Patho Exam 5

Front 1

Rapid division and growth of cells, or panus in the _________ stage of RA causes the synovium to thicken.

Back 1

Second

Front 2

_________ arthritis strikes mostly women in their 30s-50s while ___________ arthritis is most commonly associated with aging.

Back 2

Rheumatoid; Osteo

Front 3

Key symptoms of rheumatoid arthritis. Look for 4 or more in evaluation.

Back 3

•Morning joint stiffness lasting at least 1 hour
•Arthritis of three or more joint areas
•Arthritis of the hand joints
•Symmetric arthritis
•Rheumatoid nodules
•Abnormal amounts of serum RF
•Radiographic changes

Front 4

38 year old woman presents with pain, warmth, stiffness, redness and swelling around the joint (caused by swelling of the synovial lining). What stage of RA is she experiencing?

Back 4

First stage

Front 5

Rapid division and growth of cells, or panus in the _________ stage of RA causes the synovium to thicken.

Back 5

Second

Front 6

In the __________ stage of RA, the inflamed cells release enzymes that may digest bone and cartilage, often causing the involved joint to lose its shape and alignment, more pain, and loss of movement.

Back 6

Third stage

Front 7

A 53 year old woma with RA presents with ulner drift, severe pain and limited use of both hands. What stage is she experiencing?

Back 7

Third stage

Front 8

Sudden, transient alteration of brain function caused by an abrupt explosive, disorderly discharge of cerebral neurons

Back 8

Seizure

Front 9

3 common causes of seizures

Back 9

Cerebral lesions
Biochemical disorders
Cerebral trauma

Front 10

Lack of ________ during delivery can cause seizures in newborn.

Back 10

Oxygen

Front 11

Seizure diagnostic test

Back 11

EEG

Front 12

During a _________oxygen is consumed at a high rate and rapidly depleted, along with glucose, and lactate accumulates in brain tissue.

Back 12

Seizure

Front 13

During a _________ seizure, consciousness is not lost. Confusion or repetitive action may be present.

Back 13

Partial

Front 14

Seizures that involve an interruption to consciousness where the person experiencing the seizure seems to become vacant and unresponsive for a short period of time (usually up to 30 seconds). Slight muscle twitching may occur.

Back 14

Absence seizures

Front 15

Seizures involving the loss of muscle tone, causing the person to fall to the ground. These are sometimes called 'drop attacks'.

Back 15

Atonic seizures

Front 16

Seizures that involve an initial contraction of the muscles followed by rhythmic muscle contractions.

Back 16

Tonic–clonic seizures

Front 17

Seizures that involve an extremely brief (< 0.1 second) muscle contraction and can result in jerky movements of muscles or muscle groups.

Back 17

Myoclonic seizures

Front 18

Seizures that involve an extremely brief (< 0.1 second) muscle contraction and can result in jerky movements of muscles or muscle groups.

Back 18

Myoclonic seizures

Front 19

The telltale sensation experienced by some people before a seizure. It often manifests as the perception of a strange light, an unpleasant smell or confusing thoughts or experiences.

Back 19

Aura

Front 20

tonic seizure
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a seizure characterized by a sustained increase in muscle tone, of abrupt or gradual onset and offset, lasting a few seconds to a minute, usually 10–20 seconds; tonic seizures affecting proximal muscles bilaterally frequently lead to the adoption of a posture.

Back 20

Tonic seizure

Front 21

Diagnosis of Alzheimer's dimentia is made by...

Back 21

Ruling out other causes

Front 22

Mechanisms leading to dementia include...

Back 22

degeneration, compression, atherosclerosis, and trauma.

Front 23

Assessment of dementia

Back 23

Head CT
assess LOC
assess cause

Front 24

Clinical manifestations of dementia

Back 24

Forgetfulness, emotional upset, disorientation, confusion, lack of concentration, decline in abstraction, problem solving, and judgment

Front 25

Dementia associated with plaques and tangles

Back 25

Alzheimer's dementia

Front 26

Mutations on these two genes are associated with Alzheimer's

Back 26

14 and 21

Front 27

Normal intracranial pressure

Back 27

5 to 15 mm Hg

Front 28

Caused by an increase in intracranial content from tumor growth, edema, excessive CSF, or hemorrhage

Back 28

IICP

Front 29

Clinical manifestations of this neurological disorder include: nClinical manifestations include decreasing levels of arousal or central neurogenic hyperventilation, widened pulse pressure, bradycardia, and pupils that become small and sluggish

