Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
326 Cards in this Set
- Front
- Back
|
caused by atherosclerosis and leads to myocardial ischemia and infarction
|
coronary artery disease (CAD)
|
|
|
What pace does the SA node set?
|
60-100 bpm
|
|
|
What pace does the AV node set?
|
40-60 bpm
|
|
|
What pace do the Purkinje fibers set?
|
30-40 bpm
|
|
|
a consistent elevation of systemic blood pressure caused by an increase in cardiac output, an increase in peripheral resistance, or both
|
hypertension
|
|
|
What are the different types of hypertension?
|
primary
secondary isolated systolic complicated malignant |
|
|
most prevalent form of hypertension; involves systolic and diastolic values
no known cause |
primary hypertension
|
|
|
hypertension caused by a systemic disease process that raises peripheral resistance or cardiac output (renal disease, tumor, drugs)
if you can control the disease, you can control the hypertension |
secondary hypertension
|
|
|
systolic BP is above 140 and diastolic BP is below 90
occurs mainly in people over 65 |
isolated systolic hypertension
|
|
|
sustained primary hypertension that has pathologic effects on the structure and function of the heart, aorta, kidneys, eyes, brain, and lower extremities
involves organ damage and is associated with CHF, MI, or angina |
complicated hypertension
|
|
|
diastolic BP is above 140
causes major kidney damage, encephalopathy, stroke life-threatening situation |
malignant hypertension
|
|
|
What are the CM of hypertension?
|
early stages have no CM other than elevated BP
if sustained, it can cause: headache chest pain dizziness shortness of breath palpitations |
|
|
What is normal blood pressure?
|
systolic < 120
diastolic < 80 |
|
|
What is prehypertension?
|
systolic = 120-139
diastolic = 80-89 |
|
|
What is stage 1 hypertension?
|
systolic = 140-159
diastolic = 90-99 |
|
|
What is stage 2 hypertension?
|
systolic >/= 160
diastolic >/= 100 |
|
|
The volume of blood in the heart at the end of diastole is directly related to the force of contraction during the next systole.
Volume can also be described as preload. **The more it fills, the stronger it pumps** |
Frank-Starling Law
|
|
|
The amount of tension generated in the wall of the ventricle to produce a given intraventricular pressure depends on the size (radius and wall thickness) of the ventricle.
|
Laplace's Law
|
|
|
Resistance to fluid flow through a tube takes into account the length of the tube, viscosity of the fluid, and the radius of the tube's lumen.
|
Poiseuille’s Law
|
|
|
What is the normal Na+ level in the body?
|
136-145 mEq/L
|
|
|
What are the CM of hyponatremia?
|
sleepiness
weakness/lethargy N/V headache |
|
|
What are the CM of hypernatremia?
|
increased thirst
irritability confusion |
|
|
What is the normal Cl- level in the body?
|
98-106 mEq/L
|
|
|
What are the CM of "hypo" chloride?
|
hypoventilation
tetany (muscular twitching/cramps) confusion |
|
|
What are the CM of "hyper" chloride?
|
hyperventilation to blow off excess CO2
hypotension headache lethargy |
|
|
What is the normal level of K+ in the body?
|
3.5-5 mEq/L
|
|
|
What are the CM of "hypo" potassium?
|
muscle weakness/cramps
fatigue constipation confusion |
|
|
What are the CM of "hyper" potassium?
|
nausea
diarrhea hyperactive bowel sounds irritability |
|
|
What is the normal total level of Ca++ in the body?
|
9-10.5 mg/dl
|
|
|
What is the normal serum level of Ca++ in the body?
|
4.5-5.6 mg/dl
|
|
|
What are the CM of hypocalcemia?
|
confusion
paresthesias osteoporosis/brittle nails diarrhea Chvostek/Trousseau signs |
|
|
What are the CM of hypercalcemia?
|
constipation
confusion polydipsia polyuria bone pain |
|
|
What is the normal level of phosphate in the body?
|
3-4.5 mg/dl
|
|
|
What are the CM of hypophosphatemia?
|
Reduced O2 transport by RBCs
hypoxia bradycardia dysfunctions in WBCs and platelets |
|
|
What are the CM of hyperphosphatemia?
|
Those of hypocalcemia:
confusion paresthesias osteoporosis diarrhea Chvostek/Trousseau signs |
|
|
What is the normal level of Mg++ in the body?
|
1.3-2.1 mEq/L
|
|
|
What are the CM of "hypo" magnesium?
|
twitching
disorientation Chvostek/Trousseau signs |
|
|
What are the CM of "hyper" magnesium?
|
increased perspiration
muscle weakness N/V |
|
|
What is the pH and CO2 level for respiratory acidosis?
|
pH < 7.35
CO2 > 45 |
|
|
What is the pH and CO2 level for respiratory alkalosis?
|
pH > 7.45
CO2 < 35 |
|
|
What is the pH and HCO3 level for metabolic acidosis?
|
pH < 7.35
HCO3 < 22 |
|
|
What is the pH and HCO3 level for metabolic alkalosis?
|
pH > 7.45
HCO3 > 26 |
|
|
Acidosis causes nervous system __________, and alkalosis causes nervous system ____________.
