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Test 2 Patho
test 2 patho
231
Pathology
Undergraduate 3
09/15/2012

Additional Pathology Flashcards

 


 

Cards

Term
Tumor
Definition

denotes new growth "neoplasia"

 

 

Term
Characteristics of Benign tumor
Definition

-well differentiated cells

-do not reproduce at a higher than normal rate

-well encapsulated

-do not spread to lymph nodes or distant areas

-usually suffix "oma" i.e. adenoma, Lipoma, Leiomyoma

Term
general Characteristics of Malignant tumor
Definition

-undifferentiated, non-functional cells and not organized

-rapid reproduction - abnormal mitotic figures

-infiltrate/spread into surround tissue

-spread to lymph nodes/distant sites

Term
carcinoma
Definition

cancer arising in epithelial tissue

 

ex. adenocarcinoma

Term
sarcoma
Definition

cancer arising from tissues that developed from embryonic mesoderm

 

bone, cartilage, muscle

 

ex. rhabdomyosarcoma

Term
oncology
Definition
study of malignant tumors, otherwise known as cancer
Term
lymphoma
Definition

cancers from lymphatic tissue

 

ex. diffuse large B cell lymphoma

Term
leukemia
Definition

cancers from blood forming cells

 

ex. acute lymphoblastic leukemia

Term
Carcinoma in situ
Definition

"CIS"

-preinvasive epithelial tumors of glandular or squamous cell origin

(provides excellent opportunity for early diagnosis)

-cancer has not broken through the basement membrane

-can occur in cervix, skin, oral cavity, esophagus, bronchus

Term
More specific characteristics of malignant tumors
Definition

-cancer cells exhibt autonomy

-lass of differentiation (anaplasia)

-abnormal cell membranes

-altered surface antigens

-tumor mass compresses blood vessels

-tumor cells may secrete enzymes or hormones

-inflammation and loss of normal cells

-angiogenesis 

Term
autonomy of cancer cells
Definition

-lack control of mitosis

-do not undergo apoptosis

-no contact inhibition

Term
abnormal cell membranes of cancer cells
Definition

loss of cell-to-cell communication

-do not adhere to each other and often rbeak loose from mass

-invade other tissues and may spread to distant sites

Term
enzymes or hormones cancer cells secrete
Definition

-collagenase (break down of proteins and cells

-ACTH

-growth factors

Term
angiogenesis 
Definition

development of new capillaries in the tumor

tumor cells "steal nutrients" from healthy cells

Term
warning signs of cancer
Definition

-unusual bleeding or discharge

-chnage in bowel or bladder habits

-change in wart or mole

-sore that does not heal

-unexplained weight loss

-anemia or low Hgb and persitent fatigue

-persistent cough or hoarseness w/o reason

-solid lump, often painless anywhere in body

Term
local effects of tumors
Definition

-pain

-necrosis and ulceration

-obstruction

Term
Pain due to tumor
Definition

-often a late symptom

-due to: 

compression

stretching of visceral capsule

inflammation (pressure and irritation of nerves)

ischemia

blood in tissue (irritating)

Term
systemic effects of malignant tumors
Definition

-weight loss

-anemia

-severe fatigue

-effusions

-infections

-bleeding

-paraneoplastic syndrome

Term
systemic effect: weight loss
Definition

-anorexia, fatigue, pain, stress

-increased demands from tumor cells on body

- cachexia (severe tissue wasting)

Term
cachexia
Definition
severe tissue wasting
Term
anemia from tumors is due to
Definition

-blood loss at tumor site

-nutritional deficits may reduce hemoglobin synthesis

-bone marrow depression

Term
severe fatigue from tumor is due to
Definition

-inflammatory changes, cachexia, anemia

-stress of treatment schedule

-psychological factors

Term
effusions
Definition
inflammation causes fluid buildup in body cavities
Term
bleeding from tumor is due to
Definition

-tumor cells may erode the blood vessels

-lack of clotting proteins

(malnutrition and liver involvement)

Term
Paraneoplastic syndrome
Definition

additional problems associated with certain tumors

-tumor cells release active substances which may affect neurologic function, may affect clotting function, may have hormonal effects

-this syndrome may confuse the diagnosis of cancer, complicate monitoring and treatment and cause change in body image

Term
routine screening is for
Definition

-early detection

-follow up after treatment (to assess effectiveness of treatment and to detect recurrence)

Term
What blood test may be low during cancer
Definition

Hgb and erythrocyte

(general sign of cancer)

Term
presence of what tumor markers helps diagnose what cancers
Definition

(presence is not diagnostic by itself)

