity
smoking |
|
|
Term
| Coniditon characterized by abrupt appearance of a neurologic deficit due to a focal vascular disruption |
|
Definition
|
|
Term
| 2 classifications of stroke |
|
Definition
Ischemic - 85-90% - vessel becomes occluded
Hemorrhagic (10-15%). vessel bleeds |
|
|
Term
| Stroke-like symptoms that completely clear in <24 hours. no infarction |
|
Definition
|
|
Term
2 types of ischemic stroke
1. clot forms at site of atherosclerotic plaque rupture. most common kind.
2. clot fragment dislodged from elsewhere in the body (usually carotids) |
|
Definition
|
|
Term
2 types of hemorrhagic stroke
1. associated with htn - "pressure blowout". small vessels and precapillary arterioles
2. often due to congenital vessel weakness (aneurysm) of cerebral circulature. usually very dramatic, fast death. can occur in young peopl |
|
Definition
intracerebral hemorrhage
subarachnoid heorrhage |
|
|
Term
| 30 y/o with terrible headache that suddently collapses and dies... think? |
|
Definition
|
|
Term
| Most common sites for subarachnoid (congenital) hemorrhage |
|
Definition
40% at anterior communicating artery
20% at posterior communicating artery
34% at middle cerebral artery |
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Term
| 2 most common sites for ischemic strokes |
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Definition
| right and left middle cerebral arteries |
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Term
| Right sided stroke produces motor deficits on ___ side |
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Definition
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Term
Which side had stroke?
1. speech-language deficits. slow, cautious behavior. memory deficits
2. spatial perceptual deficits, quick, impulsive behavior. memory deficits |
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Definition
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Term
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Definition
| platelet inhibiting drugs to prevent future stroke |
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Term
| Mural thrombi from atrial fib is the most common cause of ?? |
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Definition
| cardiac source of embolic stroke |
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Term
All thrombolytic drugs enhance __ activity
First thing you want to give an ischemic stroke pt (within 6 hrs). but must be sure its not a hemorrhagic stroke. |
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Definition
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Term
What disease?
chronic, slowly progressive movemnet disorder
due to loss of dopaminergic neurons in substantia nigra
reduced dopamine/Ach ratio in neostriatum
Due to progressive decline of fxning of the extrapyramidal motor system |
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Definition
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Term
Components of the ___ system:
reticular formations (pons, medulla)
Modulated by basal ganglia, cerebellum, nigrstriatal pathway
Fxn to modulate voluntary muscle movement, initiate and coordinate movement |
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Definition
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Term
Main symptoms of parkinsons -
1. ___ - slow movment, difficulty initiating movment
2. ___ tremors
others |
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Definition
bradykinesia
pill rolling
also rigidity, postural instability, mild intellectual impairment |
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Term
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Definition
| Dopamine precursor used to treat Parkinsons bc it can pass the blood-brain barrier |
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Term
| Paroxysmal even characterized by abnormal excessive synchronized discharge of CNS neurons |
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Definition
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Term
| condition characterized by recurrent seizures caused by a chronic, underlying process |
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Definition
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Term
What type of seizure?
loss of consciousness, rigidity, cessation of resp
"falling sickness"
jerky contractions of muscle groups
followed by flaccid coma pahse (muscle relaxatio)
Ends in post-ictal phase (headache, confusion, muscle soreness, fatigue) |
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Definition
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Term
| Repetitive seizures close together with consciousness not regained between seizures. lasts > 5 minutes. is a medical emergency |
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Definition
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Term
| Why is enhancing GABA activity an anti-seizure treatment? |
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Definition
bc it's an inhibitory neurotransmitter
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Term
| 2 common anti-seizure drugs |
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Definition
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Term
| What happens if pt abruptly stops taking anti-seizure meds |
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Definition
| may trigger frequent seizures/status epilepticus |
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Term
What disease?