|
depression
irritability |
|
|
What is the normal range of pH?
|
7.35-7.45
|
|
|
What is the normal range of pCO2?
|
35-45 mm Hg
|
|
|
What is the normal range of pO2?
|
80-100 mm Hg
|
|
|
What is the normal range of HCO3?
|
22-26 mEq/L
|
|
|
What is the normal range of O2 sat?
|
96-98%
|
|
|
type of shock that results from heart failure
most cases follow MI or surgery requiring cardiopulmonary bypass |
cardiogenic shock
|
|
|
type of shock that is caused by loss of blood, plasma, or interstitial fluid in large amounts
begins to develop when ICF volume has decreased by 15% |
hypovolemic shock
|
|
|
type of shock that results from an imbalance between parasympathetic and sympathetic stimulation of vascular smooth muscle
causes extreme, persistent vasodilation caused by trauma to spinal cord/medulla, depressive drugs, anesthetics, severe emotional stress, and pain |
neurogenic shock
|
|
|
most severe type of shock that begins as an allergic reaction to snakebite venom, pollens, shellfish, etc.
|
anaphylactic shock
|
|
|
type of shock that begins with an infection, progresses to bacteremia, and on
most often caused by gram-negative bacteria |
septic shock
|
|
|
What is the normal level of creatinine in the blood?
|
0.7-1.2 mg/dl
|
|
|
What is the normal level of BUN in the body?
|
10-20 mg/dl
|
|
|
What is the normal pH of urine?
|
5.0-6.5
|
|
|
What is the normal specific gravity of urine?
|
1.016-1.022
|
|
|
commonly results from inflammatory damage to the glomerulus as a consequence of immune reactions after a streptococcal infection.
Symptoms occur 10 to 21 days after infection and include hematuria, red blood cell casts, proteinuria, decreased GFR, oliguria, hypertension, edema around the eyes or feet/ankles, and occasionally pleural effusions. Most people (especially children) recover without significant loss of renal function or recurrence of the disease |
acute glomerulonephritis
|
|
|
What are some ABNORMAL constituents of urine?
|
RBCs
protein glucose WBCs |
|
|
A problem before the blood gets to the kidney (ex. hypotension or hypovolemia) causes:
|
prerenal failure
|
|
|
Something wrong with the kidney (ex. glomerulonephritis) causes:
|
intrarenal failure
|
|
|
Anything wrong past the kidney (trauma to ureters, obstruction) causes:
|
postrenal failure
|
|
|
What are the age related changes in the renal system?
|
decreased RBF and GFR
decreased number of nephrons tubular transport is affected drug elimination is delayed |
|
|
a serum glycoprotein produced by plasma cells in response to an antigen challenge
|
antibody
|
|
|
type of immunity that is produced by the host either naturally (through clinical infection) or artificially (through vaccines)
long-acting immunity |
active immunity
|
|
|
type of immunity that is given to the host either naturally (through breast milk) or artifically (through a serum injection)
short-acting immunity |
passive immunity
|
|
|
type of lymphocyte that produces and secretes antibodies and matures in the bone marrow
is responsible for humoral immunity |
B cell
|
|
|
type of lymphocyte that attacks the antigen directly and matures in the thymus gland
responsible for cell-mediated immunity |
T cell
|
|
|
What are the CM of inflammation?
|
redness
heat swelling pain loss of function |
|
|
the immune system begins to recognize self-antigens as foreign
involves periods of remission and exacerbation usually develops after age 45 |
autoimmunity
|
|
|
type of cell that used to be a monocyte in the blood
important in cleaning an injured area before healing can occur has a long lifespan and may stay in damaged tissues for weeks |
macrophage
|
|
|
decreases blood glucose (moves glucose into the cells)
|
insulin
|
|
|
increases blood glucose
|
glucagon
|
|
|
What is the disorder associated with ADH hypersecretion?
|
SIADH (syndrome of inappropriate ADH)
|
|
|
What are the causes of SIADH?
|
head trauma
ADH-secreting tumors medications surgery |
|
|
What are the CM of SIADH?
|
fluid volume retention
dilutional hyponatremia decreased urine output |
|
|
What is the disorder associated with ADH hyposecretion?
|
diabetes insipidus
|
|
|
What are the causes of diabetes insipidus?
|
idiopathic
brain tumor closed head trauma intracranial surgery |
|
|
What are the CM of diabetes insipidus?
|
polyuria
hypernatremia polydispia weight loss hypovolemic shock |
|
|
most common form of hyperthyroidism; is an autoimmune disease
CM include: tachycardia arrhythmias diarrhea weight loss diaphoresis fatigue exophthalmos goiter etc. |
Graves disease
|
|
|
a life-threatening emergency caused by infection, trauma, or surgery in a patient with existing hyperthyroidism
CM include: severe tachycardia heart failure shock hyperthermia up to 105.3 seizure coma |
thyroid storm (thyrotoxic crisis)
|
|
|
clinical state of deficient production of TH by the thyroid gland
CM include: fatigue/lethargy weight gain cold hands and feet subnormal temp and pulse thinning hair dry skin brittle nails |
hypothyroidism
|
|
|
severe, long-standing hypothyroidism
|
myxedema
|
|
|
medical emergency associated with hypothyroidism
CM include: decreased LOC hypothermia without shivering hypoventilation hypotension hypoglycemia |
myxedema coma
|
|
|
disorder that is characterized by greater-than-normal secretion of parathyroid hormone (PTH)
|
hyperparathyroidism
|
|
|
Hyperparathyroidism leads to what 2 things?
