Pathophysiology

Front 1

Androgens

Back 1

Male
wil increase sebaceous gland activity

Front 2

Acne

Back 2

chronis inflammatory process that involves sebaceous glands
= great place for microbial growth

Front 3

Estrogens

Back 3

decrease sebaceous gland
= combo birth control has lots of estrogen in it

Front 4

Antibiotics

Back 4

Topical and Systemic
Erythromyecin
Tetracycline
Pseumyacins

Front 5

Atopic Eczema

Back 5

Hereditary
Around flexure surfaces
on a continuum
can appear at any age
in children BAD

Front 6

Eczema

Back 6

red blistering, itchy, scaly, weepy, thick skin lesions

Front 7

Contact Eczema

Back 7

localized, allergic reaction
poison ivy
inhalant allergies
ALLERGIES

Front 8

Neurodermatitis

Back 8

compulsive, scratching of the skin
in Winter-skin is dry
hydrocortison, topical creams

Front 9

Hives

Back 9

Edema and erythema
(swelling and redness)
- due to allergic reactions

Front 10

Psoriasis Locations

Back 10

Knees, Elbows, Scalp
= increase in cell production in the epidermal layer ( top) of the skin

Front 11

Psoriasis

Back 11

thick, scaly, grayish-white lesions
(fish scales)

Front 12

Flat Warts. Where?

Back 12

appear anywhere but most likely on face and upper body

Front 13

Plantars Warts. Where?

Back 13

On the bottom of the foot
*pressure point
invades tissue in a V formation- hit a nerve-infected= PAIN

Front 14

Herpes Simplex I

Back 14

cold sores/fever blisters
after a compromising event ( flu, cold, stress, surgery)

Front 15

Herpes Simplex II

Back 15

STD- below the waist
Contagious virus

Front 16

Chicken Pox & Shingles

Back 16

Shingles is caused by the same virus that causes chicken pox- VZ Virus
**review in notes**

Front 17

Yeast that causes thrush and vaginal yeast infection

Back 17

Candidiasis

Front 18

Vaginal Yeast Infection

Back 18

decrease in other bacteria in the vagina

Front 19

Thrush

Back 19

in newborns

Front 20

Oral CAndidiasis

Back 20

always think compromised immune
intense antibiotic treatment

Front 21

Basal Cell Carcinoma

Back 21

arising from epidermal cells along the basal layer of the skin
MOST COMMON
increase with age ( less pigmented skin)
face, head, neck
SUN EXPOSURE
rarely metsticized

Front 22

Squamous Cell

Back 22

arise from epidermis
SUNLIGHT
rarely metasticize if they are occurring on routinely sun exposed areas
ON BUTT, higher incidence of metasticizing

Front 23

Melanoma % overall cancer

Back 23

3%
60% of all deaths from skin cancer

Front 24

Melanoma Ages

Back 24

40-70
*inpast decade 20-40

Front 25

Melanoma/Sun exposure

Back 25

Increases probability
- involved with pigmented cells (Skin and EYE)

Front 26

4 major causes of CVA

Back 26

Thrombosis
Embolisms
Intracranial Hemorrhage
Aneurysms

Front 27

Thrombosis

Back 27

most commom- PLAQUE
platelets stick to plaque--occludes vessel
*morning

Front 28

TIA
Transient Ischemic Attack

Back 28

numbness, contricted right arm, slurring of speech

Front 29

TIA of Stroke

Back 29

Angina

Front 30

TIA MI

Back 30

Embolism

Front 31

Symptoms of THrombosis

Back 31

SUDDENLY
1. no feeling in right arm
2. no feeling in right chest
3. no feeling in right leg
ALL OF A SUDDEN

Front 32

Embolism

Back 32

Younger population
- MIddle Cerebral Artery-
= most common site of occlusion

Front 33

Cerebral Embolism

Back 33

originated from thrombosis that was created in the heart

Front 34

Cerebral Hemorrhage

Back 34

a bleed
ruptured cerebral artery and have intercranial bleeding
Space betwwen skull and brain -- bleeding--pressure on brain against immvoable skull--dead brain tissue

Front 35

Brain stem poushes against bottom of sull?

