Western Medical Pathology: Quiz 2

Front 1

lab tests for primary liver cancer

Back 1

alpha-fetoprotein

Front 2

lab test for hepatitis (liver cell injury)

Back 2

ALT

Front 3

lab test for acute pancreatitis

Back 3

amylase and lipase

Front 4

BMI for overweight

Back 4

25-30

Front 5

BMI for obesity

Back 5

30.0+

Front 6

kidney stone can be seen in 25% of patients with what disease?

Back 6

gout

Front 7

which disease shows an acute onset of monoarthritis in a joint of the lower extremity, especially in first metatarsophalangeal joint, accompanied with painful erythema and swelling; other joints like foot, ankle, knee, wrist, and hand may also be involved.

Back 7

gout

Front 8

these patients often feel nervousness, increased sweating, hypersensitivity to heat, palpitation, weakness or fatigue, increased appetite and weight loss, tachycardia, diffuse or nodular enlargement of thyroid, tremor of hands, oxophthalmos, periorbital edema, lid lag, conjunctive congestion and swelling, some patients have diarrhea, or pretibial myxedema

Back 8

Graves Disease (Hyperthyroidism)

Front 9

Graves Disease (hyperthyroidism) shows high levels of ___ and ____ and low levels of ____

Back 9

high levels of T3 and T4, low levels of serum TSH

Front 10

a type of hypothyroidism in infants, which causes a disturbance of growth and development and may result in permanent physical and mental retardation

Back 10

cretinism

Front 11

a type of hypothyroidism in adults, which causes a syndrome of low metabolic rate

Back 11

myxedema

Front 12

clinical manifestations include impaired development of the skeletal system and central nerve system, manifested by severe mental retardation, short stature, coarse facial features, a protruding tongue, hypotonia, inactivity, an open posterior fontanelle, umbilical hernia, and delayed puberty occur if treatment is delayed

Back 12

cretinism (hypothyroidism in infants)

Front 13

clinical manifestations include slowing of physical and mental activity, initial symptoms usually start from fatigue, lethargy, cold intolerance, constipation, and gradually gain weight, the skin is dry, coarse, cold, and orange in color, with hair loss. non-pitting edema results in puffy appearance, bradycardia, low blood pressure, slow reaction and delayed reflxes

Back 13

myxedema (hypothyroidism in adults or older children)

Front 14

lab exam of hypothyroidism results show low levels of __ and ___ and high level of ______

Back 14

low levels of T3 and T4 and high level of serum TSH

Front 15

the most common pathogen of a urinary tract infection

Back 15

E. Coli

Front 16

-lower tract infections that involve the bladder

Back 16

cystitis

Front 17

upper tract infections that involve primarily the kidneys

Back 17

pyelonephritis

Front 18

these patients usually present with a history of dysuria, frequency and urgency of urination or suprapubic pain

Back 18

cystitis

Front 19

usually characterized by signs of low tract infection in association with back pain, flank pain, fever and chills, and other systemic symptoms

Back 19

pyelonephritis

Front 20

physical findings may include suprapubic tenderness

Back 20

cystitis

Front 21

physical findings may include costovertebral angle tenderness

Back 21

pyelonephritis

Front 22

clinical manifestations include severe heart burn

Back 22

gastroesophageal reflux disease (GERD)

Front 23

clinical manifestations: may have no pain (asymptomatic), or may have chronic epigastric pain or discomfort usually occurring after a meal but with no regularity

Back 23

chronic gastritis

Front 24

clinical manifestations: pain in epigastrium 1-3 hours after a meal

Back 24

gastric ulcer (25% of ulcers)

Front 25

clinical manifestations: pain in epigastrium when the stomach is empty, with patient usually being awakened by pain around midnight

Back 25

duodenal ulcer (70% of ulcers)

Front 26

clinical manifestations: chronic and recurrent abdoominal pain in lower right quadrate or around umbilicus

Back 26

Crohn's Disease

Front 27

clinical manifestations: chronic relapsing abdominal pain in lower left quadrate or both lower quadrates, blood and mucus in diarrhea

Back 27

ulcerative colitis

Front 28

clinical manifestations: severe right epigastric pain, often referred to right shoulder/interscapular region, lasting 30 min to several hours

Back 28

cholelithiasis (gallstones)

Front 29

clinical manifestations: abrupt onset of nausea, vomiting, fever, right epigastric discomfort

Back 29

Hepatitis A

Front 30

clinical manifestations: abrupt onset of severe right epigastric pain with anorexia, fever and chills, fatigue

Back 30

Hepatitis B

Front 31

disorder in which the lining of the esophagus is damaged by stomach acid and changed (metaplasia) into a lining similar to that of the stomach (columnar gastric type mucosa)

Back 31

Barrett's Esophagus

Front 32

Helicobacter pylori (HP) infection is related to what types of stomach diseases?

