Term
|
Definition
TP/TP+FN
Test w/ 100% sensitivity excludes a disease if a negative test results |
|
|
Term
| Negative Predictive Value (NPV) |
|
Definition
TN/TN+FN
Probability that a perosn who tests negative DOESN'T have the disease |
|
|
Term
|
Definition
TN/TN+FP
Tests w/ 100% specificity confirms a disease is present if a postitive test results |
|
|
Term
| Positive Predictive Value (PPV) |
|
Definition
TP/TP+FP
Probability that a person who tests positve for a disease HAS the disease |
|
|
Term
| Will a test with high sensitivity increase the incidence or prevalence of a disease? |
|
Definition
| Prevalence; it is highly sensitive so it will increase the diagnoses of that disease which will increase prevalence |
|
|
Term
| How will increasing the upper limit of normal of a test reference interval affect the sensitivity, specificity, PPV, and NPV? |
|
Definition
| It will increase the specificity and PPV and decrease the sensitivity and NPV |
|
|
Term
| How will decreasing the upper limit of normal of a test reference interval affect the sensitivity, specificity, PPV, and NPV? |
|
Definition
| It will decrease the specificity and PPV and increase the sensitivity and NPV |
|
|
Term
Prevalence
Incidence
Duration |
|
Definition
Prevalance = Incidence x Duration
As duration deceases, prevalence decreases; as duration increases, prevalence increases; incidence will not change |
|
|
Term
| Name 4 things that are elevated NORMALLY in pregancy. |
|
Definition
| Greater increase in plasma volume than RBC mass; Alk phos; Resp alkalosis; T4 and cortisol |
|
|
Term
| What is the main laboratory difference in adult men and women? |
|
Definition
| Iron studies will all be lower in women; Hgb concentration will also be lower in women |
|
|
Term
| What two things are elevated in labs studies of children compared to adults? What would be lower? |
|
Definition
| Alk phos and serum phosphate (indicative of rapid bone growth); Hgb |
|
|
Term
| What is the cause of high hemoglobin values in newborns? |
|
Definition
| HgbF; stimulates erythropoetin production; protects newborns w/ sickle cell disease |
|
|
Term
| What direction will the Oxygen Dissociation Curve be shifted as a result of high HgbF? |
|
Definition
| Left - causes tissue hypoxia |
|
|
Term
| What drug is given for sickle cell crisis and what is its MOA? |
|
Definition
| Hydroxurea; raises HgbF to prevent sickling |
|
|
Term
| What drugs elevate the cytochrome system in liver SER? |
|
Definition
| Alcohol, barbiturates, rifampin, phenytoin |
|
|
Term
| What drugs inhibit the cytochrome system in liver SER? |
|
Definition
| H2 blockers, proton blockers |
|
|
Term
| What is a laboratory value is good indication of a disease process occuring in older pts? |
|
Definition
| Erythrocyte Sedimentation rate (ESR) |
|
|
Term
| What are the 5 laboratory test alterations common in smokers? |
|
Definition
| Respiratory acidosis, hypoxemia (low PaO2), increase carbon monoxide levels, secondary polycythemia, absolute neutrophilic leukocytosis |
|
|
Term
| What two indicators would be increased in a blood sample that are directly resulting from the venipuncture which could be confused with other pathologic sources? |
|
Definition
|
|
Term
| What two lipid indicators require that the pt fast before testing their levels in the blood? |
|
Definition
| Triglycerides and LDL because they are affected by diet-derived chylomicrons after eating |
|
|
Term
| What two lipid indicators DO NOT require the pt to fast before testing their levels in the blood? |
|
Definition
|
|
Term
| What are 6 laboratory findings in alcoholics? |
|
Definition
1. Increase cytochrome p-450 system = increase GGT production
2. Increase production of NADH
3. Increase in ketoacid synthesis = acetyl CoA will eventually be converted to B hydroxybutyrid acid
4. Increase fatty acid synthesis
5. Hyperuricemia
6. Increased anion gap metabolic acidosis |
|
|
Term
| What causes an increase in turbidity of plasma/serum? |
|
Definition
| Triglycerides; not cholesterol |
|
|
Term
| What proportion of chylomicrons and VLDL does triglyceride make up? |
|
Definition
| 85% of chylomicrons and 55% of VLDL |
|
|
Term
| Which component of blood forms a supranate? |
|
Definition
|
|
Term
| Which component of blood forms an infranate? |
|
Definition
|
|
Term
| When you have increased turbidity in the serum, what will be the result on measured enzymes and sodium levels? |
|
Definition
| Increased turbidity interferes with measurement and you will get a falsely LOW measuremment of enzymes and sodium (pseudohyponatremia) |
|
|
Term
| What percent of total calcium in blood is bound to albumin? |
|
Definition
|
|
Term
| What will be the effect on calcium when there is low serum albumin? |
|
Definition
| Hypocalcemia; but there will not be any tetany present because the level of ionized calcium is normal; PTH will also be normal |
|
|
Term
How many Barr bodies does a normal female cell have?