CEA = colon cancer

hCG = testicular cancer

AFP = hepatocellular cancer

CA125 = ovarian cancer

PSA = prostate cancer

Term
cytologic tests
Definition

require biopsy or cell sample

-determine degree of differentiation and tumor type

- most dependable confirmation of malignancy

Term

Malignant tumors spread by

 

Definition

-invasion

-metastasis 

- seeding

Term
Invasion
Definition

-local spread

-tumor cells grow into adjacent tissues and secrete lytic enzymes that break down tissue

-example: uterine carcinoma invades vagina

Term
metastasis 
Definition

-spread to distant sites

-via blood or lymph or other body fluids

-regional lymph nodes are usually first site of metastases (micrometastases)

-different cancers are selective for different sites

-due to regional blood and lymph flow, lungs and liver are common sites 

Term
seeding
Definition

-spread of cancer cells through body fluids or along membranes (usually in body cavities)

-cancer cells break free and travel along membranes/through fluids

examples: ovarian cancer spread through pelvic and peritoneal cavity fluids

Term
staging cancer is based on
Definition
extent of tumor spread
Term
purpose of staging cancer
Definition

-helps determine treatment

-used to estimate prognosis

-common language for communication between health care providers

-essential to standardize comparative studies of clinical trials

Term
TNM staging takes into account
Definition

T = size of primary tumor

N = involvement of regional lymph nodes

M - metastasis (spread) of tumor

Term
romen numeral system for staging cancers
Definition

stage 0 = carcinoma in situ

stage I = tumor limited to tissue of origin 

stage II = limited to local spread

stage III = extensive local and regional spread

stage IV = metastasized to other organs or throughout the body

Term
grading of cancers is based on
Definition
degree of differentiation of the malignant cells and the histologic exam of a tumor
Term
Does staging or grading give the best indicator of cancer prognosis, response to treatment and survival
Definition
staging 
Term
carcinogenesis
Definition

-process by which normal cells are transformed into cancer cells

 

Term

cancer is though to be a multi-factorial disease due to:

 

Definition

-environmental effects

-change in gene expression (heredity)

-infection in some cases

Term
stages in carcinogenesis
Definition

-initiation

-promotion

-progression

Term
initiation stage
Definition

"initiating factors" - procarcinogens

-irreversible change in cellular DNA

-does not create active neoplasm

-must be combined with a promoting event for a cancer to develop and spread

Term
promoting event
Definition

-leads to development of tumor

-exposure to "promoters"

-includes hormones and environmental chemicals and chronic inflammation

-causes further changes in DNA

-depends on the continued exposure to the promoter

Term
Carcinogens (risk factors for cancer)
Definition

-genetic factors

-viruses

-radiation

-chemicals

-biological factors

Term
genetic factors as risk factor in cancer
Definition

oncogenes that regulate all growth and basic cell functions

tumor suppressor genes (when functioning normally they suppress oncogenes and malfunction can lead to cancer)

 

example: breast cancer and leukemia

Term
viruses as a risk factor of cancer
Definition

oncoviruses alter host cell DNA

 

examples: hepatic cancer, cervical (HPV) cancer

Term
radiation as a risk factor for cancer
Definition

-ultraviolet rays

-x-rays and gamma rays

-radioactive isotopes

-risk is increased with higher cumulative dosage

 

examples: skin cancer and leukemia

Term
chemicals as a risk factor for cancer
Definition

-related to duration and amount of exposure

-organic solvents

-asbestos

-heavy metals

-formaldehyde

-chemotherapy agents

 

examples: lung cancer, leukemia, bladder cancer

Term
biological factors as risk factor for cancer
Definition

-chronic irritation and inflammation with increased mitosis

-age (increasing)

- diet i.e. high fat: colon cancer and smoked foods: gastric cancer

-hormones i.e. endometrial cancer: estrogen

Term
hyperinsulinemia is associated with
Definition
colon, breast, pancreatic and endometrial cancers
Term
cancer risk reduction
Definition

-limit UV exposure

-regular medical and dental exams

-self-exam

-diet

(increse fiber content, reduce fats, 5-10 servings of fresh fruits and vegetables (these act as antioxidants, which reduce changes to DNA))

Term
cancer suppressor genes
Definition
can inhibit neoplastic growth
Term
treatment of cancer can be
Definition

curative

palliative

prophylactic 

Term
curative treatment of cancer
Definition

-eradicates cancers

-best success with small, less aggressive, localized cancers early in course

 

Term
palliative treatment for cancer
Definition

-reduce s/s

-prolong life - quality over quantity

Term
prophylactic treatment of cancer
Definition

-used when risk of micrometastases is high

 

example: radiation therapy following removal of rbeast cancer with no apparent metastases