Back 35

If 5 mL = DEATH

Front 36

Cerebral Hemorrhage Symptoms

Back 36

severe headaches, projectile vomiting, convulsions, coma, death

Front 37

Aneurysm

Back 37

Asymptomatic until eruption
"berry" sneurysms
rupture during activity
"runs in the family"

Front 38

Circle of Willis

Back 38

most likley vessel affected by an aneurysm

Front 39

Classic Migraine

Back 39

Pro-dromal phase= que
- ringing in the ears
- loss of peripheral vision

Front 40

Vascular Migraine

Back 40

Female < 40 years old
Vasodilation
Blood flow

Front 41

Common

Back 41

No pre-phase ( prodromal)
sudden onset
Unilateral o bilateral pain
throbbing pain
photosensitivity/ sound sensitivity

Front 42

MIgraine TX

Back 42

- 50 years ago
Morphine
Ergot- LSD effects

Front 43

Modern TX of Migraine

Back 43

Imitrex- works by vasoconstriction
*can't give if someone has plague

Front 44

TX of migraine if plaque is present

Back 44

take off Imitrex and give a BIG narcotic

Front 45

Rebound Effect

Back 45

greater dilation because of fluctuating vessels

Front 46

Other meds used for Migraine

Back 46

Trycyclic Antidepressants
Beta Blockers
Ca Channel Blockers

Front 47

CLuster HEadache

Back 47

clusters of time
males
unilateral
constant pain ( not throbbing)
localized around the eyes
want to move around
correlated with REM sleep

Front 48

Muscle Tension Headache

Back 48

TYLENOL
pain in back of neck, forehead, back of scalp
BAND-LIKE
If tylenol doesn't work, then Ibuprofen ( means muscle)

Front 49

Traction Headache

Back 49

secondary to other pathology
*Meningitis- increased pressue in spinal cord
"referred pain"

Front 50

Jacksonian Seizures

Back 50

Localized-specific area of brain
psychomotor seizure- start small
1 side of body
Conscious

Front 51

Generalized Seizures

Back 51

Entire Cerebral Cortex is involved
Bilateral

Front 52

Absence/Petit Mal Seizure

Back 52

stare, maybe rapid blinking
lasts 5 seconds and then normal
"not there"
people under 20

Front 53

Tonic/Clonic
aka, Grand Mal

Back 53

jerking motion
"aura"
Not upright, not conscious
3-5 minutes
lose bladder and bowel control
CONSTANT random firing of brain

Front 54

Febrile Tonic

Back 54

Rapid Hyperthermias ( temp of 103-104)
put in tub--cool down

Front 55

ALS Etiology

Back 55

UNKNOWN
- genetic
-virus
-autoimmune

Front 56

ALS
Amyotrophic Lateral Sclerosis

Back 56

PROGRESSIVE neurological disease ( 40-70s)

Front 57

ALS Etiology

Back 57

Uknown
- Losing motor control
- muscle atrophy
INTELLECTUAL and SENSORY neurons are unaffected

Front 58

ALS will die of

Back 58

Pneumonia
( can't deep breath)

Front 59

Huntingtons DIsease

Back 59

Chromosome 4- genetic
= cell decrease in basal ganglia and cerebral cortex
SLOW PROCESS

Front 60

HUntington's Onset

Back 60

38

Front 61

Parkinsons

Back 61

rhythmic tremors, bradykinesia
- decreased dopamine production
- decrease/loss of doapmine receptors

Front 62

Parkinson's Signs

Back 62

"pill-rolling"
slow movement

Front 63

PArkinson TX

Back 63

ELdopa- will become tolerant to this
Deep Brain Stimulation- stimulate dopamine production

Front 64

MS Age Occurence

Back 64

YOUNG population
mean age of diagnosis = 30

Front 65

MS Etiology

Back 65

Unknown
lesions develope in the white matter of the CNS, optic nerves and brain stem
=DEMYELINATION of nerve cells

Front 66

Myelin Sheath

Back 66

insulation that keeps charge from "leaking out"

