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127 Cards in this Set

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The mov't of water up a conc. gradient from lower to higher solute load
osmosis
The mechanical force of water pushing against the cellular membranes
hydrostatic pressure
abnormal changes in size, shape & organization of mature cells (often reversible)
dysplasia
hypoxia or chemical injury resulting in protein denaturation in kidneys, ht, adrenal glands
coagulative necrosis
injury to neurons & glial cells; dead enzymes digested by hydrolytic enzymes
liquefactive necrosis
Dead cells not completely digested; cauess lesions that can still contain active TV
caseous necrosis
breast, pancreas, abdomen; fatty acisds release a lipase that dissoves
fat necrosis
hypoxic injury usually from blocked circulation in ower leg. bacterial invasion follows. dark, wet & gas
gangrenous necrosis
Intracellular fluids make up how much of body water?
60%
excess K+ in ECF causes ________, whereas low ECF K+ means _______. Essentially, K+ affects the _______.
excitability & depolarization (high K+) & hyperpolarization & nonresponsiveness (low K+); it affects resting potential
What's the most abundant ECF ion? What's it affect?
Na+ , affects water distribution & ECF)
A protein hormone released by the thyroid to regulate plasma Ca levles
calcitonin
What happens to K & Ca in acidosis?
K & Ca leave cell
What happens to K & Ca in alkalosis?
K & Ca enter cell
The differnece b/n calculated serum cations & anions
anion gap
what's the formula for the anion gap?
(Na + K) -(Cl + Co2). Normally 9-16 mEq/L
This normalizes Na concentration
ADH
How ADH workd
osmorectpros in hypothalamus sense high plasma conc. of Na, ADH is released, widens kidney tubule pores and water is reabsorbed, thus lowering sodium concentrations
This causes active reabsorption of Na in the distal convuluted & Collecting tubes, water follows if pores are open due to ADH
aldosterone
What stimulates Aldosterone?
renin-angiotensi, elevated K levels, and diminished Na levels.
Individual has 47 chromosomes w/ 3 copies at 13. May be the lowest trisomy one can live with. polydactyl common
trisomy 13 aka Patau syndrom
47 chromosomes w/ 3 copies @ 18
Trisomy 18/ Edward syndrome
47 chromosomes w/ 3 copies @ 21; most common chromosomal disorder
Trisomy 21/ down syndrom
47XXY
Kleinfelter's Syndrome
45X
Turner Syndrome
Severity of the expression of a phenotype; variable expressivity is when sesverity of a disease differs in people w/ same genotype
expressivity
the probability a gene will have any phenotyic expression; can be reduced anytime its less than 100$ of the time (i.e. 75% means 75% of those w/ genotype will show a particular phenotype too)
penetrance
1 copy of allele is needed for expression of the phenotype; each pregnancy has a 50% chance of getting trait. Affects males & females equally
Autosomal dominant
Autosomal dominant disease w/ large number of triplet CAG repeats on chromosome 4. protein aggregates in the brain
Huntington's Disease
Autosomeal dominant disease NF 1 gene on chromosome 17, which codes for a suppressor protein
neurofibromatosis
autosomal dominant disease; connective tissue disorder. Tall, thin, long fingers, cardiovasc lesions (aortic dissection, ht valve dysfunction). mutation on chrom 15, caues deficienty of fibroblasts
marfan syndrome
to pass on, both parentshave to either be carriers or recessive. males & fem's affected equally
autosomal recessive
autosomal recessive disease; implicated gen on chromosome 7. manifests w/ respiratory, GI & reprod.
cystic fibrosis
autosomal recessive disease; due to single mutation . 1/12 african americans have it
SCd
2 copies of diesead allele needed on x chromosome for individual w/ 2 X's to be affected; males only need one copy. females are carriers.