How many Barr bodies does a normal male cell have?
How many Barr bodies does a male w/ Klinefelter's syndrome have?
How many Barr bodies does a female w/ Turner's syndrome have? |
|
Definition
|
|
Term
| What is the genetic defect in Cystic Fibrosis? |
|
Definition
| Deletion of three-nucleotide codon for phenylalanine on Chromosome 7 = CF transmembrane regulator is defective leading to dysfunctional chloride channel |
|
|
Term
| What is the genetic defect in Tay Sach's disease? |
|
Definition
| Four base insertion producing a frameshift mutation that codes for a defective hexosaminidase |
|
|
Term
| What is the genetic defect in sickle-cell disease and sickle-cell trait? |
|
Definition
Sickle-cell disease = point mutation on both genes (chromosomes) involving thymidine replaced by adenine which codes for valine instead on glutamic acid at 6th position of B-globin chain
Sickle-cell trait = point mutation on one gene(chromosome) |
|
|
Term
| What is the gentic defect in B-thalassemia major? |
|
Definition
| Point mutation that produces a STOP codon leading to termination of DNA transcription of B-globin chain |
|
|
Term
| What is the common genetic defect in Huntington's disease, fragile X syndrome, Friedreich's ataxia, and myotonic dystrophy? |
|
Definition
| Trinucleotide repeats; repeats increase in successive generations |
|
|
Term
|
Definition
| Due to unequal separation of chromosomes in phase 1 of meiosis; cause of the majority of chromosome number defects (trisomy 21, Turner's syndrome) |
|
|
Term
|
Definition
| Nondisjunction of chromosome in mitotic division early in embryonic period; two chromosomally different cell lines are derived from a single fertilized egg |
|
|
Term
|
Definition
| One part of a chromosome is transferred to a non-homologous or homologous chromosome; called a balanced translocation if the translocated fragment is functional |
|
|
Term
| What is the mechanism that results in Down's Syndrome in a 46 chromosome individual? |
|
Definition
| Robertsonian translocation = translocation or nondisjunction of fragment chromosome 21 to another chromosome (usually 14) in the mother or father that results in three functional chromosome 21s in the child (2 normal chromosome 21s and 1 functional fragment of 21 on 14) |
|
|
Term
| What is the genetic defect in Cri-du-chat syndrome? |
|
Definition
| Deletion of short arm of chromosome 5; mental retardation, cry like a cat |
|
|
Term
| What is the mechanism of the genetic disorder leading to Prader-Willi syndrome? |
|
Definition
| Microdeletion of fragment on chromosome 15 of PATERNAL origin; results in obesity, hypogonadism, and mental retardation |
|
|
Term
| What is the mechanism of the genetic disorder that leads to "happy puppy" syndrome? |
|
Definition
| Microdeletion of small fragment of chromosome 15 of MATERNAL origin; results in child who is alays laughing and happy but can't speak |
|
|
Term
| What is the risk of recurrence in genetic disorders? |
|
Definition
| Mendelian disorders have the greatest risk of recurrence, AR defects have a 25% chance of recurrence |
|
|
Term
| What are the most common genetic disorders in African Americans? |
|
Definition
1. Sickle-dell disease/trait (8-10% prevalence)
2. a/B thalassemia
3. G6PD deficiency
4. persistence of HgbF (protects from sickle-cell) |
|
|
Term
| What are the most common genetic disorders in Ashkenazi Jews? |
|
Definition
1. Factor XII deficiency
2. Gaucher's disease (deficiency of enzyme glucocerebrosidase)
3. Tay-Sachs disease |
|
|
Term
| What are the most common genetic disorders of Northern Europeans? |
|
Definition
|
|
Term
| What are the most common genetic disorders of Southeast Asian? |
|
Definition
|
|
Term
| What are the most common genetic disorders of Mediterranean people? |
|
Definition
1. G6PD deficiency
