patho final

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  1. What are the 5 cellular adaptation?
    • atrophy
    • hypertrophy
    • hyperplasia
    • metaplasia
    • dysplasia
  2. what is reduction in cell or organ size?
  3. what is the increase of the cell or organ?
  4. what is increase in number of cells?
  5. what is change in morphology and functuion due to conversion of one type of adult cell to another type?
  6. what is increase in cell numbers by altered cell morphology and loss of histological function?
  7. what is coordinated reaction of biochemical and cellular processes initiated by the body with cellular injury?
  8. chronic over use/repeated trauma, autoimmune diseases and viruses can cause what type of inflammation?
  9. what is the breakdown in the ability of the body to recognize self from non-self?
  10. what are the three phases of tissue repair?
    • inflammatory
    • proliferative
    • remodeing/maturation
  11. how long does the inflammatory phase of tissue healing last?
    0-3 days
  12. how long does the proliferative phase of tissue repair last?
    day 3-3 weeks
  13. what are the cardinal s/s of inflammation?
    • erythema
    • heat
    • edema
    • pain
    • decreased function/loss of motion
    • increased muscle tone or spasm
  14. how would you describe acute inflammation?
    short in duration, self limiting
  15. how would you describe chronic inflammation?
    long in duration, may last for weeks, months or even years and is self perpetuating
  16. what are the 4 responses during acute inflammation?
    • vascular
    • hemostatic
    • cellular
    • immune
  17. what is the purpose of the vascular response?
    mobilize and transport the  bodys defenses
  18. what is the purpose of the vascular response?
    • vasoconstruction: decrease blood loss; stops transmission; allows for margination
    • vasodilation: blood vessels open back up
    • edema: build up of fluid
  19. what happens during the hemostatic response of acute inflammation?
    small vessels retract and seal
  20. what is the main purpose of the cellular response during acute inflammation?
    draws leukocytes to the area to initate phagocytosis (eating the bad stuff)
  21. What 2 types of "-cytes" are involved with the cellular response?
    • polymorphonuclear; neutrophils
    • monocytes
  22. what happens during the immune response during acute inflammation?
    the lympatics drain the fluid from the area and allows presentation of any foreign sustances to the lymphatics
  23. what are the two types of lymphocytes involved with the immune response?
    T-cells and B-cells ( lymphocytes)
  24. what is the time frame for the remodeling/maturation phase of tissue repair?
    day 9 to 3-18 months; depends on the target tissue
  25. what are some of the factors that affect inflammation and repair?
    • comorbitiies 
    • drugs
    • immobilization
    • MOI
  26. what is defined as symptoms associated with a multitude of different systmic conditions; are NOT definitive diagnostic indicators in and of themselves, but function as signlas to dig deepers and possible reasons to refer...
    constitutional s/s
  27. what is defined as protection from; specifically against infetious organisms. based upon ability to distinguish self from non-self.
  28. what is defined as the study of the physiologic mechanisms by which the body recognizes foreign and the mechanisms to neurtalize/elimaiate foreign>
  29. what is defined as the study of how unregulated immuno responses cause disease?
  30. what is defined as the network of specialized organs both peripherally and cnetrally that provides quick waring and action against threats
    immune system
  31. what is defined as any substance in the body that does not have the characteristic cell surgace makrers of the individual is recognized as foreign
  32. what is defined as the serum proteins produced by b-lymphocytes'; bind to and destrol specific antigens
  33. antibody
  34. what is defined as organism capable of producing disease?
  35. what are the two types of immunity?
    • innate
    • acquired
  36. what is the first line of innate immunity?
    mechanical and chemical barriers
  37. what is the second line of innate immunity?
    inflammatory response and phagocytosis
  38. what is defined as the system for recognizing and destroying oreign substances. has a memory and produces specific immune reactions against infectious agent to eradicate them or eliminate prolieration of mutant cells
    acquired immunity
  39. what are the three important aspects of immunity?
    • specific recognition of self and non-self
    • memory for non-self
    • self-regulation of responses
  40. what is defined as cells drived from undifferentiated stem cells in the bone marrow, differentiate in the thymus
    central lymphoid organs
  41. what are the peripheral lymphoid organs?
    • lymphatic system
    • spleen
    • tonsils 
    • peyers patches
  42. what are the polymorphonuclear leukocytes?
    • the phills...
    • baso, eosino, neutro
  43. what are the tattle tale pac men?
  44. what are the 3 different types of T-cells?