|
hypercalcemia
hypophosphotemia |
|
|
What are the CM of hyperparathyroidism?
|
dysrhythmias
constipation bone pain headache confusion kidney stones |
|
|
disorder characterized by abnormally low parathyroid hormone levels
|
hypoparathyroidism
|
|
|
Hypoparathyroidism leads to what 2 conditions?
|
hypocalcemia
hyperphosphotemia |
|
|
What are the CM of hypoparathyroidism?
|
dysrhythmias
abdominal cramps constricted feeling in the throat dry skin hair loss bone deformities |
|
|
What are the CM of hypoglycemia (blood glucose between 45-60 mg/dl)?
|
shaking
fast heartbeat sweating anxious dizziness hunger impaired vision weakness fatigue irritable |
|
|
What are the CM of hyperglycemia (blood glucose over 200 mg/dl)?
|
extreme thirst
frequent urination dry skin hunger blurred vision drowsiness nausea |
|
|
type of diabetes caused by a lack or defect of the beta cells, which produce insulin
diagnosed most commonly in whites younger than age 30 |
Type I
|
|
|
the more common type of diabetes; most powerful risk factor is obesity
causes insulin resistance with inadequate insulin secretion |
Type 2
|
|
|
What are the characteristics of a malignant tumor?
|
not well differentiated
poorly defined invades local tissues spread through blood/lymph to distant locations |
|
|
What are the different viruses that cause cancer, and what organ do they affect?
|
Hepatitis - liver
Flavivirus - liver Herpes - nasopharyngeal HPV - cervical, genital Retrovirus - adult T cell lymphoma |
|
|
tumor that arises from endothelial and epithelial tissues
|
carcinoma
ex. hepatocellular carcinoma |
|
|
tumor that arises from mesenchymnal (connective) tissues
|
sarcoma
ex. osteogenic sarcoma, leiomyosarcoma |
|
|
carcinomas arising from glandular or ductal epithelium
|
adenocarcinoma
ex. mammary adenocarcinoma |
|
|
tumor that arises from germ cells
|
terato-
ex. teratocarcinoma |
|
|
nonmalignant enlargement of the prostate gland
happens in older men |
benign prostatic hypertrophy
|
|
|
What are the risk factors for developing cervical cancer?
|
intercourse before age 16
multiple sex partners male partner with multiple partners smoking poor nutrition HIV-positive |
|
|
What are the CM of cervical cancer?
|
usually asymptomatic; may cause:
vaginal discharge/bleeding pelvic pain back pain |
|
|
What are the complications of STIs?
|
pelvic inflammatory disease
genital cancer neonatal mortality HIV |
|
|
STI in which the normal balance of bacteria in the vagina is disrupted and replaced by an overgrowth of bad bacteria
|
bacterial vaginosis
|
|
|
bacterial STI with a low incidence in the U.S.
women are usually asymptomatic causes men to develop an inflamed, painful ulcer |
chancroid
|
|
|
most common STI in the U.S. and the leading cause of blindness in the world
causes women to develop symptoms of a UTI, men to develop urethritis and epidydimitis, and neonates to develop eye infections |
chylamidia
|
|
|
bacterial STI that adolescents are at high risk for
causes urethral/anorectal infections, vaginal discharge, spotting, and heavy menses |
gonorrhea
|
|
|
bacterial STI that is often confused with syphilis, herpes, or chancroid
begins as a skin lesion and spreads to lymphatic tissue |
LGV
|
|
|
bacterial STI that is decreasing in incidence due to the use of penicillin
occurs in 5 stages: incubation, primary, secondary, latent, late/tertiary) |
syphilis
|
|
|
STI that causes cervical cancer in women and genital cancer in men
causes soft, skin colored warts |
HPV
|
|
|
viral STI that replicates in the dermis, leading to vesicles
can remain latent and be reactivated by stress, sun, or illness |
genital herpes
|
|
|
parasitic STI that causes "crabs"
ranges from mild itching to severe, intolerable itching |
pediculosis pubis
|
|
|
parasitic STI transmitted by close skin-to-skin contact, typically occuring within families or between sexual partners
|
scabies
|
|
|
parasitic STI that is a common cause of lower genital tract infection
CM include pain on intercourse, dysuria, and spotting |
trichomoniasis
|
|
|
an obstruction of the pyloric sphincter caused by hypertrophy of the sphincter muscle
one of the most common disorders of early infancy |
pyloric stenosis
|
|
|
the narrowing or blocking of the opening between the stomach and the duodenum
can be congenital or acquired (peptic ulcer disease or carcinoma near pylorus) |
pyloric obstruction
|
|
|
What are the CM of pyloric obstruction?