Term
micrometastases
Definition
when secondary tumors are too small to be detected
Term
surgery for cancer
Definition

-removal of tumor and surround tissue

-removal of adequate surrounding tissue may result in changes in function

Term
laparoscope surgery
Definition

-minimizes tissue damage

-improves recovery time

Term
radiofrequency ablatin (RFA)
Definition

-alternative to surgery for small single tumors in solid or fluid-filled organs

-RFA prob inserted into tumor --> radiofrequency waves from probe raise temp. within tumor destroying tumor cells

-can be used in conjunction with locally delivered chemo

Term
radiation therapy
Definition

-may be used alone or in combination

-causes mutations/alterations in DNA

-most effective in rapidly dividing cells

-some cancers are radioresistant

-may be used prior to surgery to shrink the tumor

Term
methods of radiation adminstration
Definition

-external sources: cobalt machine (radiation for short time to specific site) (gamma knife) (requires multiple treatments)

-internal insertion of radioactive material at tumor site

- instilling radioisotope in a solution into a body cavity to control excessive inflammatory exudate or blood from tumor

Term
what must be monitored when instilling tradioisotope in a solution into a body cavity
Definition
leakage of the radioisotope
Term
adverse reactions of radiation 
Definition

-bone marrow depression

-epithelial cell damage

-infertility

(due to abdominal radiation)

-non-specific fatigue and lethargy

(can lead to depression)

Term
most serious negative effect of radiation
Definition

bone marrow depression

 

because

 

decreased leukocytes - increased risk of infection

decreased erythrocytes - fatigue, tissue breakdown

decreased platelets - excessive bleeding

Term
chemotherapy
Definition

-antineoplastic drugs

-can be used alone or in combination

-usually combination of two to four drugs 

(each drug interferes with a specific cell cycle)

-drug interferes with protein synthesis and/or DNA replication

Term
adverse effects of chemotherapy
Definition

-bone marrow depression

(blood test taken before each treatment)

-nausea

(zofran, decadron, stemetil may be given)

-epithelial cell damage

(alopecia)

-damage to specfic areas

(fibrous in lungs due to damage to myocardial cells)

Term
nadir
Definition
point of lowest cell count - different points in cycle
Term
prednisone is used to
Definition

decreased mitosis and increase erythrocyte counts

 

improve appetite and sense of well being

 

decrease inflammation and swelling around tumor

Term
sex hormones are used to treat cancer
Definition

inhibit hormone dependent cancers

 

example: estrogens slow prostate cancer growth

Term
blocking agents are used to treat cancer by
Definition

blocking receptors for growth promoters on cancer cells

 

ex: tamoxifen for breast cancer

Term
biologic response modifiers (BRMs) are used to treat cancer by
Definition

augmenting the natural immune response to improve survelillance and removal of abnormal cells

 

example Herceptin for advanced breast cancer

Term
angiogenesis inhibitors are used to treat cancer by
Definition
inhibiting the stimulus for growth of blood vessels that tumors create for themselves
Term
How would angiogenesis inhibitors may chemotherapy not as effective
Definition
they reduce the amount of blood vessels to the tumor therefore the delivery of the chemotherapy drug is reduced as well
Term
analgesics are used to treat cancer by
Definition
prescribed to alleviate pain
Term
contributing factors of malnutrition 
Definition

-change in taste sensation

-anorexia

-vomiting and/or diarrhea from treatments

-sore mouth or loss of teeth

-pain and fatigue

-malabsorption due to inflammation in the digestive tract

Term
CAM therapies for cancer
Definition

-massage

-meditation 

-counseling

-exercise

-therapeutic touch

-raw food macrobiotic diet

-insulin and glucose with chemotherapy

Term
cure is generally defined as
Definition
5 year survivial in cancer-free state without recurrence
Term
remission
Definition

no clinical signs of cancer

(client may expeirence many remissions)

Term
top three cancer killers in U.S.
Definition

-lung

-colon

-breast

Term
most common skin cancer in U.S.
Definition
non-melonoma skin cancer
Term
most common cancers in men
Definition

-prostate, lung, colon

 

-lung is the most common cause of death in men from cancer, with colon second and prostate last (out of those three)

Term
most common cancers in women
Definition

breast, lung, colon

 

-lung is the most common cause of death, with breast being second and colon last (out of those three)

