Term
| Alpha cells of pancreas are responsible for what? |
|
Definition
|
|
Term
| Beta cells of the pancreas are responsible for what? |
|
Definition
|
|
Term
| What is the primary function of insulin? |
|
Definition
| move glucose to tissues for growth; decreases blood glucose levels |
|
|
Term
| Insulin secretion is simulated by what type of stimulation? |
|
Definition
|
|
Term
| What organ does not require insulin for glucose transport? |
|
Definition
|
|
Term
| What is the primary function of glucagon? |
|
Definition
| in liver to increase blood glucose; stimulates glycogenolysis; stimulated by hypoglycemia and SNS response |
|
|
Term
| What is the possible purpose of somatostatin? |
|
Definition
| regulating alpha and beta cell secretions |
|
|
Term
| Describe the diagnostic factors of diabetes mellitus |
|
Definition
| >1 fasting blood glucose >126 |
|
|
Term
| What are the 3 classic symptoms of hyperglycemia? |
|
Definition
| polyuria, polydipsia, polyphagia |
|
|
Term
| Hyperglycemia is a potent stimulant for ______ |
|
Definition
|
|
Term
| Describe Type 1 Diabetes Mellitus |
|
Definition
| insulin dependent diabetes mellitus, juvenile onset |
|
|
Term
| What are the two types of type 1 diabetes mellitus? |
|
Definition
| immune (immune destruction of beta cells from drugs chemicals or viruses); non-immune (idiopathic); type 2 sensitivities |
|
|
Term
| What are 3 results of beta cells destruction? |
|
Definition
| decreased progressing to absent insulin secretion, excess of glucagon, hyperglycemia |
|
|
Term
|
Definition
| glucose exceeds renal threshold and appears in urine; glucose pulls water to urine to be excreted |
|
|
Term
|
Definition
| water is attracted from body cells leading to intracellular dehydration |
|
|
Term
|
Definition
| depletion of cellular stores of nutrients leads to cellular starvation triggering hunger |
|
|
Term
| What are the 3 classic sign of diabetes in lamense terms? |
|
Definition
| pee a lot, thirsty and hungry |
|
|
Term
| How does stress reduction treat diabetes? |
|
Definition
| reduces cortisol secretion which causes hyperglycemia |
|
|
Term
| Describe type 2 diabetes mellitus |
|
Definition
| non insulin dependent; obesity is common characteristic; traditionally 40+; cellular resistance to insulin following yrs of hyperinsulinemia; can be controlled with diet and exercise |
|
|
Term
| Describe the clinical manifestations of type 2 diabetes |
|
Definition
| slow onset of recurrent infections, visual changes from abnormal water balance in eyes, parasthesias from neuropathies, genital pruritis, 3 Ps |
|
|
Term
| What are two meds for glucose control in type 2 diabetes? |
|
Definition
| oral hypoglycemic or insulin |
|
|
Term
| Describe the acute complications of diabetes mellitus |
|
Definition
| neurologic symptoms r/t decrease glucose to brain (headache, visual changes, confusion, lost concentration, tremors, seizures, death from insulin shock) |
|
|
Term
| What are the SNS symptoms of acute complications of diabetes? |
|
Definition
| tachycardia, pallor, diaphoresis, palpitations |
|
|
Term
| If a diabetic has a SNS response during sleep, what do you do? |
|
Definition
| wake them up and take blood glucose |
|
|
Term
| Describe the patho of DKA |
|
Definition
| develops with deficiency of insulin and increase in insulin counterregulatory hormones (cortisol, glucagon) |
|
|
Term
| What are the clinical manifestations of DKA? |
|
Definition
| 3 PS, fruity breath, metabolic acidosis, kussmaul respirations |
|
|
Term
|
Definition
| hyperosmolar hyperglycemic non ketonic diabetes; similar patho to dka but glucose >600; NOT in type I; 3 Ps and weight loss |
|
|
Term
| Describe diabetic neuropathies |
|
Definition
| hyperglycemia leads to atherosclerosis then ischemia to nerves r/t uncontrolled glucose; can effect internal organs and extremities |
|
|
Term
| Describe and give examples or visceral neuropathies |
|
Definition
| gastroparesis (delayed gastric emptying), neurogenic bladder (bladder paralysis with retention), Impotence (sexual dysfunction in males) |
|
|
Term
| What is a consequence of neuropathy? |
|
Definition
|
|
Term
| Gives examples of microvascular diseases from chronic complications of diabetes |