|
*vomiting*
vague epigastric fullness nausea anorexia weight loss |
|
|
a relatively common systemic disease that affects primarily the liver
|
viral hepatitis
|
|
|
the accumulation of fluid in the peritoneal cavity
most commonly caused by cirrhosis, but also by heart failure, liver cancer, nephrotic syndrome, etc. |
ascites
|
|
|
inflammation of the vermiform appendix thought to be caused by obstruction of the lumen with stool, tumors, or foreign bodies
|
appendicitis
|
|
|
What are the CM of appendicitis?
|
lower right quadrant pain
nausea vomiting low-grade fever |
|
|
enzyme produced by the pancreas that hydrolyzes starch
deficient production of this and other enzymes is termed pancreatic insufficiency |
amylase
|
|
|
black, sticky, tarry, foul-smelling stools caused by digestion of blood in the GI tract
this is a sign of gastrointestinal bleeding |
melena
|
|
|
one of the major causes of peptic ulcers (break in the protective mucosal lining of the lower esophagus, stomach, or duodenum)
|
H. pylori
|
|
|
a psychologic and physiologic syndrome characterized by the following:
1. Fear of becoming obese despite weight loss 2. Distorted body image 3. Body weight 15% less than normal 4. Absence of 3 consecutive menstrual periods |
anorexia nervosa
|
|
|
What is the transmission route for Hepatitis A?
|
fecal-oral
blood crowded conditions |
|
|
What is the incubation for Hepatitis A?
|
4-6 weeks
|
|
|
What is the treatment for Hepatitis A?
|
vaccine
immune globulin |
|
|
What is the transmission route for Hepatitis B?
|
blood and body fluids
needles sex coinfection with HIV |
|
|
What is the incubation for Hepatitis B?
|
6-8 weeks
|
|
|
What is the treatment for Hepatitis B?
|
vaccine
immune globulin |
|
|
What is the transmission route for Hepatitis C?
|
blood transfusions
IV drugs |
|
|
What is the incubation for Hepatitis C?
|
35-60 days
|
|
|
What is the treatment for Hepatitis C?
|
medication (interferon)
|
|
|
gallstone formation
2 types are cholesterol and pigmented |
cholelithiasis
|
|
|
What are the risk factors for developing a gallstone?
|
obesity
middle age female gender |
|
|
What are the CM of cholelithiasis?
|
abdominal pain
jaundice food intolerance, particularly to fats |
|
|
an irreversible inflammatory disease that disrupts liver structure and function
develops slowly over a period of years |
cirrhosis
|
|
|
What are the 2 types of cirrhosis?
|
alcoholic
biliary |
|
|
an inflammatory disorder that affects the GI tract anywhere from the mouth to the anus
there is a genetic predisposition to this |
Crohn disease
|
|
|
What are the CM of Crohn disease?
|
nonbloody diarrhea
weight loss lower abdominal pain |
|
|
inflammation associated with herniations or saclike outpouchings of mucosa through the muscle layers, usually in the sigmoid colon
|
diverticulitis
|
|
|
What are the CM of diverticular disease?
|
cramping pain of the lower abdomen
fever leukocytosis |
|
|
What is the treatment for diverticulitis?
|
surgical resection
increase dietary fiber |
|
|
inflammation of the pancreas
can be acute or chronic and is associated with alcoholism, obstructive biliary tract disease, peptic ulcers, trauma, hyperlipidemia, and certain drugs |
pancreatitis
|
|
|
Elevated serum amylase is a characteristic of what disorder?
|
acute pancreatitis
|
|
|
What are the CM of acute pancreatitis?
|
pain
fever leukocytosis |
|
|
structural or functional impairment of the pancreas leads to:
|
chronic pancreatitis
|
|
|
What is the most common cause of chronic pancreatitis?
|
chronic alcohol abuse
|
|
|
Chronic pancreatitis is a risk factor for:
|
pancreatic cancer
|
|
|
replacement of the squamous epithelium of the distal esophagus with metaplastic columnar epithelium as a result of chronic exposure of the esophagus to stomach acid
occurs after many years of GERD |
Barrett's esophagitis
|
|
|
most prevalent type of cirrhosis
caused by the toxic effects of alcohol on the liver |
alcoholic cirrhosis
|
|
|
bleeding in the esophagus, stomach, or duodenum
characterized by frank, bright red bleeding or "coffee ground" material that has been affected by stomach acids |
upper GI bleeding
|
|
|
What causes upper GI bleeding?
|
varicose veins in the esophagus
peptic ulcers Mallory-Weiss tear |
|
|
bleeding from the jejunum, ileum, colon, or rectum
|
lower GI bleeding
|
|
|
What causes lower GI bleeding?