Term
total body water depends on
Definition

age

gender

amount of body fat

Term

%'s of body fat for

 

average adult

women

elderly

obese

infant

Definition

60%

50%

45%

even less

70%

Term
individuals with less fluid reserve are... 
Definition
more likely to be adversely affected by any fluid or electrolyte imbalance
Term
2/3 of total body water is
Definition
intracellular water
Term
1/3 or total body water is
Definition
extracellular water
Term
extracellular water is composed of
Definition

intravascular (plasma)

interstitial fluid

lymph

transcellular

Term
transcellular water
Definition

fluid enclosed within epithelial layers in body spaces (pericardial cavity as example)

-referred to as the "third space"

found in joints, body cavities and CSF

Term
mechanisms regulating water balance
Definition

-thirst

-water excretion

-neural mechanisms

-hormonal mechanisms

Term
sensible water losses
Definition
urine and feces
Term
insensible water losses
Definition
unapparent losses (skin and exhaled air)
Term
mechanisms promoting fluid intake/preservation
Definition

-thirst 

-hormonal 

Term
thirst mechanism
Definition

-hypothalmus

(osomoreceptors stimulated by cellular dehydrtion and decrease in blood volume)

Term

hormonal mechanisms

 

Definition

-ADH (vasopression - controls amount of fluid leaving in urine)

promotes reabsorption of water

 

-aldosterone (determiens reabsorption of both sodium and water)

regulated by angiotensin II which is regulated by a drop in blood pressure

Term
mechanisms promoting fluid excretion
Definition

Hormonal - atrial natriuretic peptide (ANP

 

secreted by atrial myocytes in response to elevated blood pressure

promotes water excretion

Term

water movement within ECF compartment is determined by

 

Definition

filtration - hydrostatic pressure

osmosis - osmotic pressure

Term
filtration
Definition

-the "push"

-regulated by pressure gradients between blood in capillaries and fluid in interstitial space

Term
osmosis
Definition

- the "pull"

-regulated by the concentrations of osmotic particles that do not diffuse across semi-permeable membrane of capillary wall

Term
water movement between ECF and ICF is pimarily due to 
Definition
osmotic pressure
Term
edema
Definition

excessive amounts of fluid in the interstitial fluid compartment which causes a swelling of tissues

 

-can be visable or unseen

-worse in dependent areas

Term
four mechanisms of edema
Definition

-increased capillary hydrostatic pressure

-loss of plasma proteins

-obstruction of lymphatics

-increased capillary permeability 

Term
increased capillary hydrostatic pressure
Definition

best way I can describe it:

Increased blood pressure means the heart pushes blood into the arteries more forcefully, when it reaches the capillary there are "holes" that allow the fluid to be pushed out of the capillary into the interstial space, as the blood continues down to the venous end the fluid that was pushed out should return through osmotic pressure, but the push(hydrostatic pressure) is still higher than the pull (osmotic pressure) which doesn't allow fluid to return to the capillary therefore creating edema in the interstital space.

Term
etiologies of increased capillary hydrostatic pressure
Definition

anything that causes high blood pressure

- hypervolemia

-pulmonary edema

-Congestive heart failure

-kidney failure

-pregnancy

-high plasma sodium

-administration of excessive fluids

Term
loss of plasma proteins 
Definition

"less pull" 

best way I can explain it:

Proteins especially albumin "attact water" creating osmotic pressure. When the proteins are not there at the venous end of the capillary to pull the water that was pushed out by hydrostatic pressure then less water returns to venous circulation and accumulates in the interstitial fluid causing edema

Term
etiologies of loss of plasma proteins
Definition

kidney disease

malnutirion

malabsorption

liver disease

 

example: burn patients (protein leaks)

Term
obstruction of lymphatic circulation
Definition

hydrostatic pressure in lymphatic capillaries is increased and is greater than hydrostatic pressure in ISF

 

prevents removal of ISF by lymphatic system and fluid stays in ISF

Term
etiologies of obstruction of lymphatic circulation
Definition

tumor compression

infection (scar tissue in node)

surgical removal of lymp node

trauma

Term

increased capillary permeability

 

Definition

increased flow of fluid, solutes, protein into ISF

 

loss of albumin into ISF increases osmotic pressure in ISF space which pulls more fluid into ISF space

Term

etiologies of increased capillary permeability

 

Definition

inflammatory response

allergic reactions

bacterial i nfections

large burns

Term
general edema
Definition

-seen with increased hydrostatic pressure, loss of plasma protein, increased capillary permeability

 

-"dependent edema"

- pitting edema

-anasarca (extreme generalized edema)

Term
localized edema
Definition

-more common with lymphatic circulation obstruction but can also be due to other causes 

 

-can occur anywhere

 

-periorbital edema

-ascites

-cerebral edema

-pulmonary edema

Term
signs and symptoms of edema
Definition

-swelling

-pitting edema

-increase in body weight

-lab abnormalities

-functional impairment

-pain

-impaired arterial circulation

-edema in skin

Term
dehydration
Definition

inadequate body fluid due to:

-inadequate intake

-excessive loss

-combo of the two

Term
Are water losses or inadequate intake more common cause of dehydration
Definition
water losses
Term
water is lost first from
Definition
the ECF
Term
2% weight loss
Definition
mild deficit
Term
5% weight loss
Definition
moderate deficit
Term
8% weight loss
Definition
severe deficit 
Term
isotonic dehydration
Definition
equal loss of electrolytes and fluid
Term
hypotonic dehydration
Definition
greater loss of electrolytes than fluid
Term
hypertonic dehydration
Definition
greater loss of fluid than electrolytes
Term
causes of dehydration
Definition

-vomiting and diarrhea

-excessive sweating with loss of sodium and water

-diabetic ketoacidosis (loss of fluid, electrolytes, and glucose in urine)

-insufficient water intake in older adults or unconscious persons

-concentrated formula in attempt to provide more nutrition to infant

Term
those at greatest risk for dehydration
Definition

elderly and infants

 

-lack fluid reserves

-renal function not as good

-larger body surface area of infants

-higher metabolic rate of infants requires more water intake

Term
s/s of dehydration
Definition

-poor skin turgor and dry mucous membranes

-sunken eyes

-suken fontanelles

-lower blood pressure, rapid weak pulse

-pale, mottled skin

-incresed Hct

-increased temp

-fatigue

-decreasing LOC

-low volume and high specific gravity of urine

Term

third spacing

 

Definition

shift of fluid from intravascular or intracellular spaces into non-functional transcellular compartments (body cavities)

 

-fluid is not lost from body but becomes no longer available as circulating blood volume

Term
functions of sodium
Definition

-helps regulate extracellular osmotic pressure

-nerve impulse conduction

-muscle contraction

-acid/base balance (sodium bicarbonate buffer)

Term
sodium moves by 
Definition
diffusion and active transport across cell membrane
Term
sodium levels in body are controlled by 
Definition
kidneys and the action of aldosterone
Term
hyponatremia
Definition

 

- < 135 mEq/L

- sodium deficit or water excess (dilutes sodium concentration)

Term

deficit in sodium results in 

 

 

Definition

- a decrease in the osmotic pressure of the ECF

-water shifts into cells- cells will eventually swell/rupture-lose function

-plasma volume decreases - results in s/s of hypovolemia

Term

etiologies of sodium deficit

 

 

Definition

- loss of excessive sodium from excessive sweating/ DA, vomiting

-diuretics that increase sodium loss in urine

-addison's disease, adrenal insufficiency

Term

water excess

 

 

Definition

-water content of ECF increases resulting in diluting ECF sodium - creates hypotonic ECF enviornment

-water shifts into cells

-swelling/rupture of cells and loss of function

Term

etiologies of water excess

 

 

Definition

- excessive intake

-dilute formula

-chronic renal failure

-inappropriate use of D5W

-syndrome of inappropriate anti-diuretic hormone

Term

 

SIADH

 

 

Definition

- syndrome of inappropriate anti-diuretic hormone

- brain tumors, head trauma, bronchogenic carcinoma, surgery, drugs

Term

s/s of hyponatremia

 

 

Definition

- imapired nervve impulse conduction

-fatigue, muscle cramps, abdominal pain/cramps, nausea and vomiting

-decreased ECF volume (low BP)

-shift of fluid to ICF space (swelling of neurons, confusion, headache, weakness, lethargy, seizures)

Term

hypernatremia

 

 

Definition

> 145 mEq/L

-excessive sodium intake or deficit of ECF water

Term

increase in serum sodium results in

 

 

Definition
- intracellular dehydration - cells shrink
Term

etiologies of excessive sodium

 

Definition

-inappropriate use of hypteronic saline solution (treating acidosis with sodium bicarbonate)

-oversecretion of aldosterone 

-oversecretion of ACTH

Term

etiologies of deficit of ECF water

 

 

Definition

-fever

-increased rate of respiration

-diabetes insipidus (decreased secretion of ADH

-DM with hyperglycemia

-water diarrhea 

-inadequate thrist mechanism 

Term

s/s of hypernatremia

 

Definition

-thirst, dry mucous membranes

-decreased urine output (unless due to lack of ADH)

-weakness, agitation

-edema

-eleaved BP

Term

functions of potassium

 

 

Definition

-regulates intracelluar fluid balance

-membrane potential

-nerve impulse conduction

-muslce contraction

-metabolic reactions

-cardiac muslce contraction 

Term

potassium levels are controlled by

 