|
Definition
| diabetic retinopathy (leading cause of blindness/visual impairment), diabetic neuropathy (most common cause of end stage renal disease [ESRD]) |
|
|
Term
| Give examples of macrovascular disease from chronic diabetes |
|
Definition
| CAD (leading cause of MI and heart ischemia), CerebroVD (leading cause of CVA/stroke), PVD (leading cause of infection/gangrene/lower extremity amputation) |
|
|
Term
| Why are diabetics at increased risk for infection? |
|
Definition
| hypoxia, ischemia and decreased WBC from vascular disease; decreased sensory ability; pathogens multiply due to increased glucose |
|
|
Term
| Describe glycosylated hgb/Hgb A1C |
|
Definition
| increase in glycated hgb; Hgb A1c reflects blood sugar levels for past 2-3 months (high= high, low= more normal) |
|
|
Term
| What are the value ranges for Hgb A1c? |
|
Definition
Normal: <6.5
Excellent: 6.5-7.5
Good: 7.5-8.5
Fair: 8.5-9.5
Poor: >9.5 |
|
|
Term
|
Definition
| dysfunction that leads to inability of heart to properly perfuse tissues |
|
|
Term
| What are 4 mechanisms of heart failure? |
|
Definition
| altered contractility, altered ratio of O2 supply and demand, blood clot formation, atrial dysrhythmias |
|
|
Term
| What is left heart failure called? |
|
Definition
|
|
Term
| What is the name of right heart failure? |
|
Definition
|
|
Term
| What are the causes of L heart failure? |
|
Definition
| increased afterload/resistance, increased fluid volume, decreased function from ischemia/infarction |
|
|
Term
| Describe Frank Starling's law of the heart |
|
Definition
| low preload=low contractility, as preload increases contractility increases, increased preload past optimum results in decreasing contractility |
|
|
Term
| Systolic heart failure is ___ failure |
|
Definition
|
|
Term
| Diastolic heart failure is ____ failure |
|
Definition
|
|
Term
ID:
inability of heart to generate adequate CO to perfuse tissues |
|
Definition
|
|
Term
ID:
pulmonary congestion despite normal stroke volume and CO |
|
Definition
|
|
Term
| Describe backward failure of the heart |
|
Definition
| pulmonary edema and impaired gas exchange from increased hydrostatic back pressure; continued backpressure causes RVF |
|
|
Term
| What is cardiogenic shock? |
|
Definition
|
|
Term
| Describe forward heart failure |
|
Definition
| systolic failure-> less forward blood flow-> baroreceptors sense decreased pressure-> decrease renal perfusion->SNS->RAA stimulated |
|
|
Term
| What are the clinical manifestations of LVF? |
|
Definition
| pulmonary edema, crackles/rales, dyspnea, dry cough, hypotension, stress response |
|
|
Term
| What information can be provided by an echocardiogram? |
|
Definition
| ultrasound of the heart; valve status, ejection fraction: the lower it is the worse the heart failure (60-75 is normal) |
|
|
Term
| Describe natriuretic peptides |
|
Definition
| produced in response to heart chamber stretching; ANP= atrial, BNP=ventricular |
|
|
Term
| What hypoxic pulmonary disease can cause RHF? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Describe biventricular failure |
|
Definition
| typical LVF leading to RVF |
|
|
Term
| Describe high output failure |
|
Definition
| inability of heart to supply body with nutrients r/t anemia/hyperthyroidism with cardiac exhaustion+ |
|
|
Term
| Describe cardiogenic shock |
|
Definition
| impaired tissue perfusion caused by anaerobic metabolism leads to lactic acidosis |
|
|
Term
| What is a consequence of the trabeculated trait of the endocardium? |
|
Definition
| gives bacteria a place to hide |
|
|
Term
| What are the 4 cardiomyopathies? |
|
Definition
| ischemic cardiomyopathy, dilated, hypertophic (asymmetrical septal hypertrophy), restrictive |
|
|
Term
| What are the types and causes of valvular dysfunction? |
|
Definition
| stenosis (opening problem) and regurgitation (closing problem); rheumatic fever, infective endocarditis CAD and MI |
|
|
Term
| What are two risks of valvular dysfunction? |
|
Definition
| blood clot formation; atrial dysrhythmias |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Mitral valve prolapse syndrome; cusps of mitral valve prolapse into LA; causes mitral regurgitation; genetic (marfan's), hyperthyroidism? |