characterized by areas of demyelination in CNS
probbly autoimmune
followed by gliosis (scarring)
lesions vary in time and location |
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Definition
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Term
| Main target of MS in brain == grey/white matter |
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Definition
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Term
clinical forms of MS:
1. __ - most common. limited fxn usually confined to one muscle group or autonomic fxn. over period of time relapse occurs and is more permanant and progresses to form (3)
2. ___ - abrupt onset and steady progression. remission rare and incomplete. worst version
3. ___ - after inital form (1), rapid progression of disease |
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Definition
Relapse-remitting
primary progressive
secondary progressive |
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Term
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Definition
lim weakness, tingling, nubmess
spastic paraparesis
vision loss
double vision
loss of control of bowel/bladder
vertigo |
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Term
| Woman in first 6 mos after having baby with neurologic symptoms... think? |
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Definition
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Term
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Definition
corticosteroids
interferon-beta-1a
IVIG
Immune suppressing drugs |
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Term
What drug?
donor IgG binds to hose IgG
Massive amounts of IgG trigger purge of it by complemetn
may block macrophage receptors and prevent them from becoming stimulated |
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Definition
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Term
___ is the most common motor neurodegenerative disorder
Characterized by progressive death (apoptosis) of both upper and lower motor neurons in the spinal cord and brain |
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Definition
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Term
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Definition
Weakness and gradual paralysis of any muscle group
dysphagia
limb weakness
ambulation difficulties
muscle fasciculations |
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Term
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Definition
death in 3-5 years - usually due to resp failure/infection
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Term
___ is the most common cause of dementia in the elderly
Incidence in 65 y/o?
Incidence in 85 y/o? |
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Definition
Alzheimers
2-5% in 65
30-50% in 85 |
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Term
| Alzheimer's Pathophysiology |
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Definition
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Term
| 2 major treatments for alzheimer's |
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Definition
Acetylcholinesterase inhibitors - increase levels of Ach in the body
NMDA antagonists - reduces glutamate activity |
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Term
| Benign v. malignant brain tumors |
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Definition
| Malignant grow faster and invade normal tissue but both can be lethal due to confined space in the skull. |
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Term
| Primary v. Secondary Brain tumors |
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Definition
Primary - usually just one tumor
Secondary - Metastasis. usually multiple tumors. Much more common. |
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Term
| Most common type of brain tumor |
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Definition
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Term
| What is gliobastoma multiforme? |
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Definition
high grade (IV) astrocytoma
most aggressive form
most common in adults |
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Term
Where is the brain tumor?
Personality change
intellectual decline
symptoms appear after tumor is very large |
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Definition
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Term
Where is the brain tumor?
Seizures with olfactory or gustatory hallucinations
Deja vu or jamais vu |
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Definition
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Term
Where is the brain tumor?
sensory deficit
spontaneous pain sydnrome |
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Definition
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Term
Where is the brain tumor?
visual defects
visual agnosia (can't recognize what you're seeing) |
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Definition
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Term
Where is the brain tumor?
ataxia
nystagmus
cranial nerve palsies |
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Definition
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Term
Prolactiomas resulting in galactorrhea and hypogonadism
Cortisol excess resulting in cushings syndrome
What organ?
How would you treat? |
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Definition
pituitary
dopaminergic drugs |
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Term
| Some MIs present with ___ symptoms. In particular, women may present this way. |
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Definition
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Term
| Functional unit of the kidney |
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Definition
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Term
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Definition
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Term
| What are some factors signally renal disease? |
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Definition
proteinuria (>150 mg/day)
Elevated BUN and creatinine
low urine output
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Term
| ___ is most common cause of UTI |
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Definition
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Term
What diagnosis?
Irritative symptoms - urinary frequency, urgency, pain, cramping
Hematuria
fever (esp in kids) |
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Definition
| cystitis - bladder infection |
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Term
What diagnosis?
irritative symptoms - urinary frequency, urgency, pain, cramping
hematuria
fever
flank pain |
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Definition
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Term
| what is uremia? What is azotemia |
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Definition
chronic renal failure
progressive uremia = azotemia |
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Term
| how can renal osteodystrophy lead to secondary hyperparathyroidism? |
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Definition
Decreased GFR leads to low Ca which stimulates PTH secretion
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Term
| ___ is the most common cause of ESRD |
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Definition
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Term
| general prevention of ESRD |
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Definition
control HTN
tightly control glucose in diabetics
recognize and avoid drug toxicity
better treatment of acute renal failure |
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Term
What disease?