|
polyps
inflammatory disease cancer hemorrhoids |
|
|
fresh, bright red blood passed from the rectum
|
hematochezia
|
|
|
bloody vomitus
either fresh, bright red blood or dark grainy digested blood with "coffee grounds" appearance |
hematemesis
|
|
|
early clinical manifestations, such as malaise, headache, or a sense of depression, that may occur hours to a few days before the onset of a seizure
|
prodroma
|
|
|
a state of muscle contraction in which there is excessive muscle tone
|
tonic phase
|
|
|
a state of alternating contraction and relaxation of muscles
|
clonic phase
|
|
|
the time period immediately following the cessation of seizure activity
people will sleep, and often do not remember the seizure; they wake up frightened, wondering what has happened |
postictal phase
|
|
|
seizure that results from electrical discharges that affect both hemispheres of the brain
|
generalized seizure
|
|
|
A progressive degenerative disorder of the cerebral cortex. It accounts for more than ½ of all dementias
|
Alzheimer disease
|
|
|
What are the CM of Alzheimer disease?
|
Initially, symptoms include forgetfulness, subtle memory loss, difficulty learning and retaining new info, inability to concentrate, and deterioration in personal hygiene and appearance.
Later, there is difficulty with judgment, communicating, restlessness, combativeness, nocturnal awakening, and disorientation. |
|
|
A chronic autoimmune disease mediated by antiacetylcholine receptor antibodies that act at the neuromuscular junction. These antibodies attach to the acetylcholine receptor sites, blocking, destroying, and weakening these sites, leaving them insensitive to acetylcholine, thereby blocking neuromuscular transmission.
Often associated with other autoimmune disorders: rheumatoid arthritis, lupus, and thyroid disease |
myasthenia gravis
|
|
|
What are the CM of myasthenia gravis?
|
Symptoms of fatigue, weakness that worsens with activity, recurring URI. The muscles of the eyes, face, mouth, throat, neck are generally affected first. The EOMI muscles and levator muscles are most affected. Diplopia, ptosis, and ocular palsies.
|
|
|
How is myasthenia gravis treated?
|
Meds:
anticholinesterase drugs to counteract fatigue and restore about 80% of muscle function. Corticosteriods. Plasmapheresis to remove acetylcholine receptor antibodies. |
|
|
Primary demyelinating disorder leading to widespread neurologic dysfunction, and forms hard yellow plaques of scar tissue. It does not affect the PNS.
|
multiple sclerosis (MS)
|
|
|
What are the CM of multiple sclerosis?
|
Initially vision problems and sensory impairment such as parathesias that can be transient. Later, blurred vision, diplopia, poorly articulated speech, muscle weakness and spasticity, hyperreflexia, urinary problems, tremor, gait ataxia
|
|
|
How is multiple sclerosis treated?
|
steroids
muscle relaxants meds for urinary retention physical therapy supportive measures |
|
|
A degenerative disorder involving the dopamine receptors, causing deficiency
|
Parkinson disease
|
|
|
What are the CM of Parkinson disease?
|
muscle rigidity
tremors kinesia (gait and movement disturbances) mask-like facial expression drooling higher pitched voice impaired speech difficulty swallowing |
|
|
Acquired inflammatory disease (humoral and cell mediated immunologic) that results in demyelination of the peripheral nerves, generally preceeded by a campylobactor jejuni infection. The humoral component blocks conduction of nerve impulses to muscles and results in paralysis.
|
Guillain-Barre' syndrome
|
|
|
What are the CM of Guillain-Barre' syndrome?
|
May vary from paresis of the legs to complete quadriplegia, respiratory insufficiency, and ANS instability. There may be burning, tingling pain… Generally, an ascending paralysis that usually plateaus and improves in 4 weeks. May take days to months to return to baseline, if it does.
|
|
|
Generally benign reoccurring headache often triggered by stress, hunger, fatigue, red wine, nitrates, MSG, chocolate, cheese, hormonal fluctuation, medications. Generally, unilateral. May have an aura, scotoma, or if complicated-CVA type symptoms. Mainly in women, and genetic component
|
migraine
|
|
|
Occurs primarily in men, several attacks can occur during the day for several days, followed by none for weeks or months. It can occur without warning, and can be severe, unilateral tearing, burning periorbital pain lasting 30-120 mins. Usually occurs at the same time of day, and on the same side.
|
cluster headache
|
|
|
What are the CM of cluster headache?
|
lacrimation
reddening of the eye nasal stuffiness eyelid ptosis nausea pain is referred to the face and teeth |
|
|
Most common type of headache, mild to moderate band like or pressure around the head without other associated symptoms. Treat with anti-inflammatory meds.
|
tension-type headache
|
|
|
blood cell production
|
hematopoiesis
|
|
|
Where does hematopoiesis occur in the fetus?
|
liver and spleen
|
|
|
Where does hematopoiesis occur after birth?
|
only in bone marrow (medullary hematopoiesis)
|
|
|
most common type of anemia
caused by inadequate iron intake, blood loss, or pregnancy |
iron deficiency anemia
|
|
|
What are the CM of iron deficiency anemia?
|
fatigue
weakness SOB pale earlobes/palms |
|
|
type of microcytic-hypochromic anemia that is most prevalent in Mediterranean population
autosomal-recessive genetic disorder |
thalassemia
|
|
|
What are the CM of thalassemia?