Definition

-kideny

-aldosterone

-acid-base balance

-insulin

Term

hypokalemia

 

 

Definition
< 3.5 mEq/L
Term

etiologies of hypokalemia

 

 

Definition

-excessive losses (GI losses, diarrhea, bulemia nervosa)

-renal losses (diuretics, excessive secretion of aldosterone)

-deficient intake (anorexia nervosa, alcoholism)

-insulin therapy 

-alkalosis 

Term

 

s/s of hypokalemia

 

Definition

-problems with neuromuscular function (weakness,fatigue, paresthesias (pins and needles))

-weakness of respiratory muscles 

-decreased GI motility (anorexia, nausea)

-cardiac dysrhythmias (prolonged PR interval, flattening of T wave, depression of ST interval)

Term

 

hyperkalemia

 

 

Definition
> 5 mEq/L
Term

etiologies of hyperkalemia

 

 

Definition

- renal failure

-lack of aldosterone

-use of potassium-sparing diuretics

-leakage of intracellular K+ to ECF space with extensive tissue trauma (crush injuries or burns)

-severe acidosis 

Term

 

s/s of hyperkalemia

 

Definition

-fagtigue

-msucle weakness - paralysis

-paresthesias

-cardiac dysrhythmias (cardiac arrest)

Term

calcium

 

 

Definition

-99% in bone

-serum calcium (total calcium ionized and bound)

-ionized calcium (free calcium) is important form physiologically (4-5 mEq/L)

Term

functions of calcium

 

 

Definition

-strength to bones

-blood clotting

-metabolic processes

-nerve impuluse transmission

-muslce contraction

Term

calcium levels are controlled by

 

Definition

-PTH

-calcitonin

-vitamin D

-phosphate level

Term

hypocalcemia

 

 

Definition
< 4 mEq/L
Term

 

etiologies of hypocalcemia

 

 

Definition

-malnutrition/malabsorption (vitamin D/calcium)

-deficient serum albumin (binds to albumin in blood)

-alkalosis

-blood transfusions

-renal failure (elevated phosphate which causes lowered calcium and failure to activate vitamin D which impairs calcium absorption)

Term

s/s of hypocalcemia

 

Definition

-muscle spasms and hyeractive reflexes

--carpopedal spasms (atypical contraction of fingers/toes)

--chvostek's sign

--trousseau's sign

--tetany

--laryngospams

- cardiac arrhythmias (weak contractions)

Term

hypercalcemia

 

 

Definition
> 5 mEq/L
Term

etiologies of hypercalcemia

 

 

Definition

-calcium release from bone due to destruction of bone by malignant bone tumors

-bronchiogenic carcinoma secretion of PTH

-hyperparathyroidism

-immobility (demineralization of bone)

-milk-alkali syndrome (excessive intake of milk and antacids (calcium carbonate))

Term

 

s/s of hypercalcemia

 

Definition

-depression of neuromuscular activity 

-weakness, lethargy

-anorexia

-personaility changes

-interferes with ADH (polyuria, thirst)

-cardiac dysrhythmias

-weakened bones/pathological fractures 

-increased bone strength if due to excessive intake of calcium

Term

normal value of magnesium

 

 

Definition
0.7-1.1 mmol/L
Term

 

causes and s/s hypomagnesemia

 

 

Definition

-results from malabsorption or malnutrition often associated with alcoholism

-use of diuretics, diabetic ketoacidosis, hyperthyroidism, hyperaldosteronism

Term

causes and s/s of hypermagnesemia

 

 

Definition

-occurs with renal failure

-depresses neuromuscular function

-decreased reflexes

-cardiac arrhythmias

Term

 

normal vaule of phosphate

 

 

Definition
0.85-1.45 mmol/L
Term

functions of phosphate

 

 

Definition

-bone and tooth mineralization

-important in metabolism (ATP)

-phosphate buffer system

-integral part of cell membrane

-reciprocal relationship with serium calcium

Term

 

causes of hypophosphatemia

 

 

Definition
-malabsorption syndromes, diarrhea, excessive antacids
Term

causes of hyperphosphatemia

 

 

Definition

-renal failure

-tissue damage

Term

normal value of chloride

 

 

Definition
-96-106 mmol/L
Term

causes of hypochloremia

 

 

Definition

-usually associated with alkalosis 

--early stages of vomiting (loss of hydrochloric acid)

--loss of chloride causes shift of bicarbonate ions from RBC into ECF

-excessive sweating

Term

causes of hyperchloremia

 

 

Definition
-excessive sodium chloride intake
Term
pH not compatible with life
Definition
below 6.8 or above 7.8
Term
three mechanisms that control serum pH
Definition