2. Sickle-cell trait/disease
3. B-thalassemia |
|
|
Term
| What is the pathogensis of Down syndrome? |
|
Definition
| Trisomy 21; 47 chromosomes w/ extra coming from maternal origin; 46 chromosomes - Robertsonian translocation: mother has 45 chrmosomes but 2 functional chromsome 21s |
|
|
Term
| What are the clinical findings of Down's syndrome? |
|
Definition
| Epicanthal folds w/ upward slanting; simian palm crease; poor reflexes, hypotonicity; endocardial cushion defects (major determining factor for survival in infancy and early childhood); duodenal atresia; Hirschsprung's disease; increased incidence of leukemia; Alzheimer's; sterility (females have 50% chance, males 0%) |
|
|
Term
| What is the risk of having children w/ Down's syndrome? |
|
Definition
| 1-2% overall risk; maternal age>35 increases risk; 5-15% risk for parents w/ balanced translocation; karyotype affected child to determine risk of siblings having affected children |
|
|
Term
| What is the genetic defect in Edward's syndrome? |
|
Definition
| Trisomy 18; severe mental retardation, clenched hands w/ overlapping 2nd & 5th digits, rocker bottom feet |
|
|
Term
| What is the genetic defect in Patau's syndrome? |
|
Definition
| Trisomy 13; cleft lip/palate, severe mental retardation, polydactyly, cystic kidneys |
|
|
Term
| What are the Mendelian disorders in descending order of frequency? |
|
Definition
| Autosomal dominant (AD), autosomal recessive (AR), sex-linked recessive (SXR), sex-linked dominant (SXD) |
|
|
Term
| What is the method of inheritance of autosomal dominant traits? |
|
Definition
| Only one abnormal gene is required to express trait; only one parent has to have the gene to pass it on to their children; when one affected parent mates with a normal parent - 50% affected children and 50% normal children |
|
|
Term
| What is the method of inheritance of autosomal recessive traits? |
|
Definition
| Both abnormal genes have to be present to express trait; both parents must have the gene to pass it on to their children; when two asymptomatic carriers of the gene mate, they have 25% chance of normal children, 50% chance of asymptomatic carrier children, and 25% chance of affected children; when an asymptomatic carrier parent mates with an affect parent, they have a 50% chance of asymptomatic carrier children and 50% chance of affected children |
|
|
Term
| What is the method of inheritance and expression in sex-linked recessive traits? |
|
Definition
| Only males with abnormal gene express the trait, males are homozygous because they only have one X chromosome; an affected male will transmit the gene to all daughters but none of their sons; the daughters will usually be asymptomatic carriers; if an affected male and asymptomatic female mate they will have 50% chance of affected boys, 25% chance of asymptomatic girl, 25% chance of affected girl |
|
|
Term
| What is the method of inheritance of sex-linked dominant traits? |
|
Definition
| Male children and homozygous female children will express trait |
|
|
Term
| What AD disorders are enzyme deficiencies? |
|
Definition
Acute intermittent porphyria (deficiency of uroporphyrinogen synthase)
Hereditary angioedema (C1 esterase inhibitor deficiency) |
|
|
Term
| What are some examples of AD disorders in order of decreasing frequency? |
|
Definition
von Wiilebrand's disease
familial hypercholesterolemia, APKD, hypertrophic cardiomyopathy
Huntington's disease
Neurofibromatosis
Congenital spherocytosis
Famillial polyposis
Acute intermittent porphyria
Osetogenesis imperfecta
Marfan's syndrome |
|
|
Term
| What are three characteristics of most AD disorders? |
|
Definition
Late manifestations (Huntington's disease)
Penetrance (complete or incomplete)
Variable expressivity (affected people have different levels of severity) |
|
|