x-linked recessive
x-linked recessive disease w/ progressive muscle wasting . located on p32 of larege gene that codes for dystrophin
duchenne muscular dystrophy
x-linked recessive bleeding disease
hemophila A
absence of maternal contribution of a region on chrom 15 that causes delayed motor milestones, unusual mov'ts, laughing, epilepsy
angelman syndrome
absence of paternal contribution to region on chromosome 15. feeding difficulties, then excessive eating, morbidly obese, mental retardation
prader willi syndrome
autosomal recessive disorder; can't metabolize phenylalanine
PKU
rare deletion of short arm of chromosome 5; abnormal larynx development, resp. prob's , normal life expectancy
cri du chat
the cells are found in marrow & can be pluripoten, myeloid, or lymphoid
progenitor cells
the colony forming units before the actual full differentiation
precursor cells
hormone released by kidney, stimulates globin synthesis, response to hypoxia. joins w/ IL-3 & GM-CSF to inc production of erythrocyte progenitor cells
erythropoietin
have granules in cytoplasm; polymorphonuclear (cell types too)
granulocytes (neutrophils, eosinophils & basophils)
no granules in cyto.
agranulocytes (monocytes & lymphocytes)
majority of wbc's; multilobed nucleus. also called segs in more mature cells. first line of defense against infection. lifespan 8 hours
neutrophil
total WBC x (%bands + %segs)
absolute neutrophil count (normal is 2000)
bilobed nucleus, mainly tissue cells, present in GI, bronchial & lower GU tracts. respond to IgE & IgA
eosinophils
have a blueberry muffin appearance; least common in peripheral blood. response to inflam states like histamine release w/ Type I hypersensistity
basophils
respond to bacterial & viral infectoins as well as chronic inflma diseases by performing phagocytosis. mature in tissue
monocytes in circulation; macrophages (mature) in tissue
cells of the adaptive immune response; recognize self
lymphocytes
increased wduring viral infection, more infrequently in bacterial infections, alleric condictions. an increase in lymphocytes
lymphocytosis
which has a nucleus, proerythrocyte, or a reticulocyte?
proerythrocyte
increased RBCs, found in newborns, CHD, chronic hypoxia, high altitueds, smoking
polycythemia (eg. polycythemia vera)
what vitamins are critical for RBC production:
iron, folate, B12
The % of RBC to the whole blood. Ratio of cells to fluid
hematocrit
when this is absent, oxidative stressors can damage Hgb & the plasma membranes of RBCs; eventually exposure to oxidating substances resutls in precipitation of insoluble Hgb inclusions called Heinz bodies, ultimately causing hemolysis in splee
G6PD deficiency
formed by damage; Hgb usually by oxidation; since denaturation is irreversible, over time you can have Heinz anemia; alpha thalassemia & G6PD deficiency can both result in these
heinz bodies
cellular frags of megakaryocytes
platelets aka thrombocytes
myeloproliferative disease, acute blood loss, & polycythemia vera
thrombocytosis
high RBC mass (Hct > 50%). 2 types
polycythemia. primary (vera) is proliferative disease of the bone marrow. Secondary is an increase in erythropoietin in response to hypozia (altitude, smoking, ht/lung disease)
abnormally deep or rapid breathing
hyperpnea
shortness of breath, resp clinical sign of anemia
dyspnea
disease of arterial bv's, chronic inflam response in walls of arteries, caused by formation of mult plaques; can cause stenosis or aneurysm. plaques can rupture leading to thrombus leasing to ischemia
atherosclerosis
ebv penetrates thru nose/mouth/salivary glands. selectively infects b cells, w/ ebv receptors. cd8 t's & NK cells try to control prolif
mononucleosis
This nerve recognizes odors
olfactory
this cranial nerve does visual acuity, visual fields, & fundi exam
optic
the first cranial nerve does visual motor stuff & acuity & these other ones constrict & accomodate to light & exraocular movements
oculomotor, trochlear & abducens
this nerve does superficial pain & touch sensation & tone & strength of jaw muscles
trigeminal
this nerve tstes of sweet & salty
facial
this nerve does the whisper test, rinne & weber tests
acoustic
this nerve tastes sour & bitter & does swallowing
glossopharyngeal
this nerve does vocal tone & uvula symmetry
vagus
this nerve does the trapezius & sternocleidomastoid muscle strength
the spinal accessory nerve
this nerve does tongue movement
hypoglossal
Injury or defect @ hich level of the spine is consistent w/ a complaint of loss of sensation of mid portion of dorsum of foot?