-buffer pairs in blood

-respiratory system

-kidneys

Term
four major buffers
Definition

-sodium bicarbonate

-phosphate system

-hemoglobin

-protein system

Term
normal ratio between bicarbonate and carbonic acid
Definition

20:1

 

(20 represents the bicarbonate and 1 represents the H+)

Term

acidosis

 

Definition

-excess hydrogen ions

-decrease in serum pH

-can be respiratory or metabolic

--respiratory = increase in CO2 levels

--metabolic = increase in non-respiratory acids or decrease in amount of serum bicarb

Term
alkalosis
Definition

-deficit of H+ ions

-increase in serum pH

-can be respiratory or metabolic

--respiratory = decrease in CO2

--metabolic = decrease in amount of non-respiratory acids or increase in serum bicarbonate

 

Term
compensation
Definition

-renal and respiratory adjustments to changes in pH that act to maintain the normal range of pH

-usually limited and usually short term

-does not remove the cause of the imbalance

Term
decompensation occurs when
Definition

-causative problem becomes more severe

-additional problems occur

-compensation mechanisms are exceeded or fail

Term
etiologies of respiratory acidosis
Definition

-acute problems (pneumonia, airway obstruction, chest injuries, drugs that depress the respiratory control center)

-chronic respiratory acidosis (COPD)

Term

compensation of respiratory acidosis

 

Definition

-increased respiratory rate

-increased renal excretion of H+

-increased reabsorption of HCO3 (will see increase in serum HCO3)

-pH should return to normal range

Term
etiologies of metabolic acidosis
Definition

-diarrhea (loss of bicarb from intestines)

-increase in non-carbonic acids (Shock, DKA, renal disease or failure)

Term
compensation of metabolic acidosis
Definition

-increased respiratory rate

-increased renal reabsorption of bicarb (level may still be low because it is being used to buffer extra acids)

Term
effects of acidosis
Definition

-headache

-lethargy

-weakness

-confusion

-coma and death

Term

causes of respiratory alkalosis

 

Definition

-hyperventilation (blow off too much CO2)

caused by anxiety, high fever, overdose of aspirin

head injuries

brainstem tumors

Term
compensation of respiratory alkalosis
Definition

-kidneys hold onto H+

-kidneys excrete more bicarb (HCO3)

 

Term
causes of metabolic alkalosis 
Definition

-loss of hydrochloric acid from stomach

-hypokalemia

-excessive ingestion of antacids

Term
compensation of metabolic alkalosis
Definition

-kidneys hold onto acids

-kidneys excrete more HCO3

 

Term
effects of alkalosis
Definition

-restlessness

-muscle twitching

-tingling and numbness of fingers

-tetany

-seizures

-coma

Term
normal pCO2
Definition
35-45 mmHg
Term
normal serum CO2 (HCO3)
Definition
22-26 mEq/L
Term
normal pH of the body
Definition
7.35-7.45
Term
How many pairs of chromosomes in a human
Definition
23
Term
how many chromosomes in the body
Definition
46
Term
karyotype
Definition

-visual representation of chromosomes arranged in order of size

-used in diagnosis of chromosomal disorders

Term
variations of a gene are known as
Definition
alleles
Term
if the alleles are the same the organism is
Definition
homozygous for the gene
Term
if the alleles are different then the organisms is
Definition
heterozygous for the gene
Term
genotype
Definition

-actual genetic info carried by the indivdual 

-all cells except the gametes of an individual have the same genotype

-not all genes are expressed in all cells

Term
phenotype
Definition

-expression of genes

-appearance of the individual's characteristics

Term
congenital disorders
Definition

-disroders present at birth

could be genetic, inherited (chromosomal) disorders or developmental disorders

Term
inherited disorders may be due to
Definition

-single gene expression (traite controlled by one set of alleles)

-chromosomal defect (chromosomal anomalies usually result from an error during meiosis)

-multifactorial (polygenic expression

Term
single gene expression
Definition
trait controlled by one set of alleles
Term
chromosomal defect
Definition
chromosomal anomalies usually result from an error during meiosis
Term
autosomal recessive disorder
Definition

-both parents must pass on defective gene

-males and females equally affected

-

Term
examples of recessive gene disorders
Definition

-storage diseases (Tay Sachs)

-PKU

-sickle cell disease (also incomplete dominant)

-cystic fibrosis 

Term
autosomal dominant disorders
Definition

-no carriers, individuals with defective gene have the disease

-affected parent has 50% chance of passing on defective gene

-unaffected indivudals do not pass on the trait

-some are not apparent at birth or early in life (huntington's disease)