|
|
Term
| Describe rheumatic fever/heart disease |
|
Definition
| inflammatory disease caused by delayed immune reaction to GABHS; autoimmune; can cause scarring of endocardium/valves |
|
|
Term
| What is the classic clinical manifestation of acute rheumatic fever/heart disease? |
|
Definition
| polyarthritis (all synovial joints esp. large extremities) |
|
|
Term
| What are the major manifestations of jones criteria (acute rheumatic fever)? |
|
Definition
| carditis, polyarthritis and chorea |
|
|
Term
| What are the 3 critical elements of infective endocarditis |
|
Definition
| turbulent blood flow damage preps endocardium for colonization; endocardium is colonized; microorgs proliferate and promote endocardial vegetation |
|
|
Term
| What are the classic signs of infective endocarditis? |
|
Definition
| fever, new murmur, petechiae of skin, nails, mouth and conjunctiva |
|
|
Term
| What are the classic manifestations of embolic sequelae? |
|
Definition
| splinter hemorrhages, conjunctival petechiae, osler's nodes, janeways lesions |
|
|
Term
| Describe pericardial tamponade |
|
Definition
| large pericardial effusion; life threatening |
|
|
Term
| What is an important clinical manifestation of acute pericarditis? |
|
Definition
| pericardial friction rub; ischemia on ECG |
|
|
Term
| Transudate is evidence of what? |
|
Definition
|
|
Term
| Exudate is evidence of what? |
|
Definition
|
|
Term
|
Definition
| manifestation of pericardial effusion; hypotension, muffled heart sounds, JVD |
|
|
Term
|
Definition
| decreased BP on inspiration, increased BP on expiration |
|
|
Term
| Describe constrictive pericarditis |
|
Definition
| consequence of chronic pericarditis and SLE; adhesion of pericardial layers;gradual |
|
|
Term
| What are the RHF manifestations of constrictive pericarditis? |
|
Definition
| JVD, peripheral edema, hepatomegaly |
|
|
Term
|
Definition
| St Vitus Dance with CNS involvement from rheumatic fever |
|
|
Term
| What are the two possible causes of a urinary tract obstruction? |
|
Definition
| anatomic/mechanical and functional defect (peristalsis failure) |
|
|
Term
| What are the 4 effects of UT obstruction? |
|
Definition
| urine may accumulate behind obstruction; obstructed ureter= hydroureter; obstructed renal pelvis/calyces=hydronephrosis; obstructed urethra= cystitis (possible) |
|
|
Term
| What 4 possible substances can a kidney stone be made of? |
|
Definition
| calcium, struvite, uric acid and cystiene |
|
|
Term
| How can prolonged bed rest lead to kidney stones? |
|
Definition
| bed rest leads to demineralization of bone, hypercalciuria and stone formation |
|
|
Term
|
Definition
|
|
Term
| Describe the pain associated with kidney stones |
|
Definition
| colic pain (rhythmic) with nausea and vomitting |
|
|
Term
| What are some ways of treating kidney stones? |
|
Definition
| increase urine flow, decrease dietary cause, adjust pH (make acidic for Ca and alkaline for Uric acid), hydrate |
|
|
Term
| People who tend to be "stone formers" should drink what? |
|
Definition
|
|
Term
| Describe a functional urinary tract obstruction |
|
Definition
| neurogenic bladder: loss of control, motor paralysis, sensory paralysis |
|
|
Term
| What are the evaluations for a neurogenic bladder? |
|
Definition
| assessment for distension, loss of sensation of bladder fullness, decreased output compared to intake |
|
|
Term
| What is the most common UTI bacteria? |
|
Definition
|
|
Term
| What is the most common UTI? |
|
Definition
| cystitis: inflammation of the bladder |
|
|
Term
| What is the sign for UTI in elderly? |
|
Definition
|
|
Term
|
Definition
| infection of the renal pelvis and interstitium; tubules are primarily effected, renal inflammation and edema, leukocytosis with left shift |
|
|
Term
| Describe glomerulonephritis |
|
Definition
| inflammation of the glomerulus; associated with SLE, post strep, may scar and damage glomeruli |
|
|
Term
| What are the clinical manifestations of glomerulonephritis? |
|
Definition
| casts, proteinuria, salt and water retention, elevated creat |
|
|
Term
| Describe nephrotic syndrome |
|
Definition