Front 67

MS/Myasthenia Gravis INcidene

Back 67

1:10,000

Front 68

MS/ Myasthenia Gravis Peak age of DX

Back 68

20

Front 69

MS and Acetylcholine

Back 69

Antibody to proteins that are found in acetycholine receptors --> Antibody reaction that changes the shape of the receptors

Front 70

Alzheimer's Age

Back 70

over 65

Front 71

Alzheimer's

Back 71

decreased in hippocampal and cortical neurons AND decrease in acetycholine levels
( As acetylcholine goes down...dementia goes up)

Front 72

Alzheimer's Etiology

Back 72

UNKNOWN
- virus
- autoimmune
-aluminum toxicity
- genetic

Front 73

ADAP-AZ

Back 73

found in spinal cord of AZ patients

Front 74

Normal ICP

Back 74

50-200 mm H20
or
5-15 mm Hg
- increases throughout the day

Front 75

Increased ICP

Back 75

Brain is immovable-- increased pressure( blood, fluids)-- pushing brain aganst an immovable skull = DECREASED BLOOD FLOW

Front 76

Head trauma

Back 76

Brain tissue damage-- breakdown of BBB-- Cerebral edema--increased ICP--decreased cerebral blood flow-- hypoxic, ischemic, co2 buildup--increase pCo2, decrease pH--> DEATH

Front 77

Glasgow Coma Scale

Back 77

Tests CNS response
1-5 graded in terms of response
- Eye Opening (1-4)
- Verbal Response (1-5)
- Motor REsponse ( 1-6)

Front 78

Amenorrhea

Back 78

absence of menstruation
always a SYMPTOM

Front 79

Primary Amenorrhea

Back 79

absence of menstruation by the age of 17

Front 80

Secondary Amenorrhea

Back 80

absence for 3-6 months after establishing a normal menstrual cycle
*weight ( 3-5% body fat)

Front 81

PMS Current ideas

Back 81

If you have never been pregnant and you have never been on the pill: YOU WILL NOT GET PMS
Old view: drop in progesterone NO

Front 82

Prostaglandin/Dysmenorrhea

Back 82

causes muscles to contract in the endometrial lining of the uterus--lots of tissue= lots of prostaglandins = LOTS OF CONTRACTION

Front 83

TX for Dysmenorrhea

Back 83

Midol
Combo Birth Control ( inhibits ovulation) --egg doesn't mature--endometrium doesn't build up --less tissue= less prostaglandin

Front 84

PID

Back 84

Pelvic Inflammatory Disease
- because of infection
--scar tissue in the fallopian tube= Ectopic Pregnancy

Front 85

IUD

Back 85

increases risk of PID

Front 86

TSS/ S.aureus

Back 86

carry s.au in lining of vagina-->staph LOVES sugar( super absorbant tampons will break down into sugar)--> sau grows like crazy--> puts exotoxin absorbed through mucosal lining-->circulated

Front 87

Exotoxins of TSS cause

Back 87

rash that resembles a sunburn
fever
BIG TIME diarrhea
(diarrhea and fever will kill you)

Front 88

Cervical Cancer

Back 88

"In-situ" involves full thickness epithelium
characteristics of benign bu malignant!!! ( in disguise)

Front 89

Malignant bound by perfectly normal cells

Back 89

Cervical Cancer

Front 90

Cervical Cancer cause by

Back 90

HPV and Herpes

Front 91

WHo gets cervical cancer most often?
Lowest?

Back 91

Prostitutes
Nuns

Front 92

Endometrial Cancer

Back 92

After menopause- no symptoms
Endometrium--Myometrium-->fallopian tubes-->ovaries

Front 93

Ovaries ( Endometrial CAncer)

Back 93

primary site of metastisis

Front 94

estrogen and endometrial cancer correlation

Back 94

Being on the pill your entire life = exposure to less estrogen= down probability

Front 95

Ovarian Cancer

Back 95

26% of reproductive cancers
post-menopause ( not diagnosed early)

Front 96

Fallopian tube cancer

Back 96

RARE
poor mortality
nothing going on in tube tat will give us an early sign

Front 97

Fibrocystic Disease of the Breast....Estrogens and Progesterone levels

Back 97

= palpable nodules/ masses
INCREASE in ESTROGEN
DECREASE in PROGEST.
- during luteal phase
aka, Fibrocystic Changes