Term
| What type of deficiencies are most AR disorders? |
|
Definition
| Enzyme deficiencies - inborn errors of metabolism |
|
|
Term
| What are some examples of AR disorders that aren't enzyme deficiencies? |
|
Definition
| CF, sickle cell trait/disease, hemochromatosis, Wilson's disease |
|
|
Term
| What are the SXR disorders in order of decreasing frequency? |
|
Definition
1. Fragile X syndrome
2. G6PD deficiency
3. Duchene's muscular dystrophy
4. Hemophilia A/B
5. SCID
6. Wiskott-Aldrich syndrome
7. Testicular feminization
8. Color blindness
9. Chronic granulomatous disease of childhood
10. Bruton's agammaglobulinemia |
|
|
Term
| What is the most common genetic syndrome linked w/ increased maternal age? |
|
Definition
|
|
Term
| Which SXR disorder affects 30% of female carriers, presumably based on the concept of anticipation? |
|
Definition
|
|
Term
| What are the clinical findings in Fragile X syndrome? |
|
Definition
| Mental retardation, macroorchidism at puberty |
|
|
Term
| What is the disorder and the method of inheritance of Lesch Nyhan syndrome? |
|
Definition
| SXR; HGPRT deficiency = no inhibition of PPrP in purine metabolism --> hyperuricemia, mental retardation, self mutilation |
|
|
Term
| What is the pattern of inheritance of SXD disorders? |
|
Definition
| Affected mothers transmit the disorder to 50% of their sons and 50% of their daughters. Affected fathers transmit the disorder to all of their daughters and none of their sons. |
|
|
Term
| What are some examples of SXD disorders? |
|
Definition
1. Familial hypophosphatemia - defect in the proximal reabsoprtion of phosphate and conversion of 25(OH)D3 to 1,25(OH)2D3
2. Alport syndrome - hereditary glomerulonephritis associated with nerve deafness |
|
|
Term
| Cleft lip/palate, congenital heart disease, coronary artery disease, gout, type II DM, essential hypertension, open neural defects, and congenital pyloric stenosis are examples of what type of inherited disorders? |
|
Definition
| Multifactorial (polygenic) inheritance - several small mutations plus the effect of environment |
|
|
Term
| What is the method of inheritance of mitochondrial DNA disorders? |
|
Definition
| mtDNA codes for enzymes in mitochondrial oxidative phosphorylation reactions; ova contain mitochondria while sperm don't, therefore, affected women transfer their abnormal genes to all their children |
|
|
Term
| What are some examples of mitochondrial DNA disorders? |
|
Definition
1. Leber's hereditary optic neuropathy
2. Myoclonic epilepsy
3. Lactic acid w/ stroke |
|
|
Term
| How do you calculate the prevelance of a genetic disease when given the carrier rate? |
|
Definition
Multiply the carrier rate in males times the carrier rate in females and then multiply times the risk of having a child with the gentic combination that will result in the disease.
Example: Cystic fibrosis- risk for male carriers = 1/25, risk for female carriers = 1/25, risk of having CF (AR)from carrier parents = 1/4 , so the prevalence = 1/25 x 1/25 x 1/4 = 1/2500 |
|
|
Term
| How do you calculate the carrier rate of a genetic disease when given the prevalance? |
|
Definition
Divide the prevalence by the risk of having the gentic combination resulting in that disease, then take the square root of what you have which is the number of couples at risk.
Example: Cystic fibrosis- prevalence = 1/2500, number of couples at risk = (1/2500)/(1/4) = 1/625, the carrier rate = sq rt 1/625 = 1/25 |
|
|
Term
|
Definition
| Anatomical defect resulting from mecahnical (extrinsic) factors that usually occurs in the last two trimesters after organs have developed. Example: Potter's facies- limb and facial abnormalitities resulting from oligohydramnios |
|
|
Term
|
Definition
A disturbance in the development of an organ, usually by drugs or infection.