| excretion of 3.5> gram of protein/day in urine; low albumin and edema |
|
|
Term
| What are 3 categories of cause of acute renal failure? |
|
Definition
| pre-renal, intrarenal (damage directly to nephrons), post-renal |
|
|
Term
| What are the most common causes of chronic renal failure? |
|
Definition
| diabetes and hypertension |
|
|
Term
| What is the functional unit of the kidney? |
|
Definition
|
|
Term
| What structure of the kidney helps in fluid, electrolyte and acid base balance? |
|
Definition
|
|
Term
| What is the purpose of the juxtaglomerular apparatus? |
|
Definition
| sensing status of blood to determine renin secretion |
|
|
Term
| What are the important functions of the nephron? |
|
Definition
| forms filtrate of protein free plasma, regulates fluid volume, pH range, ADH and water/sodium |
|
|
Term
| Why may protein end up in the urine? |
|
Definition
| inflammatory damage and increased capillary permeability |
|
|
Term
| What is the best indirect measure of renal function? |
|
Definition
|
|
Term
| What is the best measurement of patient hydration? (kidneys) |
|
Definition
|
|
Term
| Describe turbidity from a urinalysis |
|
Definition
| clarity; urine should be clear even if there is color to it |
|
|
Term
| Describe specific gravity from a urinalysis |
|
Definition
| concentration in comparison to water (1). The higher the number the more concentrated the urine is |
|
|
Term
| Why would ketones be present in the urine? |
|
Definition
| Fat; if patient has DKA (sugar and fat); not enough carbs for E, on starvation status |
|
|
Term
| What are some reasons blood may be in the urine? |
|
Definition
| inflammation, kidney stones, low platelets |
|
|
Term
| What could cause bilirubin to be in the blood? |
|
Definition
| issue with the liver, hemolytic anemia, gallstones |
|
|
Term
| Crystals in the blood indicate what? |
|
Definition
|
|
Term
| How much bacteria is permissible to be in the urine? |
|
Definition
|
|
Term
| When is there an increase in WBC in the urine? |
|
Definition
| UTI which causes nitrates to change to nitrites |
|
|
Term
| What developmental changes are there for the elderly regarding renal function? |
|
Definition
| decreased kidney size, renal blood flow, nephrons and GFR; Glomerular capillaries atrophy |
|
|
Term
| What does schizophrenia mean? Describe it |
|
Definition
| split mind; disorganization of personality in social function/distorted reality |
|
|
Term
| What are 3 symptoms of schizo? How long must the be present for diagnosis? |
|
Definition
| delusions, hallucinations, disorganized speech; 6 months |
|
|
Term
| What is the average age of onset of schizo? |
|
Definition
|
|
Term
| What is the estimated cost of schizo annually? |
|
Definition
|
|
Term
| What is the chance that one seperate twin will develop schizo if the other has it? |
|
Definition
|
|
Term
| What is the most common side effect of many psych meds? |
|
Definition
|
|
Term
| What are the 4 phases of schizo? |
|
Definition
| premorbid, prodromal, schizo, residual |
|
|
Term
| What are the 5 divisions of schizo? |
|
Definition
| paranoid, disorganized, catatonic, residual, undifferentiated |
|
|
Term
| What type of schizo has the best prognosis? |
|
Definition
|
|
Term
| What type of schizo has blunt affect as a symptom? |
|
Definition
|
|
Term
| What are the positive symptoms of schizo? |
|
Definition
| delusions, hallucinations, magical thinking, paranoia |
|
|
Term
| What are the negative symptoms of schizo? |
|
Definition
| flat or blunted affect, apathy, anhedonia, autism |
|
|
Term
| During auditory hallucination there is an increase in activity in what part of the brain? |
|
Definition
|
|
Term
|
Definition
| repeating what is said to the person or by the person |
|
|
Term
| What are two common assessment tools for schizo and psychotic disorders? |
|
Definition
| Abnormal involuntary movement scale (AIMS) and global assessment of functioning scale (GAF)- 1-100 |
|
|
Term
| What was a monumental treatment for schizo and psych disorders? |
|
Definition
|
|
Term
| What is an important EPS? |
|
Definition
|
|
Term
|
Definition
| kidnets cannot remove waste from blood leading to altered fluid, electrolyte and acid base balance |
|