Term
x-linked dominant disorders
Definition

-males and females can be affected

-no carriers

-50% chance child will be born with disease

-not as common as x-linked recessive disorder

Term
x-linked recessive disorders
Definition

-disorders affect males

-females are typically the carriers

(if mother is a carrier and father is affected then can see females with disease)

Term
examples of x-linked recessive disorders
Definition

duchenne muscular dystrophy

color blindness

hemophilia A

Term
Chromosomal disorders
Definition

- leading cause of mental retardation and miscarriage

-often arise during meiosis

-can involve autosomes or sex chromosomes

-

Term
abnormal structure of chromosomes can result in
Definition

-birth defect

-loss of pregnancy

-if all info on affected chromosome is present the individual may not show signs of the defect

Term

Abnormal structure of chromosome

 

Deletions

Definition

-chromosome breaks and DNA is lost

-gamete with abnormal chromosome then unites with gamete with normal copy of chromosome

 

example: Cri du Chat 

Term

abnormal structure of chromosomes

 

duplications 

Definition

-usually see less serious consequences with duplication of genetic material than with loss

 

 

Term

abnormal structure of chromosomes

 

inversions

Definition

-two breaks occur in a chromosome and have re-insertion of the missing fragment at its original site but in an inverted order

-usually don't result in serious consequences unless genetic material is influenced by the other genes it is closee to

Term

abnormal structure of chromosomes

 

translocations

Definition

-interchange of genetic material between non-homologous chromosomes

 

Term
reciprocal translocations
Definition
-chromosome breaks and material is simply exchanged so individual still has all the genetic info
Term

robertsonian translocations

 

Definition

-only involves loss of the short arms of chromosomes 13-15, 21 or 22 and subsequent fusion of the long arm of another non-homologous chromosome with the remaining long arm of one of the chromosomes mentioned above

 

-this type of translocation between long arm of chromosome 21 and 14 is a cause of down syndrome

Term
abnormal number of chromosomes
Definition

-missing or extra chromosome

-usually the result of non-disjunction (when chromosomes fail to divide properly during meiosis

Term
monosomy
Definition

one one chromosome out of the pair of chromosomes is present

 

monosomy of any autosome is not compatible with post-natal survival 

 

ex. turner syndrome

Term
trisomy
Definition

one extra copy of the chromosome is present

 

ex. trisomy 21

Term
multifactorial disorders
Definition

-risk of developing a multifactorial disorder can be influenced by lifestyle, environmental influences or the presence of other diseases

 

-presence of the genetic info in a person's genome is a risk factor for developing the disease but does not mean the person will develop it

Term
developmental disorders
Definition

-disorders that disrupt the normal development of a child (disruption of normal embryological/fetal development)

 

-linked to teratogens (a variety of drugs and environmental agents that are capable of damaging the developing embryo/fetus

 

-most critical time is first 2 months (organogenesis)

Term
chemical teratogens
Definition

-alcohol

-cocaine

-thalidomide

-mercury

Term
physical teratogens
Definition
radiation
Term
microbial teratogens
Definition

TORCH

-toxoplasmosis

-other (HBV, mumps, rubella, varicella, gonorrhea, syphilis)

-rubella

-cytomegalovirus

-HSV

Term
down syndrome can be due to
Definition

-non-disjunction

-robertsonian translocation

-mosaicism

 

(risk increases with maternal age)

Term
prenatal testing for down syndrome
Definition

triple/quad screen test and/or first trimester screen test (ultrasound + maternal blood screening) used to screen for the risk

 

-amniocentesis or chorionic villous sampling is used to confirm the disorder prior to birth

Term
characteristics of someone with down syndrome
Definition

-small head, round face, flat facial profile

-slanted eyes and epicanthic fold

-large tongue, high arched palate

-small hands, single palmar crease

-short stature

-muscles tend to be hypotonic, loose joints

-shortened 5th finger

-delayed developmental stages

-cognitive impairment ranges from mild to major

delayed or incomplete sexual development (males infertile, females have lower rate of conception)

Term
testing for diseases in pregnant women is recommended for
Definition

-family history of a specific disease

-previous birth to child with abnormality

-ethnic groups to with high risk for specific disease

-pregnant women over 35 years of age

Term
in utero testing
Definition

-ultrasound (detects malformations of head, extremities, organs and placenta

-amniocentesis (amniotic fluid contains fetal cells which can be karyotyped, performed 15-20 weeks)

-chorionic villus assay (sample is obtained - fetus's cells can be karyotyped and analyzed, performed at 10-12 weeks)

Term
PUBS
Definition
percutaneous umbilical cord blood sampling
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