Examples: hypospadias = faulty closure of urethral folds; epispadias = defect in genital tubercle; club foot; ventricular septal defect |
|
|
Term
| When are most teratogens most detrimental? |
|
Definition
| Embryonic period - first 9 weeks of pregnancy |
|
|
Term
| When does the neural tube close? |
|
Definition
|
|
Term
| What are some methods of teratogenic effects? |
|
Definition
| Interference w/ mitotic spindles; interference w/ ATP production; interference w/ gene production (eg. isotretinoin effect on Hox/hedgehog genes) |
|
|
Term
| What are the teratogenic effects of cocaine? |
|
Definition
effects on mother: HTN, abruptio placenta
effects on newborn: hyperactivity, microcephaly, interruption of blood flow leading to infarction (CNS, bowel, missing digits) |
|
|
Term
| What are the effects on the newborn or maternal diabetes? |
|
Definition
| increased birthweight (macrosomia, LGA); hyperinsulinemia in fetus from poor maternal glycemic control increases muscle mass, fat deposition; open neural tube defects; cleft lip/palate; respiratory distress syndrome: fetal hyperinsulinism in response to maternal hyperglycemia inhibits fetal surfactant production by type II pneumocytes |
|
|
Term
| What are the teratogenic effects of DES? |
|
Definition
| Interferes w/ development of mullerian structures in female fetus: abnormalities in tubes, uterus, cervix, upper 1/3 of vagina; female siblings may have: vaginal adenosis is the most common and a precursor for clear cell adenocarcinoma of vagina/cervix, cervical incompetence (increased incidence of spontaneous abortion) uterine abnormalities (problems w/ implantation), and fallopian tube abnormalities (fertility problems) |
|
|
Term
| What are the teratogenic effects of Fetal Alcohol Syndrome? |
|
Definition
1. Mental retardation
2. Intrauterine growth restriction
3. Maxillary hypoplasia
4. Microcephaly
5. Atrial septal defects
6. Hypoglycemia at birth |
|
|
Term
| What are the teratogenic effects of heroin? |
|
Definition
1. SGA
2. Irritability/hyperactivity
3. High pitched cry w/ excessive hunger, salivation, sweating, tremors, fist sucking
4. Temperature instability
5. Seizures |
|
|
Term
| What are the teratogenic effects of Isotretinoin? |
|
Definition
3 C's
1. Craniofacial abnormalities (small ears, micrognathia, cleft palate)
2. Cardiac defects
3. CNS malformations (hydrocephalus, microcephaly) |
|
|
Term
| What are the teratogenic effects of phenytoin? |
|
Definition
1. Nail hypoplasia
2. CNS abnormalities
3. Cleft lip/palate
4. Congenital heart disease |
|
|
Term
| What are the teratogenic effects of maternal smoking? |
|
Definition
| Vasoconstrictive effects of nicotine produce placental ischemia; endothelial damage increases risk for thrombosis in placental vessels; low birth weight babies |
|
|
Term
| What is the manifestation in the baby of a mother with SLE, having anti-SS antibodies in the serum? |
|
Definition
|
|
Term
| What are the uses for and teratogenic effects of thalidomide? |
|
Definition
Use: previously used for nausea in pregnancy, currently used for leprosy
Effects: Limb abnormalities- amelia (absent limbs), phocomelia (seal-like limbs) |
|
|
Term
| What are the teratogenic effects of valproate? |
|
Definition
|
|
Term
| What are the teratogenic effects of warfarin? |
|
Definition
1. CNS defects
2. Nasal hypoplasia
Contraindicated in pregnancy, use heparin |
|
|
Term
| What are the most common congenital infections? |
|
Definition
TORCH
Toxoplasmosis
Other (HBV, AIDS, Parvovirus, syphilis)
Rubella
CMV
Herpes |
|
|
Term
| What are the methods of transmission of most congenital infections? |
|
Definition
1. Vertical transmission/transplacental (mother to fetus, most common)
2. Blood contamination during delivery (HBV)
3. Cervical infection (HSV, chlamydia)
4. Breastfeeding (HIV, HBV, CMV) |
|
|
Term
| What is the most common in-utero viral infection? |
|
Definition
|
|
Term
| What is the most common complication of congenital CMV? |
|
Definition
| Bilateral sensorineural hearing loss |
|
|
Term
| What are the clinical manifestations of congenital CMV? |
|
Definition
Most commonly asymptomatic
1. Bilateral sensorineural hearing loss
2. Periventricular calcifications*
3. Hepatosplenomegaly, chorioretinitis (may lead to blindness) |
|
|
Term
| How is congenital CMV diagnosed? |
|
Definition
| Urine culture = gold standard - cytology reveals large basophilic intranuclear inclusions (owl's eyes) in renal tubular cells |
|
|
Term
| What is the treatent for congenital CMV? |
|
Definition
| Ganciclovir; foscarnet (if ganciclovir doesn't work) |
|
|
Term
| What are the effects of congenital rubella? |