|
Term
| Define azotemia; What term is it interchangeable with? |
|
Definition
| high levels of urea, creat., and other waste products in blood; uremia |
|
|
Term
|
Definition
| Acute Renal Failure; sudden onset but reversible, increase in plasma BUN and creat |
|
|
Term
| What are the 5 high risk groups for ARF? |
|
Definition
| elderly,dehydrated, hypotensive, critically ill, surgical patients |
|
|
Term
|
Definition
| scanty urine; <30mL output/hour |
|
|
Term
ID type of ARF:
imparied renal blood flow (reduced perfusion), GFR declines from decrease in filtration pressure; most common cause |
|
Definition
|
|
Term
| If prerenal ARF is not corrected what does it lead to? |
|
Definition
|
|
Term
ID type of ARF:
ATN, acute glomerulonephritis, vascular disease (malignant hypertension), toxic injury |
|
Definition
|
|
Term
| Give 2 examples of toxic injury |
|
Definition
| nephrotoxic (from meds/drugs) and free hgb with hemmolysis |
|
|
Term
ID type of ARF:
Occurs with UT obstructions that affect kidneys and increase upstream pressure |
|
Definition
|
|
Term
| What are 3 things that cause postrenal arf? |
|
Definition
| prostatic hypertrophy, bladder outlet obstruction, bilateral ureteral obstruction |
|
|
Term
| What are the 4 phases of ARF and then end result if untreated? |
|
Definition
| initiation, oliguria, diuresis, recovery; CRF and ESRD |
|
|
Term
| What are the effects of oliguria? |
|
Definition
| high bun, creat., potassium; metabolic acidosis, volume overload, uremic symptoms |
|
|
Term
| What are the uremic symptoms? |
|
Definition
| anorexia, nausea, vomiting, fatigue, muscle jerks, uremic pericarditis, |
|
|
Term
| What are the 3 signs of uremic pericarditis? |
|
Definition
| chest pain, pericardial friction rub, pericardial tamponade |
|
|
Term
|
Definition
| gradual urine output increase and GFR recovers; watch for dehydration |
|
|
Term
| What are the causes of CRF? |
|
Definition
| diabetic neuropathy, hypertension, glomerulonephritis, polycystic kidneys, SLE, BPH |
|
|
Term
| What are the classifications of decreased renal function? |
|
Definition
reduced renal reserve= GFR 50%
Renal insufficiency= GFR 25%
Renal failure= GFR <20% |
|
|
Term
| What are the signs of renal insufficiency? |
|
Definition
| increased BUN and creat, mild anemia, mild uremia |
|
|
Term
| What stage of CRF is marked by oliguria, metabolic acidosis and severe anemia? |
|
Definition
|
|
Term
|
Definition
| waste products crystalize on skin |
|
|
Term
| Describe what happens in liver dysfunction (chart) |
|
Definition
| increase in liver enzymes, bilirubin and coag measures; decrease in proteins/albumin |
|
|
Term
| What helps fix coag meas. issues? |
|
Definition
|
|
Term
|
Definition
| indirect=unprocessed=pre-liver |
|
|
Term
|
Definition
|
|
Term
| What is the most common cause of extrinsic mechanical obstruction in dysphagia? |
|
Definition
|
|
Term
|
Definition
| functional dysphasia; decreased muscle function in esophagus; food accumulates in boggy tissue |
|
|
Term
| Describe the clinical manifestations of dysphagia |
|
Definition
| stabbing pain, difficulty swallowing, regurgitation, vomiting, weight loss, aspiration->pneumonia |
|
|
Term
|
Definition
| gastroesophageal reflux disease; inflammatory response to reflux |
|
|
Term
| How does delayed gastric emptying contribute to GERD? |
|
Definition
| lengthens time of reflux and increases acid content of chyme |
|
|
Term
| How does the presence of a hiatal hernia contribute to GERD? |
|
Definition
| weakens lower esophageal Sphincter (LES) |
|
|
Term
| What are 2 important clinical manifestations of GERD? |
|
Definition
| heartburn and regurgitation of chyme; upper abdomen pain within 1 hr of eating "chest pain" |
|
|
Term
|
Definition
| protrusion of upper stomach through diaphragm and into thorax leading to GERD, dysphagia, heartburn and epigastric pain |
|
|
Term
| Define pyloric obstruction |
|
Definition
| narrowing of opening between stomach and duodenum; n/v with food but no bile |
|
|
Term
| What is the term ileus used for? |
|
Definition
| functional obstruction of the intestines |
|
|
Term
| What accounts for 60% of small bowel obstructions? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Describe the pathology of mechanical intestinal obstruction |