1 in 7 lifetime risk
second leading cuase of male deaths
symptom: pain, urinary obstruction |
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Definition
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Term
| Increased levels of ___ seen in prostatitis, BPH, and prostate cancer |
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Definition
| PSA - prostate specific antigen |
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Term
| What is the goal of endocrine treatment for prostate cancer? |
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Definition
| eliminate T and DHT effects |
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Term
| Risk factors for bladder cancer |
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Definition
Males:Females 3:1
smoking
exposure to industrial dyes/solvents |
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Term
| What is BCG (bacille calmette-guerin)? |
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Definition
| vaccine derived from weakened srain of mycobacterium bovis that is used as a general immune system stimulant... in particular, to treat bladder cancer |
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Term
2 main types of ___ cancer:
seminomas
non-seminomas (embryonal cells, teratoma, choriocarcinoma) |
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Definition
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Term
| ___ is the most common symptom of testicular cancer |
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Definition
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Term
hCG - humor chorionic gonadotropin
AFP - alpha-fetoprotein
LDH - lactate dehydrogenase
biochemical markers for? |
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Definition
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Term
| Take home point about testicular cancer prognosis? |
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Definition
| Even in stage III, long term survival rates are high (55-80%) |
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Term
| 30 y/o man with pos home pregnancy test? |
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Definition
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Term
| Inactivation of one gene allele early in development |
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Definition
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Term
| What is the purpose of the zoster vaccine? |
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Definition
Boost VZV memory T cell #'s
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Term
| Dad over 60, what is the baby at risk for? |
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Definition
| Autosomal dominant disorder |
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Term
| What kind of cells can undergo meiosis? |
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Definition
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Term
| Male to male inheritance is impossible for ___ & ___ |
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Definition
mitochondrial genes
sex-linked recessive |
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Term
ABO blood typing:
Antibodies against other blood types are Ig__
A has anti-__
B has anti-__
AB has what antibodies?
O has what antibodies?
What is the dominant allele? |
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Definition
IgM
A- anti-B
B- Anti-A
AB - no antibodies
O - antiA and antiB
A&B are codominant |
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Term
What blood type is universal donor?
What is universal recipient? |
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Definition
Donor - O-
Reciepient - AB+ |
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Term
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Definition
Mom is Rh- and baby is Rh+
Mom is exposed to baby's + blood, so mom's blood produces IgG anti-Rh antibodies and can infect a subsequent Rh- fetus |
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Term
Mom is A+, baby is O+
Can father by AB+? |
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Definition
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Term
| Mom is O+, baby is AB-... any worries? |
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Definition
| No. Would be worried if Mom is - and baby is + |
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Term
Pedigree:
1. No male-male transmission... must be?
2. Inbreeding... must be?
3. Disorder not seen in women of family. Skips a generation. |
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Definition
1. x linked
2. autosomal recessive
3. x linked recessive |
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Term
| Where do APCs, T cells, and B cells gather in response to a specific antigen? |
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Definition
| lymphoid tissues or spleen |
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Term
| Pt with a splenectomy is at higher risk for... ? |
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Definition
| septicemia bc the spleen takes care of pathogens in the circulating blood |
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Term
| Mix of 75% 46XY and 25% 47XY (trisomy 21) is an example of? |
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Definition
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Term
| A girl who had a liver transplant and then shows traits from her donors's (a boy's) blood is an example of ? |
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Definition
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Term
Which are AIDS defining illnesses?
Kaposi's sarcoma
CNS toxoplasmosis
Candida albicans vaginosus |
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Definition
just first two
candida is AIDS defining only if it's found in weird places (other than vag or mouth) |
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Term
| Woman has hemophilia. Husband doesn't. Risk of transmission? |
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Definition
All of her sons will have it
All of her daughters will be carriers
--> hemophilia is x linked recessive |
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Term
Robertsonian translocation -- chances that baby will:
be normal?
have trisomy?
have translocation? |
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Definition
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