Back 29

IICP

Front 30

Diagnosis of IICP

Back 30

Cerebral blood flow
ICP monitoring
MRI or CT scan

Front 31

Type of trauma that results when head strikes hard surface or a rapidly moving object strikes the head. The dura remains intact and brain tissues are not exposed to the environment

Back 31

Closed trauma

Front 32

Type of head trauma that causes focal (local) or diffuse (general) brain injuries

Back 32

Closed trauma

Front 33

Injury breaks the dura and exposes the cranial contents to the environment

Back 33

Open trauma

Front 34

Type of head trauma that causes primarily focal injuries

Back 34

Open trauma

Front 35

Brain injury directly below the point of impact

Back 35

Coup injury

Front 36

Brain injury on the pole opposite the site of impact

Back 36

Contrecoup injury

Front 37

What type of brain injury are contusions and hematomas?

Back 37

Focal brain injury

Front 38

Diagnostic test for head injury

Back 38

CT w/o contrast
MRI

Front 39

Diagnostic test used to differentiate head injury from stroke

Back 39

CT w/o contrast

Front 40

Symptoms of brain injury

Back 40

IIP
LOC
Altered Neuro Exam

Front 41

Hematoma between the skull and dura mater

Back 41

Epidural hematoma

Front 42

Hematoma between the dura mater and arachnoid mater

Back 42

Subdural hematoma

Front 43

Hematoma which forms within the brain

Back 43

Intracerebral hematoma

Front 44

Traumatic injury of vertebral and neural tissues as a result of compressing, pulling, or shearing forces

Back 44

Spinal cord trauma

Front 45

Most common location for spinal cord trauma

Back 45

C1, C2, C4-C7, and T11-L2 lumbar vertebrae

Front 46

Leading cause of spinal cord injury

Back 46

Automobile/motorcycle accidents

Front 47

A single break in a vertabra usually affecting transverse or spinous processes

Back 47

Simple fracture

Front 48

Vertebral body shattered into several fragments

Back 48

Comminuted (burst) fracture

Front 49

Vertebral body compressed anteriorly.

Back 49

Compressed (wedged) vertebral fracture

Front 50

Int the early phase of spinal cord injury, what makes it difficult to distinguish longterm loss of function from short term loss of function?

Back 50

Spinal cord swelling

Front 51

upon spinal cord injury, the entire _________ ______ is hemorrhagic and necrotic and edema in the ______ ________ occurs, impairing the microcirculation of the cord.

Back 51

gray matter, white matter

Front 52

The traumatized spinal cord is replaced by acellular collagenous tissue in __________. Meninges thicken as part of the scarring process.

Back 52

3 to 4 weeks

Front 53

Degenerating axons are engulfed by macrophages in the first _________ after spinal cord injury.

Back 53

10 days

Front 54

Phagocytes appear __________ hours after spinal cord injury, Red cells then begin to disintegrate, and resorption of hemorrhages begins.

Back 54

36 to 48 hours

Front 55

_________ and _________ most commonly produce occlusion, but _________ and _________ are the dominant underlying processes.

Back 55

Cerebral thrombi and cerebral emboli;

atherosclerosis and hypotension

Front 56

In __________ infarcts, the affected area becomes slightly discolored and softens 6 to 12 hours after the occlusion. Necrosis, swelling around the insult, and mushy disintegration appear by 48 to 72 hours after infarction.

Back 56

ischemic

Front 57

In ___________ infarcts, bleeding occurs into the infarcted area when blood flow is restored. The embolic fragments may be moved or lysed, or compressive forces may lessen, allowing blood flow to be reestablished.

Back 57

hemorrhagic

Front 58

_________ aneurysms occur frequently (in approximately 2% of the population) and probably result from congenital abnormalities

Back 58

nSaccular (berry) aneurysms

Front 59

_________ aneurysms occur as a result of diffuse arteriosclerotic changes and are found most commonly in the basilar arteries or terminal portions of the internal carotid arteries

Back 59

Fusiform (giant) aneurysms

Front 60

Intracranial aneurysms may result from...

Back 60

arteriosclerosis, congenital abnormality, trauma, inflammation, and cocaine.

Front 61

Intracranial aneurisms are typically as symptomatic, but can be diagnosed by...

Back 61

History
CT scan
MRI.
 

Front 62

Twenty percent of persons with ALS have a genetic mutation in ______________ on the glial cells surrounding the motor neuron.