Front 98

Breast Cancer Tissue

Back 98

LCIS
DCIS
Invasive Ductal Carcinoma

Front 99

Breast Cancer Rate/Frequency

Back 99

2nd most common cancer
-increase risk:
never given birth
prolonged exposure to estrogen
first pregnancy after 30

Front 100

LCIS

Back 100

Lobular carcinoma in situ
-non-invasive
-lobular part of breat
TX: lumpectomy

Front 101

DCIS

Back 101

Ductal carcinoma insitu
- non invasive
ductal system
TX: lumpectomy

Front 102

Invasive Ductal Carcinoma

Back 102

INVASIVE ( not in-situ)
very slow growing ( estrogen will speed up)
* by the time they are big enough, they have metasticized

Front 103

Paget Disease

Back 103

malignancy along nipple ducts
- in the ductal systems
- metasticizes

Front 104

Inflammatory Cancer
vs, Pagets

Back 104

RAPIDLY GROWING- BAD
normal on Monday--> infected, inflamed, red, swollen on Friday
*dimpled like an orange
AGGRESSIVE

Front 105

Hypogonadism and Testosterone

Back 105

decrease in testosterone
males- prepubertal period--> delays epiphysial closing of bones ( related to bone density)--> OSTEOPOROSIS

Front 106

Common TYpe of Cancer Affecting the prostate

Back 106

BPH ( Benign Prostatic Hyperplasia)
-just enlarged

Front 107

BPH TX:

Back 107

Function of who you ask
Surgeon: cut it out
Radiologist: radiate
Endocrinologist- hormone therapy
TREAT WITH ESTROGEN

Front 108

Side effect of EStrogen in males

Back 108

Gynecomastia

Front 109

PSA

Back 109

Prostatic Specific Antigen
- corr. with prostate cancers

Front 110

Prostate Cancer Screening

Back 110

No Hx: @ 50
with Hx: @ 30
African americans get 10 years earlier

Front 111

Testicular Cancer peak:

Back 111

20-35 males

Front 112

Growth in testes=

Back 112

MALIGNANT
*male need lots of sperm bc of long journey

Front 113

Can you get gonorrhea from a toilet seat?

Back 113

YES
- you do not get this from the environment--> picked it up from another individual

Front 114

Gonrrhea symptoms in males

Back 114

pain and burning on urination
discharge
(localized infection of the urethra)

Front 115

Gonorrhea symptoms in females

Back 115

pain with urination
discharge
*transmitting most - those that don't present with symptoms for weeks
can lead to scarring of tubes, spread to uterus and fallopian tubes

Front 116

DX of GOnorrhea

Back 116

looking for gran meg cocci
SEGS will have inside

Front 117

Non_Gynecoccal Urethritis

Back 117

inflammation and infection of the urthethra NOT caused by Gonorrhea-
treat the same

Front 118

Stages of Syphilis

Back 118

Incubation
Primary
Secondary
Latent
Tertiary

Front 119

INcubation (Syph)

Back 119

2-4 weeks

Front 120

Primary ( Syph)

Back 120

2-4 weeks
shanker- on external genitalia( only time can be transmitted)
= soft, moderately painful ulcer
on inside of cheek? normal

Front 121

Secondary ( Syph)

Back 121

Rashes ( measl-like), sore throat, flu symptoms, then they go away and return month later

Front 122

Latent ( Syph)

Back 122

"Equilibrium"
not any better/worse
infective powers and defesnsive powers of the body are at a standoff
NO SYMPTOMS ( internal battle)

Front 123

Teritary ( Syph)

Back 123

if you live long enough ---->
head to the CNS and Cardio system

Front 124

will see bacteria in blood stream in syphilis

Back 124

late in primary stage and on...
( as shanker disappears)

Front 125

Hutchinson's Teeth

Back 125

Syphilis
central front incisors
pronounced notch

Front 126

Syphilis TX

Back 126

penicillin

Front 127

Specific organism causing Syphilis, GC, Herpes, YEast INfections

Back 127

T. Pallidium