|
Definition
| inflammation causes bowel edema, large amounts of fluid gather in bowel-> hypovolemia/shock, electrolyte deficiencies |
|
|
Term
| What are the clinical manifestations of mechanical intestinal obstruction vs. functional? |
|
Definition
| early borborygmi, high tinkling bowel sounds then hypoactive, visual peristalsis; hypoactive bowel sounds |
|
|
Term
| What is the treatment for intestinal obstruction? |
|
Definition
|
|
Term
| What are the clinical manifestations of mechanical bowel obstruction? |
|
Definition
| hypovolemia leading to shock, strangulation->gangrene and sepsis, multiple organ system failure |
|
|
Term
| What is the major cause of type B chronic gastritis? |
|
Definition
| helicobactor pylori (eats protective mucus) |
|
|
Term
| What is the result of chronic gastritis and who does it effect? |
|
Definition
| thinning of stomach wall; elderly |
|
|
Term
| What are factors that increase gastric acid production? |
|
Definition
| increase parietal cells, increase sensitivity to food , vagal stimulation, decreased inhibition of HCl |
|
|
Term
| What are factors that impair mucosal barrier protection? |
|
Definition
| ischemia, prostaglandin inhibition by NSAIDS, H. pylori |
|
|
Term
| What is an important clinical manifestation of gastritis? |
|
Definition
| eating followed by pain pattern |
|
|
Term
| What is the most common type of PUD? |
|
Definition
|
|
Term
| What are the clinical manifestations of PUD? |
|
Definition
| gnawing chest pain while stomach is empty or at night; relieved by antacids |
|
|
Term
| What are the two types of ischemic stress ulcers? |
|
Definition
| curling's ulcer r/t burn injury; cushing's ulcer r/t head injury or brain surgery |
|
|
Term
| What are two conditions that cause impaired absorption by intestinal mucosa? |
|
Definition
|
|
Term
| What are 5 diseases that cause impaired digestive processes? |
|
Definition
| chronic pancreatitis, pancreatic cancer, CF, biliary obstruction, liver disease |
|
|
Term
| What are 4 local clinical manifestations of maldigestion and malabsorption? |
|
Definition
| diarrhea, abdominal distension, cramping, steatorrhea |
|
|
Term
| Define IBS and give two examples |
|
Definition
| diseases with malabsorption as a feature; ulcerative colitis and crohn's disease |
|
|
Term
| Describe ulcerative colitis |
|
Definition
| chronic inflammatory disease that causes ulceration of colon mucosa (rectum and sigmoid) |
|
|
Term
| Describe a primary lesion in ulcerative colitis |
|
Definition
| inflammation at base of crypt of lieberkuhn in large intestine |
|
|
Term
| Describe the clinical manifestations and prognosis for ulcerative colitis |
|
Definition
| frequent diarrhea (10-20x/day) with blood and mucus; increased colon cancer risk |
|
|
Term
| Describe the pathology and clinical manifestations of crohn disease |
|
Definition
| inflammatory disease of small and large (ascending and transverse) intestine; rectum rarely involved; nonbloody diarrhea |
|
|
Term
| What is the most common cause of peritonitis? |
|
Definition
| bacteria, normal bowel flora |
|
|
Term
|
Definition
| produced by anterior pituitary; stimulated by CRH from hypothalmus |
|
|
Term
| Describe glucocoticoid hormaones |
|
Definition
| cortisol is most potent type; effects carb metabolism, awareness and sleep habits |
|
|
Term
| Describe minerlocorticoid hormones |
|
Definition
| aldosterone is most potent type; affect ion transport |
|
|
Term
| What part of the body is responsible for adrenal estrogens and androgens? |
|
Definition
|
|
Term
| What is the purpose of the chromaffin cells and where are they located? |
|
Definition
| secrete majority of epi and nor epi; adrenal medulla |
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|
Term
| Describe primary hypersecretion |
|
Definition
| gland cause; adrenal initiated hypersecretion |
|
|
Term
| Describe secondary hypersecretion |
|
Definition
| pituitary caused; anterior pituitary initiated hypersecretion |
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Term
| Describe exogenous administration of hypersecretion |
|
Definition