Back 62

copper-zinc superoxidase dismutase (SODI)

Front 63

ALS diagnostic tests

Back 63

Electromyography and muscle biopsy verify lower motor neuron degeneration and denervation.

Front 64

Disease leading to progressive weakness leading to respiratory failure and death. Patient has normal intellectual and sensory function until death

Back 64

ALS

Front 65

results from a defect in nerve impulse transmission at the neuromuscular junction related to blocking and destruction of ___________ receptors by _________ antibodies.

Back 65

Acetylcholine receptors; IgE antibodies

Front 66

Diagnosis of myasthenia gravis is made on the basis of a response to...

Back 66

edrophonium chloride (Tensilon)

Front 67

Major symptoms of myasthenia gravis

Back 67

History of recurring upper respiratory tract infections.

Muscle fatigue and progressive weakness. The muscles of the eyes, face, mouth, throat, and neck usually are affected first.

Front 68

Relatively rare, hereditary, degenerative disorder diffusely involving the basal ganglia and cerebral cortex.

Back 68

Huntington's Disease

Front 69

nThe onset of Huntington disease is usually between ____ and ___ years of age, when the trait may already have been passed to the person's children.

Back 69

30 and 50

Front 70

Genetic inheritance pattern of Tay- Sacs disease

Back 70

Autosomal recessive

Front 71

Huntington's disease is passed through ________ inheritance with high penetrance. The gene has been isolated and cloned on chromosome __.

Back 71

autosomal dominant; chromosome 4

Front 72

Risk factor for Tay-Sacs disease

Back 72

Two parents of Askanazi Jewish heritage

Front 73

Basal ganglia and nigral depletion of ______, an inhibitory neurotransmitter, is the principal biochemical alteration in Huntington disease.

Back 73

GABA

Front 74

Symptoms of Tay-Sacs disease

Back 74

Seizures
Noticeable behavior changes, such as the infant stops smiling, crawling or rolling over and loses the ability to grasp or reach out
Increased startle reaction
Decreased eye contact
Listlessness
Increasing irritability
Slow body growth with increasing head size
Delayed mental and social skills
Feeding difficulties
Abnormal body tone
Loss of motor skills
Blindness
Deafness
Loss of intellectual skills

Front 75

Symptoms of Huntington's disease

Back 75

Abnormal movement (face, arms first then whole body) and progressive dysfunction of intellectual and thought processes (dementia).

Front 76

Huntington's disease is diagnosed through...

Back 76

Family history and clinical presentation of the disorder.

Front 77

Diagnosis of Tay-Sacs disease

Back 77

Cherry-red" spot in the back of the eyes
Blood test for Hex A activity
DNA testing of parents

Front 78

Onset of symptoms in Tay Sachs

Back 78

6 months

Front 79

Vertebral defect that allows the protrusion of the neural tube contents

Back 79

Spina bifida occulta

Front 80

Certain cutaneous or subcutaneous abnormalities suggest underlying spina bifida, including

Back 80

Abnormal growth of hair along the spine
A midline dimple with or without a sinus tract
A cutaneous angioma, usually of the “port wine” variety
A subcutaneous mass, usually representing a lipoma or dermoid cyst

Front 81

It is recommended that all women of childbearing age take ________ to reduce incidence of neural tubal defects in offspring.

Back 81

Follic acid

Front 82

Inherited metabolic disorders involving defects in amino acid metabolism, including Phenylketonuria (PKU)

Back 82

Encephalopathies

Front 83

PKU is caused by phenylalanine hydroxylase deficiency and is an _________ genetic disorder.

Back 83

autosomal recessive

Front 84

Inflammation of the brain in children associated with ingestion of aspirin or aspirin-containing products during illness and lead poisoning

Back 84

Reye syndrome

Front 85

Embryonal tumor originating in neural crest cells.

Back 85

Nueroblastoma

Front 86

Nueroblastoma has an ___________ pattern of inheritance
 

Back 86

autosomal dominant

Front 87

More than 90% of children with neuroblastoma have increased amounts of _________ and associated metabolites in their urine.

Back 87

catecholamines

Front 88

________ skull fractures include breaks in the posterior skull base or anterior skull base. Cary increased risk of vascular and nerve damage.