|
similar to iron deficiency anemia with mild splenomegaly and bronze coloring of the skin
|
|
|
RBCs with iron granules that have not been made into heme
|
ringed sideroblasts
|
|
|
What causes sideroblastic anemia?
|
inefficient iron uptake resulting in dysfunctional hemoglobin synthesis
can be congenital or acquired due to drugs/toxins |
|
|
What are the CM of sideroblastic anemia?
|
presence of ringed sideroblasts in the bone marrow
hepatomegaly splenomegaly bronze-colored skin |
|
|
What causes the 2 types of macrocytic-normochromic anemia (pernicious and folate)?
|
impaired DNA synthesis
|
|
|
What causes pernicious anemia?
|
lack of intrinsic factor production needed for absorption of vitamin B12
can be due to autoimmunity, loss of parietal cells, or chronic gastritis |
|
|
What are the CM of pernicious anemia?
|
sore, beefy red tongue**
infections N/V neurological involvement |
|
|
What causes folate deficiency anemia?
|
poor nutrition
malabsorption drugs alcohol abuse |
|
|
What are the CM of folate deficiency anemia?
|
stomatitis (painful ulcers in mouth)
malnourished appearance **no neurological involvement** |
|
|
type of anemia caused by insufficient erythropoiesis
characterized by hypoplastic bone marrow |
aplastic anemia (hypoplastic/pancytopenic)
|
|
|
What are the CM of rapid onset aplastic anemia?
|
hypoxemia
pallor weakness fever dyspnea |
|
|
What are the CM of slow onset aplastic anemia?
|
progressive weakness
fatigue |
|
|
What causes post hemorrhagic anemia?
|
blood loss due to burns, chronic GI bleed, etc.
|
|
|
What are the CM of post hemorrhagic anemia?
|
severe shock
lactic acidosis death |
|
|
autosomal recessive disorder that causes abnormally shaped RBCs
more common in African Americans |
sickle cell anemia
|
|
|
What are the CM of sickle cell anemia?
|
pain
pallor fatigue jaundice aching joints |
|
|
premature destruction of mature RBCs in the circulation
|
hemolytic anemia
|
|
|
What causes hemolytic anemia?
|
any condition that increases the fragility of RBCs
|
|
|
What are the CM of hemolytic anemia?
|
splenomegaly
jaundice bone deformities cardiovascular/respiratory manifestations |
|
|
type of anemia that is associated with chronic infections (AIDS, RA, malignancies, etc.)
|
anemia of chronic disease
|
|
|
What are the CM of anemia of chronic disease?
|
fewer/milder than other anemias
if Hbg levels drop significantly, s/s of IDA appear |
|
|
platelet count below 100,000/mm of blood
|
thrombocytopenia
|
|
|
What can cause thrombocytopenia?
|
acute viral infections
nutritional deficiencies bone marrow replacement drugs (esp. heparin) toxins |
|
|
Hemophilia A is a deficiency of __________?
|
factor VIII (8)
|
|
|
Hemophilia B is a deficiency of ____________?
|
factor IX (9)
|
|
|
Von Willebrand disease is a deficiency of __________?
|
factor VIII (8)
|
|
|
What is the difference between hemophilia A and von Willebrand disease?
|
hemophilia A is x-linked recessive and von Willebrand disease is autosomal dominant
|
|
|
Hemophilia A affects __________ and is transmitted by ____________.
|
males
females |
|
|
What are the CM of hemophilia?
|
slow persistant bleeding
uncontrolled hemorrhage hematuria hemathrosis (bleeding into joints) |
|
|
a complex syndrome resulting from a variety of clinical conditions that release tissue factor causing an increase in fibrin and thrombin activity in the blood producing augmented clot formation and accelerated fibrinolysis
characterized by a cycle of intravascular clotting followed by active bleeding |
disseminated intravascular coagulation (DIC)
|
|
|
What causes DIC?
|
bacterial endotoxins (sepsis)
infections hypoxia low blood flow blood transfusions |
|
|
What are the CM of DIC?
|
bleeding from insertion sites
pallor petechiae oozing blood hemoptysis bloody stools hematuria |
|
|
acute manifestations that accompany the general manifestations (pallor, fatigue, jaundice, and irritability) of sickling
|
sickle cell crisis
|
|
|
What are the CM of sickle cell crisis?
|
pain in the chest, back, and extremities
may be fatal due to infection |
|
|
How can sickle cell crisis be prevented?
|
avoiding fever, infection, dehydration, and exposure to cold
|
|
|
occlusion of a portion of the pulmonary bed by an embolus (blood, fat, or air)
most common cause is a DVT in the leg |
pulmonary embolism
|
|
|
What are the risk factors for developing a pulmonary embolism?
|
head injury
fractures of the lower extremities, pelvis, or spine |
|
|
What are the CM of pulmonary embolism?
|
increased heart rate
increased respiratory rate dyspnea massive occlusion can cause shock, hypotension, and death! |
|
|
presence of air and fluid in the pleural space
|
pneumothorax
|
|
|
What are the 3 types of pneumothorax?