| taking corticosteroid meds |
|
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Term
| Describe ectopic hypersecretion |
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Definition
|
|
Term
| Chronically taking corticosteroids with lead to what? |
|
Definition
|
|
Term
| What is the difference between cushing disease and cushig syndrome? |
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Definition
| disease is from excessive pituitary secretion of ACTH; syndrome is excessive level of cortisol regardless of cause |
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|
Term
| What are some effects of hypersecretion of adrenal cortex? |
|
Definition
| friable skin, increased fat deposition, hypertension, hypocalcemia |
|
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Term
| What are some effects of hypersecretion of adrenal glands? |
|
Definition
| virilization and feminization |
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Term
| Regardless of cause of cushing's, you need to worry about the ____ for fear of ____ |
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Definition
|
|
Term
| Those with cushing's need ___ therapy |
|
Definition
|
|
Term
| Describe hyperaldosteronism |
|
Definition
| primary (conn disease), hypertension, hypokalemia, metabolic alkalosis, accelerated atherosclerosis |
|
|
Term
| Describe adrenocortical hypofunction |
|
Definition
| primary=addison disease; secondary =pituitary hypofunction |
|
|
Term
| ACTH exces leads to _____ |
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Definition
|
|
Term
| What are the clinical manifestations of Adrenocortical hypofunction? |
|
Definition
| weakness, easily tired, GI disturbances hypoglycemia, vitiligo |
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|
Term
| Describe adrenal medulla hyper function |
|
Definition
| caused by tumors from chromaffin cells; pheochromocytomas; secrete catecholamines continuously or by episode |
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|
Term
| Describe colorectal cancer |
|
Definition
| 2nd most common COD in US; Tends to occur in 50+, high SES, diet and lifestyle |
|
|
Term
| What are the 3 risk factors for colorectal cancer? |
|
Definition
| genetics, diet (high fat, low fiber, low Ca), and Chronic constipation |
|
|
Term
| Most colorectal cancers develop from ____ ____ |
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Definition
|
|
Term
| Describe the progression of colorectal cancer |
|
Definition
| slow multistep process with long in-situ phase; liver metastasis is common |
|
|
Term
| What are 5 conditions often confused with colorectal cancer? |
|
Definition
| diverticulitis, chronic UC, crohn's disease, appendicitis, thrombosed hemmorhoids |
|
|
Term
| What is an early sign of colorectal cancer? |
|
Definition
|
|
Term
| What are 3 late signs of colorectal cancer? |
|
Definition
| anemia, bowel obstruction, liver metastasis |
|
|
Term
| Describe Dukes classification for colorectal cancer |
|
Definition
A: Cancer limited to bowel wall
B: Cancer extending through the bowel wall
C: Nodal Mets regardless of extension into bowel wall
D: Distant Mets regardless of primary site |
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|
Term
| What is a common treatment for colorectal cancer? |
|
Definition
| colon resection (anastomoses and colostomy) |
|
|
Term
| What are the 3 incompressable components of the cranium? |
|
Definition
| CSF, blood and brain tissue |
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|
Term
| Describe the monro kellie doctrine |
|
Definition
| increase in any of the 3 incompressable elements of the brain must be balanced by either or both remaining elements; if not ICP increases |
|
|
Term
| What is the most readily displaceable element of cerebral fluid? |
|
Definition
| CSF; cerebral blood volume is next |
|
|
Term
| What is the purpose of the jugular veins? |
|
Definition
|
|
Term
| What is increased ICP usually caused by? |
|
Definition
| increase in intracranial blood volume |
|
|
Term
| Describe stage 1 increased ICP |
|
Definition
| displacement of CSF from cranium to spinal column attempt to decrease ICP; compensatory: asymptomatic |
|
|
Term