|
Definition
| Virus interferes w/ protein synthesis and produces a vasculitis; clinical- sensorineural deafness most common; cataracts; patent ductus arteriosus |
|
|
Term
| How is toxoplasmosis acquired by the mother and how is it transmitted to the fetus? |
|
Definition
| Acquired from exposure to cat litter (most common) but can also be acquired by eating or handling undercooked meat products; transplacental transmission |
|
|
Term
| When is the greatest risk for fetal infection with congenital toxoplasmosis? |
|
Definition
|
|
Term
| What are clinical manifestations of congenital toxoplasmosis? |
|
Definition
1. Chorioretinitis late complication (most common)
2. Calcifications in basal ganglia |
|
|
Term
| How is congenital toxoplasmosis diagnosed? |
|
Definition
| Sabin Feldman dye test- gold standard but rarely performed |
|
|
Term
| What is the main mode of transmission of congenital type II Herpes? |
|
Definition
| Passing through the birth canal in women w/ active virus (women who are actively shedding virus should deliver via C-section); greater chance of congenital infection if primary Herpes rather than recurrent Herpes outbreak |
|
|
Term
| What are the clinical manifestations of congenital type II Herpes? |
|
Definition
| Local or systemic disease (encephalitis, skin infections) |
|
|
Term
| What is the treatment for congeital type II Herpes? |
|
Definition
|
|
Term
| When is the most common time for a fetus to be infected with congenital syphilis? Why? |
|
Definition
| Last 4-5 months becasue anatomical barriers prevent access to fetal circulation |
|
|
Term
| What are the clinical signs of early neonatal syphilis (first 2 yrs)? |
|
Definition
1. Hepatomegaly (most common)
2. Osteochondritis (inflammation of bone)
3. Mucocutaneous lesions
4. Pulmonary alba (lobar pneumonia), persistent rhinitis (snuffles) |
|
|
Term
| What are the clinical signs of lae neonatal syphilis (after 2 yrs)? |
|
Definition
1. Frontal bossing (most common)
2. Saber shins
3. Rhagades (perioral linear scars)
4. Hutchinson's triad- teeth (notched upper central incisors called Hutchinson's teeth and malformed molars called mulberry molars), interstitial keratitis, sensorineural hearing loss |
|
|
Term
| What is the treatment for congenital syphilis? |
|
Definition
|
|
Term
| What are the clinical signs of congenital Varicella-zoster virus? |
|
Definition
1. Chorioretinits (may lead to blindness)
2. Limb hypoplasia
3. Cortical atrophy in the brain
4. Vesicular skin lesions |
|
|
Term
| What is the inevitable with age change in body fat and what is the result? |
|
Definition
| Increase in body fat --> decrease number of insulin receptors leading to glucose intolerance |
|
|
Term
| What are the inevitable with age changes in the respiratory system? |
|
Definition
1. Obstructive pattern on PFTs (senile emphysema)
2. Decreased elasticity (reduced reciol on expiration)
3. Decreased FEV1
4. Decreased FVC
5. Increased TLC
6. Increased RV
7. Low normal PaO2 |
|
|
Term
| What are the inevitable with age changes in the cardiovascular system? |
|
Definition
1. Loss of elasticity in aorta
2. Decreased cardiac output and HR in response to stress
3. At rest, cardiac output is unchanged |
|
|
Term
| What are the inevitable with age changes in the musculoskeletal system? |
|
Definition
| 1. Osteoarthritis in weight bearing joints |
|
|
Term
| What are the inevitable with age changes in the CNS? |
|
Definition
1. Cerebral atrophy w/ mild forgetfulness
2. Impaired sleep patterns (insomnia, early wakening)
3. Parkinson's-like gait |
|
|
Term
| What are the inevitable with age changes in the peripheral sensory system? |
|
Definition
1. Cataracts
2. Arcus senilus (ring of cholesterol around cornea
3. Presbyopia (inability to focus on near objects)
4. Otosclerosis (fusion of the ear ossicles producing conductive hearing loss) |
|
|
Term
| What are the inevitable with age changes in the immune system? |
|
Definition
1. Decreased T cell function (often anergic to common skin antigens, positive PPD non-reactive or absent)
2. Loss of isohemagluttinins to blood antigens (may develop a hemolytic transfusion reaction if blood is mismatched) |
|
|
Term
| What are the inevitable with age changes in skin? |
|
Definition
1. Loss of skin elasticity (increased cross-bridging of collagen)
2. Senile purpura over dorsum of hands (common USMLE picture) and lower legs where bumping into objects is most likely to occur
3. Decreased sweating (eccrine glands fibrosed, danger of heat stroke) |
|
|
Term
| What are the inevitable with age changes in the GI system? |
|
Definition
