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Patho review
Practice
| Question | Answer |
|---|---|
| What cells are involved in Myelogenous leukemia? What are the functions of these cells? | a. Thrombocytes- clotting b. rbc- transport oxygen c. macrophages- phagocytes in the tissues d. eosinophils- go up in an allergic response or a parasitic infection e. neutrophils- phagocytic, extracellular bacterial infections |
| What are the manifestations of Myelogenous leukemia? | a. Clotting b. Anemia c. Limited protection d. Increased infection |
| How is blood volume regulated in terms of RAAS? | a. Adh- pulls water b. Aldosterone-pulls water to make sodium follow |
| How is blood pressure regulated in terms of RAAS?(which two functions of angiotensin 2 increase bp) | a. Sns activity- increasing blood flow to increase resistance b. Vasoconstriction-narrowed tubes with the same amount of flow causes more restriction |
| How does angiotensin 2 get made? | The liver makes angiotensinogen which is converted by renin from the kidneys into angiotensin 1 which is converted by ace from the lungs into angiotensin 2 |
| Why is Tuberculosis hard to treat? | Mycobacterium tb has a mycolic acid cell wall which is like wax and makes it hard to get ab through |
| What is the patho of Tuberculosis? | Mycobacterium tb gets into the lungs by inhaling bacteria, macrophages start phagocytosis |
| What are manifestations of Tuberculosis? | Malaise (no energy), weight loss, fatigue, anorexia, low grade fever, headache if it gets into meninges |
| How do we diagnose Tuberculosis? | Tuberculin skin test with chest radiograph, sputum culture |
| How do we treat Tuberculosis? | RIPE for 6 months. Rifampin, Isoniazid, Pyrazinamide, Ethambutol |
| What is pneumonia? | An organism gets into the lungs |
| What are examples of typical pneumonia? | a. S. pneumoniae b. H. influenza |
| What are examples of atypical pneumonia? | a. Tuberculosis b. Mycoplasma pneumoniae |
| What are manifestations of typical pneumonia? | a. Consolidation not in the center b. Productive cough c. Fever d. Chills |
| What are manifestations of atypical pneumonia? | a. Consolidation in the center b. Sore throat c. no productive cough, dry d. headache e. flu symptoms |
| How do we diagnose pneumonia? | a. Sputum analysis (bloody/ rust colored is pneumococcal pneumonia, green is h. influenza) or bronchoscopy b. White blood cell counts for elevated neutrophils c. Chest x-ray for consolidation |
| How do we treat pneumonia? | a. Antibiotic for appropriate gram stain b. Supplemental oxygen c. Deep breathing d. Help produce a cough through cpt or spirometer |
| What is type one DM? | a. Autoimmunity b. Deficiency of insulin, the body has made antibodies to the pancreas (beta) cells, destroying the part that makes insulin |
| What are manifestations of type one DM before diagnosis and type two DM? | a. Polyuria, excessive hunger (cells think they are starving from lack of glucose), dehydration, excessive thirst, loss of consciousness, fatigue b. Type one has weight loss due to the burning of fat c. Type two weight gain |
| How do we diagnose type one DM? | a. Random glucose (nr<200) b. Fasting glucose (nr 70-120) c. A1C ( nr<6.5%) d. Glucose tolerance (nr after one hour <160, after 2 <120) e. Urinalysis f. Serologic test for ab the pancreas cells |
| How do we diagnose type two DM? | a. Random glucose b. Fasting glucose c. A1C d. Glucose tolerance e. Urinalysis |
| How do we treat type one DM? | Insulin |
| How do we treat type two DM? | Glycemic agents |
| What are the three types of insulin? | a. Short acting- 15-30min, taken before a meal b. Intermediate- last 12hrs, taken to maintain levels between meals c. Long acting- last 18-24 hours, maintains levels at night |
| What are the types of oral glycemic? | Metformin Glyposide Acarbos Januvia Jardiance Rosidglitizone |
| What is Dawn phenomenon? | Hyperglycemia without hypoglycemia in the morning(2-8am), flight or fight causes the body to make glucose when sleeping since we aren’t eating |
| What is the symogyi effect? | Rebound hyperglycemia after hypoglycemia because the body overcompensates |
| What is DKA? | a. Diabetic Ketoacidosis from a lack of glucose the body breaks down fats to use ketones as energy. The brain can’t store ketones so they turn into ketoic acid. b. The blood glucose is >250, acidosis, fruity or acetone breathe, kussmauls |
| What is HHNK? | a. Hyperosmolar hyperglycemic noketoic b. Profound dehydration c. The blood glucose is >600 glucose, thick blood |
| Explain what the difference between a thrombotic and an embolic stroke is. | a. Thrombotic and embolic are both clots b. Thrombotic comes from the brain c. Embolic comes from somewhere else to the brain |
| What is a hemorrhagic stroke? | a. A bleed in the brain |
| What is the significance of a Transient Ischemic Attack verses a CardioVascular Accident? | a. TIA is a precursor and CVA is the stoke b. If you get a TIA within 2 years you will have a CVA |
| What are manifestations of stroke? | Hemiparesis (numbness on one side), vision loss, dizziness, ataxia (lack of coordination), aphasias (inability to communicate ex. Slurred speech or nonsense). Depends on the location |