| Describe stage 2 increased ICP |
|
Definition
| expansion of cranial contents exceeds compensatory abilities; altered LOC, normal vitals |
|
|
Term
| Describe stage 3 increased ICP |
|
Definition
| ICP approaches MAP and brain tissue becomes hypoxic; CPP drops; decreased LOC, sluggish pupils, cushing's triad (late) |
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|
Term
|
Definition
| MAP-ICP; determines cerebral blood flow; injured brain needs CPP>70; increase ICP decreases CPP; normal range 60-100 |
|
|
Term
| What is the widening of pulse pressure? |
|
Definition
|
|
Term
| Describe stage 4 increased ICP |
|
Definition
| brain tissue herniates from high pressure area to low pressure area, hemorrhage, obstructive hydrocephalus; coma, aniscoria |
|
|
Term
| What is the most potent cerebral vasodilator? |
|
Definition
|
|
Term
| What are 3 ways of treating someone with increased ICP? |
|
Definition
| decrease blood volume (diuretic), minimize CSF (diuretic), decrease brain tissue (surgery, diuretic) |
|
|
Term
|
Definition
|
|
Term
| Describe communicating hydrocephalus |
|
Definition
| CSF not effectively reabsorbed; caused by subarachnnoid hemorrhage; caused by platelets and clotting factors clogging system |
|
|
Term
| Describe noncommunicating hydrocephalus |
|
Definition
| CSF drainage from ventricular system impaired; caused by obstructions (tumor, inflammation) |
|
|
Term
| What is a classic sign of hydrocephalus? |
|
Definition
|
|
Term
| What type of shunt for hydrocephalus is at risk for peritonitis? |
|
Definition
| Ventricular peritoneal (VP) |
|
|
Term
| What are some clinical manifestations of meningitis? |
|
Definition
| positive brudzinski and kernig's signs, opisthotonus, nucchal rigidity |
|
|
Term
|
Definition
| clear, odorless, protein:15-45, glucose, few or no WBC and RBC |
|
|
Term
| What is the relationship between CSF glucose and blood glucose? |
|
Definition
|
|
Term
| What is the purpose of a lumbar puncture and what info does it give? |
|
Definition
| rule out meningitis; fever, meningeal signs, mental status changes |
|
|
Term
| Describe the 2 types of CVA |
|
Definition
| thromboembolic (TIA less than 24 hrs); Hemorrhagic (hypertension and ruptured aneurysms) |
|
|
Term
| TIA is an early sign of what? |
|
Definition
|
|
Term
| What is the FAST acronym for? |
|
Definition
| Face Arms Speech Time; brain attacks |
|
|
Term
| TIA is to ___ as ____ is to an MI |
|
Definition
|
|
Term
| What are the warning signs of an intracranial aneurysm? |
|
Definition
| sudden severe headache (thunderclap headache); meningeal signs, bloody CSF with subarachnoid bleed |
|
|
Term
| What is the main symptom of subarachnoid hemorrhage? |
|
Definition
| severe sudden headache after a pop or snap feeling in the head, bloody CFS, meningeal signs |
|
|
Term
| What is the name for intracerebral brain tumors? |
|
Definition
|
|
Term
| Describe encapsulated gliomas |
|
Definition
| noninvasive, displace and compress CNS tissue cause ischemia and impaired neuro function |
|
|
Term
| Describe nonencapsulated gliomas |
|
Definition
| invasive, destroys normal CNS tissue; |
|
|
Term
| What is the most common primary CNS tumor? Describe it |
|
Definition
| astrocytoma; astrocytes that have lost normal growth restraint and proliferate |
|
|
Term
| Describe I and II grade astrocytomas |
|
Definition
| well differentiated, slow growing, infiltrative, cause headaches early on |
|
|
Term
| Describe grade 3 and 4 astrocytomas |
|
Definition
| poorly differentiated; mostly in frontal and temporal lobes, 4 has areas of necrosis; focal signs (hemoparesis, dysphagia) |
|
|
Term
| What are 3 important clinical manifestations of brain tumors? |
|
Definition
| headache, seizure and increased ICP |
|
|
Term
| Describe oligodendrocytoma |
|
Definition
| slow gorwing well diffrentiated, focal/generalized seizure comes first; increased ICP |
|
|
Term
|
Definition
| gliomas from ependymal cells from walls of ventricles; obstructive hydrocephalus is common, non-encapsulated |
|
|
Term
| What are the clinical manifestations of ependymoma? |
|
Definition
| difficulty with balance and fine motor skills |
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