1. Decreased gastric acidity
2. Decreased colonic motility (constipation which predisposes to diverticulosis)
3. Decreased activity of the hepatic CYP 450 system (danger of drug toxicities) |
|
|
Term
| What are the inevitable with age changes in the male reproductive system? |
|
Definition
1. Prostate hyperplasia (increased urine residual volume with subsequent increase in urinary tract infections)
2. Prostate cancer (only cancer that is age dependent)
3. Decreased testosterone |
|
|
Term
| What are the inevitable with age changes in the female reproductive system? |
|
Definition
1. Breast and vulvar atrophy due to decreased estrogen
2. Increased gonadotropins |
|
|
Term
| What are the inevitable with age changes in the endocrine system? |
|
Definition
| 1. Increased glucose intolerance (due to increased body fat and subsequent reduction in insulin receptor synthesis) |
|
|
Term
| What are the inevitable with age changes in the renal system? |
|
Definition
| 1. Decreased GFR with reduction in the creatinine clearance (risk of drug toxicity due to slow clearance of drugs) |
|
|
Term
| What are the age related changes in the cardiovascular system that have increased incidence but aren't inevitable? |
|
Definition
1. Atherosclerosis with increased incidence of coronary artery disease, peripheral vascular disease and strokes
2. Temporal arteritis
3. Aortic stenosis (MOST COMMON valvular abnormality in the elderly)
4. Systolic hypertension due to loss of aortic elasticity |
|
|
Term
| What are the age related changes in the respiratory system that have increased incidence but aren't inevitable? |
|
Definition
| 1. Pneumonia, usually S. pneumoniae (underscores importance of of Pneumovax vaccination in elderly) |
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Term
| What are the age related changes in the musculoskeletal system that have increased incidence but aren't inevitable? |
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Definition
1. Osteoporosis (particularly the vertebral column in females and femoral head in males)
2. Paget's disease of bone |
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Term
| What are the age related changes in the CNS that have increased incidence but aren't inevitable? |
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Definition
1. Alzheimer's disease
2. Parkinson's disease
3. Strokes (atherosclerotic type is MOST COMMON type of stroke)
4. Subdural hematoma (falls causing tearing of bridging veins in subdural space leading to venous clot) |
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Term
| What are the age related changes in the peripheral sensory system that have increased incidence but aren't inevitable? |
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Definition
| 1. Macular degeneration (MOST COMMON cause of blindness in elderly) |
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Term
| What are the age related changes in the skin that have increased incidence but aren't inevitable? |
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Definition
1. UVB light-induced cancers
2. Actinic (solar) keratosis (common USMLE picture, presursor of squamous cancer) |
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Term
| What are the age related changes in the endocrine system that have increased incidence but aren't inevitable? |
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Definition
| 1. Type II diabetes mellitus |
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Term
| What are the top five causes of death in males and females, regardless of age, in the US? |
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Definition
1. Heart disease
2. Cancer
3. Stroke
4. COPD
5. MVA (MOST COMMON in ages 1-39) |
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Term
| What are the top 3 causes of death in children ages 1-14? |
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Definition
1. Accidents (MVAs, falls, burns)
2. cancer
3. Congenital anomalies |
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Term
| What are the top 3 risk factors leading to increased morbidity/mortality in the US/ |
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Definition
1. Cigarette smoking
2. Dietary factors and activity patterns (high saturated fat, low fiber diet, lack of exercise)
3. Alcohol abuse |
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Term
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Definition
| Rhabdomyoma (most common cardiac tumor in kids), astrocytoma (most common brain tumor in kids), ash leaf spots |
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