L5
injury or defect @ which level of spine is consistent w/ complaint of loss of sensation of middorsum of arm, elbow & 2nd & 3rd fingers?
C7
if pt. has complaint of numbness on palmer surface of 2nd & 3rd fingers?
median nerve
which peripheral nerve is most likely to be affected if pt. had a complaint of numbness of dorsal surface on 4th & 5th fingers?
ulnar nerve
Which cranial nerves have motor function?
oculomotor, trochlear, trigeminal, abducens, facial, glossopharyngeal, vagus, spinal accessory, hypoglossal
which spinal cords have sensory function?
olfactory, optic, trigeminal, facial, acoustic, glossopharyngeal, vagus
which cranial nerves have parasympathetic function?
oculomotor, facial, glossopharyngeal, vagus
what are the balance tests?
sitting, arising, immediate standing, standing, nudged
what are the gait tests?
initiation, step length & height, step symmetry, step continuity, path
what are major warning signs of brain attack?
sudden: weakness, numbness, paralysis of face, arms or legs; trouble seeing, confusion, diff. speaking, understanding speech, severe headache, trouble walking
How many of each type of vertebrae are there?
7 cervical, 12 thoracic, 5 lumbar, 5 sacral
4 tests for carpal tunnel?
flick (if that causes pain), tinnel (strike @ median nerve to cause tingling), thumb abduction (should be able to resist), phalen (numbness is bad when hands pressed together)
rotator cuff muscles?
Supraspinitis, infraspinitis, teres minor, subscapularis
This test for excess fluid involves applying downward pressure above the patella & then pushing it against the femor
ballottment
this test for excess fluid milks the medial aspect of knee upward, then laterally tapping patella
bulge sign
this test for a torn medial or lateral meniscus involves flexing the knee, rotating foot & knee in & out & listening for clicks
McMurray
this stest for instability of ant & posterior cruciate ligaments involves pushing tibia fwd & back (<5mm)
drawer
this test for ACL integrity pulls the tibia anteriorly (<5mm)
lachman
this test for instability of L & MCL applys varus force to anke & inward rotation
varus stress
bowleggedness?
valgum
The straight leg raising test is used to check for what specific lower spine problem?
nerve root irritation or lumbar disk herniation @ L4, L5 & S1
The Ottowa Ankle Rules help w/ the clinician's decision process for what test? What are the stats on it?
Ankle x-ray. 99-100% sensitivity & 50% specificity for detecting fracture.
What are 8 risk factors for cervical cancer?
PAP smear history; HPV; HIV; Sexual history (many partners, sex before 16), smoking; diet; race (higher in blacks, hispanics); oral contraceptives
List 9 risk factors for Ovarian cancer
Age, reprod history (early menarch, inferti., late 1st child), ferility drugs, FHx (ovarian, breast & colon), personal Hx (breast, endometrial, colon), genetic mutation (BRCA1 or 2), race (50% more freq. in whites), hormone replacement therapy, high fat diet
What techniques could you use to assess for ascites?
shifting dullness upon percussion, fluid wave, auscultatory percussion, puddle sign
what's the proper order of exam techniques?