|
open
tension spontaneous |
|
|
type of pneumothorax that occurs from a penetrating wound through the chest to the pleural space
|
open
|
|
|
type of pneumothorax that occurs when an open wound draws air into the pleural space during inspiration but prevents air escape
|
tension
|
|
|
What are the CM of open and tension pneumothorax?
|
severe hypoxemia
dyspnea decreased BP and HR |
|
|
type of pneumothorax that occurs unexpectedly in healthy men age 20-40
bleb rupture is the cause |
spontaneous pneumothorax
|
|
|
collapse of lung tissue
|
atelectasis
|
|
|
What are the CM of atelectasis?
|
cough
dyspnea fever increased WBC |
|
|
When does atelectasis often occur?
|
after surgery--this is why you should turn patients who are bed bound and make them do deep breathing exercises!
|
|
|
acute infection or inflammation of the airways or bronchi and commonly follows a viral illness and is usually self-limiting
|
acute bronchitis
|
|
|
What are the CM of acute bronchitis?
|
similar to pneumonia:
fever cough chills malaise |
|
|
hypersecretion of mucus and chronic productive cough for at least 3 months of the year for at least 2 consecutive years
|
chronic bronchitis
|
|
|
What are the risk factors for chronic bronchitis?
|
smoking
air pollution aging |
|
|
What are the CM of chronic bronchitis?
|
produtive cough
prolonged expiration cyanosis polycythemia cor pulmonale |
|
|
permanent enlargement of gas-exchange airways that results in obstruction
air can get in but cannot get out |
emphysema
|
|
|
What is the most common cause of emphysema?
|
smoking
|
|
|
What are the CM of emphysema?
|
prolonged expiration
dyspnea barrel chest productive cough late in course |
|
|
reduced oxygenation of cells in tissues
|
hypoxia
|
|
|
reduced oxygenation of arterial blood
|
hypoxemia
|
|
|
What are the 3 types of bone cells?
|
osteoblasts
osteocytes osteoclasts |
|
|
bone-forming cell
primary function is to lay down new bone |
osteoblast
|
|
|
osteoblast that has become imprisoned within the mineralized bone matrix
maintains the matrix |
osteocyte
|
|
|
bone cell that functions primarily to resorb (remove) bone during processes of growth and repair
|
osteoclast
|
|
|
What are the 3 parts of the bone matrix?
|
collagen fibers
proteoglycans glycoproteins |
|
|
make up the majority of bone matrix
give bone its tensile and supportive strength |
collagen fibers
|
|
|
part of the bone matrix
strengthen bone by forming compression-resistant networks between the collagen fibers |
proteoglycans
|
|
|
part of the bone matrix that functions in calcification
|
glycoprotein
|
|
|
type of bone that makes up about 85% of the skeleton
highly organized, solid, and extremely strong has a haversian system |
compact bone
|
|
|
type of bone that makes up 15% of the skeleton
not very complex and lacks a haversian system |
spongy bone
|
|
|
double-layered connective tissue that covers the bones
|
periosteum
|
|
|
makes up the skull, vertebral column and thorax (80 bones)
|
axial skeleton
|
|
|
makes up the upper and lower extremities, shoulder girdle, and pelvic girdle (126 bones)
|
appendicular skeleton
|
|
|
bone that is longer than it is wide
consists of a diaphysis, metaphysis, and epiphysis |
long bone
|
|
|
narrow tubular midportion of a long bone
|
diaphysis
|
|
|
broad neck of a long bone
|
metaphysis
|
|
|
broad end of a long bone
|
epiphysis
|
|
|
growth plate
separates the epiphysis from the metaphysis in a child |
epiphyseal plate
|
|
|
type of bone in which two plates of compact bone are roughly parallel to each other
ex. ribs and scapulae |
flat bone
|
|
|
bone that is cuboidal in shape (ex. bones of the wrist or ankles)
|
short bone
|
|
|
bones that have various shapes
(ex. facial, vertebrae) |
irregular
|
|
|
a 3 phase process in which existing bone is resorbed and new bone is laid down to replace it
|
remodeling
|
|
|
first stage of bone remodeling in which osteoclasts are activated
|
activation
|
|
|
second stage of bone remodeling in which osteoclasts cut out old bone
|
resorption
|
|
|
third stage of bone remodeling in which osteoblasts lay down new bone
|
formation
|
|
|
the site where 2 or more bones meet
|
joint
|
|
|
a joint in which bone is united directly to bone by fibrous connective tissue
usually immovable bones are very close to each other ex. skull |
fibrous
|
|
|
type of joint that has more cartilage between the bone than fibrous
ex. vertebrae |
cartilaginous
|
|
|
most movable and complex joints of the body
ex. knee |
synovial
|
|
|
a single muscle cell
|
muscle fiber
|
|
|
functional subunit of the muscle fiber
|
myofibril
|
|
|
the precursor to muscle fibers
|
myoblasts
|
|
|
the cytoplasm of the muscle cell
|
sarcoplasm
|
|
|
involved in calcium transport in the muscle cell
|
sarcoplasmic reticulum
|
|
|
portion of the myofibril where muscle contraction actually occurs
|
sarcomere
|
|
|
What is the theory associated with muscle contraction?