| How is a stroke diagnoses? | Physical exam, low blood pressure <100/<60 |
| How do we treat a stroke? | Reduce cerebral edema, rehabilitation |
| What cell is affected in Brutons disease? | B cells |
| What cell is affected in Di Georges disease? | T cells |
| What cell is affected in SCID? | Both t and b cells |
| What is the patho of fragile x syndrome? | Defect in FMRP key regulator in mRNA translation, Inheritable mental retardation |
| What are the manifestations of fragile x syndrome? | Distinctive facial features: long face, large ears, mental retardation, and cognitive impairment |
| What is the diagnosis of fragile x syndrome? | Genetic screening |
| How is fragile x syndrome treated? | Drugs to manage mental status, behavior and educational management. |
| How is fragile x syndrome inherited? | a. X- linked dominant b. If a female or male inherited it they will express |
| What is the patho of Turners? | Monosomy of x chromosome, loss all or part of 2nd chromosome |
| What are the manifestations of Turners? | a. Decreased life span b. Short stature, delayed puberty, infertility, cardiac and kidney abnormalities, learning and social problems |
| How is Turners treated? | Symptom specific, hormonal therapy |
| Compare and contrast SIADH with DI? | SIADH is excess adh, hypervolemic and di is insufficient adh and hypovolemic |
| Compare and contrast hypovolemia and hypervolemia. | a. Hypovolemia is dec fluids and concentrations b. Hypervolemia is inc fluids and dilution |
| Compare and contrast left and right side heart failure. | a. Left side is congestive, it backs up into the lungs and causes pulmonary edema b. Right side backs up into the vena cava’s and causes peripheral edema, ascites fluid in the peritoneal cavity |
| What is the patho of emphysema? | Destruction of the alveolar sacs that causes trapping of the air due to an inability to recoil, there is also inflammation of the bronchioles b. Can be due to chronic smoking or genetic from deficiency of AAT |
| What are the manifestations of emphysema? | Productive cough, dyspnea, orthopnea, wheezing, anxiety, tachycardia, lethargic, synodic, barrel chest |
| What is the diagnosis of emphysema? | AAT levels, history, lung scans, bronchoscopy, pulse oximetry, chest c ray, peak flow meter |
| How is emphysema treated? | Albuterol, cpt, mucolytics, give oxygen but not too much so that peripheral receptors will take over |
| What is the patho of ARDS? | a. Severe acute inflammation, Vasodilation/ inc capillary permeability, death after 48 hrs b. Most commonly caused by smoke inhalation |
| What are the manifestations of ARDS? | Dyspnea, hypoxemia, hypoxia, tachycardia, crackles, collapsed lungs |
| What is the diagnosis of ARDS? | Hx and physical exam, lab and imaging studies |
| How is ARDS treated? | Oxygen supplementation, PEEP (positive end expiratory pressure) to keep the sacs from collapsing |
| What are the manifestations of hyponatremia? | CNS problems like muscle cramping, if sodium's get lower than 110 it means seizures |
| What are the manifestations of hypernatremia? | Thirst, increased body temperature, CNA like lethargy |
| What are the manifestations of hypokalemia? | Muscle weakness, dysrhythmias, paralytic ileum (unable to go to the bathroom) |
| What are the manifestations of hyperkalemia? | Severe bradycardia, hyperactive bowel |
| What are the manifestations of hypocalcemia? | Increased neuromuscular excitability; tingling, cramping, laryngospasm. Slow heart rate |
| What are the manifestations of hypercalcemia? | increased heart rate, decreased neuromuscular activity, decreased deep tendon reflexes |
| How do loop (laxis) diuretics work? | Kick everything |
| What are the adverse effects of loop diuretics(2)? | Hypovolemia, hypokalemia |
| How do thiazide (hydrochlorothiazide) diuretics work? | Kick everything but ca |
| What are the adverse effects of thiazide diuretics(3)? | Hypovolemia, hypokalemia, hypercalcemia |
| How do potassium sparing (spironolactone) diuretics work? | Kick everything except potassium Kick everything except potassium |
| What are the adverse effects of potassium sparing diuretic(1)? | hyperkalemia |
| How do manifestations of MI’s vary from male to female? | a. Women- atypical: back pain and upper gastric pain b. men- chest pain, crushing pressure radiating to left arm |
| How does pulse oximetry work? What does it tell you? | Measuring oxygen saturation using a light to examine how light passes through to analyze the % of oxygen on RBCs |
| What is the patho of crohns disease? | Anywhere in bowel, Skip lesions, sub mucosal, "kinking” causing watery diarrhea |
| What are the manifestations of crohns disease? | Watery diarrhea, pain, anemia, malnutrition |
| What is the diagnosis of crohns disease? | Xrays showing lesions, physical exam, sigmoidoscopy |
| How is crohns disease treated? | Meds to suppress inflammatory response, dietary changes, surgery |
| What is preload? | work on the heart before contraction, pressure in the ventricles just before systole |
| What is afterload? | pressure in the ventricle toward the end of the contraction, it’s the resistance of blood trying to back up into the ventricles |
Created by:
Jlmasy
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