Inspect, auscultate, percuss, palpate
what sounds to organs sound like when percussed?
full bladder (dull), liver (dull), stomach (tympanic), Lg intestine (tympanic), sternum (dull), lungs (resonant)
10 risk factors for colorectal cancer:
older than 50, FHx (colon cancer, garener syndrome), PMHx (colorectal, polyps, chronic inflam bowell disease), ethnic background (A. Jew), diet (low fiber, high animal fat), obesity, smoking, physical inactivity, alcohol, PMHx (ovarian, breast, endometrial cancer)
Where do you commonly assess for bruits?
R&L renal arteries, R&L iliac arteries, R&L femoral arteries, aorta
Where are kidneys located?
T12-L3, R is lower than L
What are the 9 quadrant labels of the abdomen?
R hypochondriac, epigastric, L hypochondriac, R Lumbar, umbilical, L Lumbar, R inguinal, hypogastic (pubic), L inguinal
Name 5 functional or physiologic changes in the GI of old people
decreased: intestinal motility, secretion & absorption, circulation to intestines. Mucosa cells are more susceptible to phyical & chemical agents. Increase in gall stones & biletary lipids
The straight leg raising test is used to check for what specific lower spine problem?
nerve root irritation or lumbar disk herniation @ L4, L5 & S1
The Ottowa Ankle Rules help w/ the clinician's decision process for what test? What are the stats on it?
Ankle x-ray. 99-100% sensitivity & 50% specificity for detecting fracture.
What are 8 risk factors for cervical cancer?
PAP smear history; HPV; HIV; Sexual history (many partners, sex before 16), smoking; diet; race (higher in blacks, hispanics); oral contraceptives
List 9 risk factors for Ovarian cancer
Age, reprod history (early menarch, inferti., late 1st child), ferility drugs, FHx (ovarian, breast & colon), personal Hx (breast, endometrial, colon), genetic mutation (BRCA1 or 2), race (50% more freq. in whites), hormone replacement therapy, high fat diet
What techniques could you use to assess for ascites?
shifting dullness upon percussion, fluid wave, auscultatory percussion, puddle sign
what's the proper order of exam techniques?
Inspect, auscultate, percuss, palpate
what sounds to organs sound like when percussed?
full bladder (dull), liver (dull), stomach (tympanic), Lg intestine (tympanic), sternum (dull), lungs (resonant)
10 risk factors for colorectal cancer:
older than 50, FHx (colon cancer, garener syndrome), PMHx (colorectal, polyps, chronic inflam bowell disease), ethnic background (A. Jew), diet (low fiber, high animal fat), obesity, smoking, physical inactivity, alcohol, PMHx (ovarian, breast, endometrial cancer)
Where do you commonly assess for bruits?
R&L renal arteries, R&L iliac arteries, R&L femoral arteries, aorta
Where are kidneys located?
T12-L3, R is lower than L
What are the 9 quadrant labels of the abdomen?
R hypochondriac, epigastric, L hypochondriac, R Lumbar, umbilical, L Lumbar, R inguinal, hypogastic (pubic), L inguinal
Name 5 functional or physiologic changes in the GI of old people
decreased: intestinal motility, secretion & absorption, circulation to intestines. Mucosa cells are more susceptible to phyical & chemical agents. Increase in gall stones & biletary lipids
What tests might you do to assess for appendicitis?
Markle, McBurney, Rovsing, Iliopsoas, Rebound
List 6 risk factors for breast cancer:
Age, gender, race, personal Hx breast cancer, BRCA1 or 2 gene, FHx of B.C.
List 6 risk factors for benign breast disease
early menarche, late birth of 1st child, late menopause, high socioeconomic status, nulliparity or low parity, caffeine
How ofter should screening tests be done for breast exams?
CBE: Under 40, Q 1-3 yrs. Over 40, annually.
Mammography: (avg. risk) Under 50, Q 1-2 yrs.
High risk, @ 35 annually
Risk factors for prostate cancer (5)
age (>50), race (black), nationality (NA, NW Europe), Family Hx, Diet high in animal fat
What're the most & least common types of hernias?
Most=indirect, least=femoral
When should men get PSA screening?
40 high risk, 50 avg. risk