|
cross-bridge theory
(used to be the sliding filament theory) |
|
|
During muscle contraction, the thin filament, ________, slides toward the thick filament, __________.
|
thin = actin
thick = myosin |
|
|
What happens to bones as we age?
|
there is a loss of bone tissue and they become brittle and weak
|
|
|
type of fracture in which the bone breaks all the way through
|
complete fracture
|
|
|
type of fracture in which the bone is damaged but is still in one piece
|
incomplete fracture
|
|
|
fracture that breaks the skin
|
open fracture
|
|
|
fracture that does not break the skin
|
closed fracture
|
|
|
fracture that runs parallel to the long axis of the bone
|
linear fracture
|
|
|
fracture that occurs at a diagonal angle to the shaft of the bone
|
oblique fracture
|
|
|
fracture the encircles the bone
|
spiral fracture
|
|
|
fracture that occurs straight across the bone (perpendicular)
|
transverse fracture
|
|
|
type of incomplete fracture in which the outer surface is disrupted but the inner surface remains intact
shards of bone stick out |
greenstick fracture
|
|
|
fracture that occurs by a force that would not fracture a normal bone
associated with osteoporosis and any disease that weakens the bone |
pathologic fracture
|
|
|
fracture that occurs in normal or abnormal bone that is subjected to repeated stress, such as in athletics
|
stress fracture
|
|
|
fibrous connective tissue that attaches muscle to bone
|
tendon
|
|
|
band of fibrous connective tissue that connects bone to bone
|
ligament
|
|
|
a tear in a tendon
|
strain
|
|
|
a tear in a ligament
|
sprain
|
|
|
complete separation of a tendon or ligament from its bony attachment site
|
avulsion
|
|
|
porous bone
disease in which the mass of bone and density of bone is decreased, causing bones that are weaker and more prone to fractures |
osteoporosis
|
|
|
What are the CM of osteoporosis?
|
pain
bone deformity |
|
|
How can you lower your risk of osteoporosis?
|
take in more calcium
exercise more |
|
|
noninflammatory joint disease that causes degeneration and loss of cartilage in synovial joints
|
osteoarthritis (DJD)
|
|
|
What are the CM of osteoarthritis?
|
pain
stiffness swelling limited range of motion |
|
|
chronic, inflammatory joint disease characterized by stiffening and fusion of the spine and sacroiliac joints
|
ankylosing spondylitis
|
|
|
What are the CM of ankylosing spondylitis?
|
low back pain
stiffness concavity of the upper spine (causes you to walk bent over) |
|
|
syndrome caused by an inflammatory response to the formation of uric acid production or excretion
uric acid crystals form and harden in synovial joints |
gout
|
|
|
small, white nodules of uric acid crystals that are visible through the skin
|
tophi
|
|
|
How is gout treated?
|
medications
low purine (red meat) diet |
|
|
a chronic musculoskeletal syndrome characterized by diffuse pain, fatigue, and tender points
|
fibromyalgia
|
|
|
What are the CM of fibromyalgia?
|
diffuse, chronic pain
headaches joint pain fatigue |
|
|
curvature of the spine
occurs mainly in children |
scoliosis
|
|
|
painful tendonitis in the knee joint that occurs most often in preadolescent boys who participate in sports
|
Osgood-Schlatter disease
|
|
|
realigning the bone fragments close to their normal or anatomic position
treatment for a bone fracture |
reduction
|
|
|
may be used to accomplish or maintain reduction
weights are used to apply firm, steady pull to the bone, which stretches and fatigues the muscles that have pulled the bone fragments out of place |
traction
|
|
|
ischemic ulcer resulting from pressure and shearing forces that occlude cutaneous and subcutaneous blood flow
|
pressure ulcer (decubitus ulcer)
|
|
|
What are the risk factors for developing a pressure ulcer?
|
immobility
incontinence malnutrition chronic disease anemia |
|
|
a common form of cell-mediated or delayed hypersensitivity
several hours pass before an immunologic response is apparent ex. poison ivy |
allergic contact dermititis
|
|
|
Which type of herpes simplex virus is associated with fever blisters, usually around the mouth?
|
type I
|
|
|
Which type of herpes simplex virus is associated with genital infections?
|
type II
|
|
|
chicken pox
usually occurs in childhood contagious 1 day before breakout until 5 days after vaccine is available |
herpes varicella
|
|
|
activation of the herpes virus years after chicken pox
a.k.a. shingles found on the face, cervical, and thoracic areas |
herpes zoster
|
|
|
chronic, relapsing proliferative skin disorder
turnover time for shedding the epidermis is decreased from the normal 26-30 days to 3-4 days |
psoriasis
|
|
|
malignant tumor of the skin originating from melanocytes
most deadly and serious type of skin cancer can metastasize |
melanoma
|
|
|
What is the ABCD rule?
|
a way to check spots on your skin for malignancy:
Asymmetry Border Color Diameter |
|
|
hair loss
|
alopecia
|
|
|
occurs in women and is the growth and distribution of hair on the face, body, and pubic area in a male pattern
|
hirsutism
|
|
|
What are the CM of psoriasis?
|
thick silvery scales
erythematous plaques |