Back 88

Basilar

Front 89

Fracture type where bone protrudes through skin

Back 89

˜Open:  (Compound)

Front 90

Fracture type with no tear in skin

Back 90

Closed: (Simple)

Front 91

˜Temporary displacement of two bones, loss of contact between articular cartilage

Back 91

Dislocation

Front 92

Contact between articular surfaces is only partially lost

Back 92

Subluxation

Front 93

Fracture assessments

Back 93

˜Pain: continuous causing immobilization
˜Loss of function
˜Deformity: arm or leg is compared to the uninsured one
˜Shortening
˜Crepitus
˜Swelling and discoloration

Front 94

Population at highest risk for hip fracture

Back 94

elderly

Front 95

Fracture complication r/t hip repair surgery

Back 95

DVT leading to PE

Front 96

˜Loss of blood from bone can cause...

Back 96

Shock

Front 97

Bone fracture can cause fat emboli. What is sign of fat emboli?

Back 97

Pettichii

Front 98

Delayed union after a fracture Janice common in what population?

Back 98

Elderly

Front 99

˜term of when fracture heals but not in good position.

Back 99

Malunion

Front 100

˜Fracture of the pelvis is a medical emergency and can cause...

Back 100

Intraabdominal injury to organs
˜Paralytic ileus
˜Hemorrhage
˜Laceration of urethra, bladder or colon

Front 101

˜Tear or injury to a tendon

Back 101

Strain

Front 102

Complete separation of a tendon or ligament from its bony attachment site

Back 102

Avulsion

Front 103

Tear or injury to a ligament

Back 103

Sprain

Front 104

How are strains and sprains treated in the acute phase?

Back 104

˜RICE: Rest, Ice, Compression and Elevation

Front 105

Signs of dislocation

Back 105

pain, changing contour of joint, change in length, loss of mobility

Front 106

Diagnostic test to confirm dislocation

Back 106

˜X-ray

Front 107

Common bone disease in which bone becomes more thin and porous.

Back 107

Osteoporosis

Front 108

˜The underlying mechanism in all cases of osteoporosis is an imbalance between ________ and _________.

Back 108

bone resorption and bone formation

Front 109

Symptoms of osteoporosis

Back 109

˜Fractures of the vertebrae, wrists or hips
˜Low back pain
˜Neck pain
˜Bone pain or tenderness
˜Loss of height over time
˜Stooped posture

Front 110

Osteoporosis is diagnosed with a _________ scan, whic measures ___________.

Back 110

DEXA; bone mineral density

Front 111

Metabolic bone disease characterized by excessive breakdown of bone tissue, followed by abnormal bone formation

Back 111

˜Paget's disease

Front 112

Symptoms of Paget's disease...

Back 112

˜Bone pain (may be severe and persistent)
˜Joint pain or joint stiffness
˜Headache
˜Bowing of the legs
˜Warmth of skin overlying affected bone
˜Fracture
˜Neck pain
˜Reduced height
˜Hearing loss

Front 113

Piaget disease typically occurs in ______ over the age of ___

Back 113

Men over the age of 40

Front 114

Diagnostic tests for Piaget's disease

Back 114

˜Elevated serum alkaline phosphatase
˜Elevated markers of bone breakdown (for instance, N-telopeptide)
˜Serum calcium

Front 115

˜Infection of bone by vascular ulcer, bone surgery, blood borne from other sites

Back 115

Osteomylitis

Front 116

Symptoms of osteomylitis

Back 116

Sudden onset, client has fever, chills, pain, swelling

Front 117

Bacteria most often responsible for osteomyllitis

Back 117

Staph aureus

Front 118

__________ and _________ increase risk of osteomylitis.

Back 118

Diabetes and arteriovascular disease

Front 119

Assessment Osteomyelitis

Back 119

˜Physical exam and area swollen red warm to touch
˜X-ray shows soft tissue swelling
˜Bone scan shows increased uptake
˜Blood cultures positive increased WBC
˜Wound culture positive
˜Erythrocyte sedimentation rate (ESR)
˜Complete blood cell count (CBC) w/differential
˜C-reactive protein (CRP)
˜Radiography, magnetic resonance imaging (MRI)
˜Bone biopsy and culture

Front 120

˜Thoracic spine in convex posteriorly

Back 120

kyphosis

Front 121

Lumbar spine is convex anteriorly.

Back 121

lordosis

Front 122

Rotational curvature of the spine

Back 122

Scoliosis

Front 123

Symptoms of scoliosis

Back 123

Uneven shoulders
˜Prominent shoulder blade or shoulder blades
˜Uneven waist
˜One hip elevated as compared to the opposite side
˜Leaning to one side