Back 32

chronic gastritis (70-95% of CG patients have it)
peptic ulcer disease (related to 90-100% of duodenal ulcers, and 70% of gastric ulcers)

Front 33

What differentiates chronic gastritis type A versus type B?

Back 33

type A does NOT have sour regurgitation

(both have epigastric pain, stomach fullness, belching, nausea, and vomiting)

Front 34

Chronic gastritis and peptic ulcer disease can both be caused by ______ and __________

Back 34

HP infection and NSAIDs

Front 35

...but chronic gastritis differs in cause from peptic ulcer disease in that chronic gastritis can be caused by ______________, and peptic ulcer disease can be caused by ____________.

Back 35

gastritis = stress-related gastric mucosal damage;
peptic ulcer = increased acid secretion

Front 36

occurs globally, incidence in US ~ 50/100,000; occurs at any age, most commonly between 20-40yo, with a small peak between 50s-60s.

Back 36

Crohn's Disease

Front 37

occurs globally, incidence in US is slightly >50/100,000; more common among whites than blacks; more common in women than men; onset of disease peaks ~ age 20-25.

Back 37

Ulcerative Colitis

Front 38

Composition of gallstones in Western countries versus African/Asian countries

Back 38

Western = majority are cholesterol stones
Africa/Asia = majority are pigmented (calcium bilirubinate) stones

Front 39

Cholesterol stones form when there is a disturbance in...

Back 39

the process of cholesterol secretion in bile.

Front 40

Pigmented stones form when there is an accumulation of...

Back 40

bilirubin in the gallbladder.

Front 41

transmission of Hep A

Back 41

fecal-oral route

Front 42

transmission of Hep B

Back 42

parenteral, sexual, or vertical (maternal-infant) routes

Front 43

transmission of Hep C

Back 43

5-10% = blood transfusions
40% = IV drug abuse
5% = health care occupational exposure
10% = heterosexual activity w/ multiple partners
40% = no identifiable source of infection

Front 44

transmission of Hep D

Back 44

sexual or blood contact, or mother-to-child;
Hep D cannot exist without also being infected with Hep B

Front 45

prognosis of Hep A

Back 45

good; there is no chronic or carrier state

Front 46

prognosis of Hep B

Back 46

most acute cases have good prognosis;
5-10% turn into chronic states, and even cirrhosis or primary carcinoma of liver; even higher for those infected with Hep D also

Front 47

prognosis of Hep C

Back 47

45% of people who get Hep C are at risk to develop chronic liver disease (chronic active hepatitis, cirrhosis, carcinoma of liver, etc.);
90% mortality rate of those who develop into fulminant course

Front 48

prevention of Hep A

Back 48

passive immunization ( with ISG) within 2 weeks of exposure;
active immunization by Hep A vaccination

Front 49

prevention of Hep B

Back 49

passive immunization (with serum globulin + HBIG) within 14 days of exposure;
active immunization: HBV vaccine (3 doses at 0, 1 and 6 months), effects last 3-5 years.

Front 50

prevention of Hep C

Back 50

there is currently no vaccine;
avoid unprotected sex, blood contact, sharing needles, etc.

Front 51

Hep B patients versus HBV carriers

Back 51

Hep B patients often have acute symptoms, while chronic Hep B carriers often appear healthy with no symptoms for many years

Front 52

commonly seen in children/young people; incidence higher in males than females; edema on eyelids/face usually appears; 80% have mild-moderate HTN

Back 52

Acute Glomerulonephritis (nephritis)

Front 53

edema, anemia, and renal function impairment, plus persistent HTN

Back 53

Chronic Glomerulonephritis (nephritis)

Front 54

obvious systemic edema may be accompanied by pleural infusion and ascites; proteinuria > 3.5g/day; hyperlipidemia, hypoalbuminemia

Back 54

Nephrotic Syndrome

Front 55

same features as acute nephritic syndrome, plus renal function rapidly deteriorating, progressing to renal failure in weeks/months, oliguria/anuria, anemia, increased BUN and serum creatinine

Back 55

Rapidly Progressive Glomerulonephritis (RPGN)

Front 56

main pathogens in urinary tract infections

Back 56

most pathogens responsible for UTI's are part of the patient's normal bowel flora:

Escherichia coli (most common), Klebsiella, Enterobacter, Enterococci