    • helper T-cells
    • cytotoxic T-cells/natural killers
    • supressor T-cells
  45. what do neurotphils do?
    kill invaders or attempt to kill
  46. what do eosinophils do?
    allergic disorders; parasitic infection (large bacteria); picks up neutro's slack
  47. what do basophils do?
    release histamine; increase blood flow and phagocytosis
  48. What do T-cells do? Where are they produced and where do they mature?
    turn on or off the immune response. produced in the red marrow and mature in the thymus
  49. Where are B-cells produced and what do they do?
    produced in the bone marrow and produce antibodies/immunoglobulins
  50. what are self-regulating proteins released by macrophages?
  51. what do cytokines do?
    • cell to cell communication
    • triggering the immune response
    • transition from the acute to chronic stage of infection
  52. what are the specific cytokines?
    • colony stimulating factor: influence function of mature lymphocytes
    • intereron: inhibit tumor growth
    • interleukins: prompts T-cells to recognize pathogens
    • tumor necrosis factor: eliminate blood supply to tumors
  53. what is defined as injection of a small amount of a disabled antigen to allow the lymphocytes to create specific antibodies for a disease as well as memory for it?
  54. what are the 4 classifications for immune disorders?
    • immunodeficiencies
    • hypersensitivities
    • autoimmune response
    • immunoproliferative
  55. what does AIDS stand for?
    Acquired Immunodeficiency Syndrome
  56. what is considered congenitial; failure of organ development necessary for lymphocyte maturation or born without vertain antibody types?
    primary immunodeficiency diseases
  57. what type of immunodeficiency is from malnutrition, stress, CA Tx, leukemia, and chronic diseases?
    secondary immunodeficiency
  58. what type of hypersensitivity is anaphlacitc; typical allergies?
    type I
  59. what type of hypersensitivity is cytotoxic reactions; rejection of blood transfusions or autoimmune hemolytic anemia
    type II
  60. what type of hypersensitivity is immune complex mediated?
    type III
  61. what type of hypersensitivity has no reaction until second exposure
    type IV
  62. HA, chest pain, back/flank pain, tachycardia and hypotension, hematuria, nausea & vomiting, and urticaria are clinical s/s for what type of hypersensitvity?
    type II
  63. Fever, arthralgias, synovitis, lymphadenopathy, urticaria, and visceral inflammtion are clinical s/s of what type of hypersensitivity?
    type III
  64. Itching, erythema, and vesicular lesions on the skin are clinical s/s for what type of hypersensitivity?
    type IV
  65. what is defined by inability to distinguish self from non-self causing the immune response to attack the bodys own tissues?
    autoimmune disease
  66. Gradual onset, flushed face, thirst, fruity odor to breath, HA, hyperventilation, lethargy/confusion/coma, abdominal pain & distention, and a blood glucose level >250 mg/dl are s/s for which blood glucose extreme?
  67. rapid onset, pallor & perspiration, blurred vision, numbness of lips & tongue, HA, increased sympathetic activity- nervousness, irritability, & increased heart rate, difficulty speaking or concentrating and poor coordination are s/s which blood glucose extreme?
    hypoglycemia/ insulin shock
  68. what is defined as chronic, systemic inflammatory disorder of unknown etiology typiacly involving synovial joints, but can also affect other organs
  69. a pt. must have ___ out of ___ to meet the criteria to be Dx with RA
  70. what is defined as chronic, systemic inflammatory rheumatic connective tissue disease; characterized by multiple autoantibodies
  71. systemic lupus erythematosus
  72. What are the three top systemic symptoms of infection?
    • fever
    • chills
    • malaise
  73. s/s of infection of the skin would present how?
    rash, purulent drainage from a wound, red streaks
  74. s/s of infection of the cardiovascular system would present how?
    petechial lesions, tachycardia, hypotension, change in pulse rate
  75. s/s of infection of the CNS would present how?
    altered level of consciousness, confusion, confulsions; HA's, photophobia, memory loss, stiff neck myalgia
  76. s/s of infection of the GI would present how?
    nausea, vomiting, diarrhea
  77. s/s of infection of the GU would present how?
    dysuria, flank pain, hematuria, oliguria, urgency and frequency
  78. s/s of infection of the upper respiratory would present how?
    cough, hoarseness, sore throat, nasal drainage, sputum production, decrease in exercise tolerance
  79. Are viruses affected by antibiotics?
    well hell no!!
  80. what are some blood born viral pathogens?
    • hep B and C
    • HIV
  81. what are the herpes viruses?
    • herpes simplex 1: cold sores
    • herpes simplex 2: genital
    • Mono
    • cytomegalovirus
    • Varicella Zoster: chicken pox/shingles
  82. what are some viral upper resp. infections?
    • influenza
    • respiratory syncytial virus (RSV)
  83. Which is life threatening; viral or bacterial menegitis?
  84. what is defined as single celled orgainisms that do not require another living organism for growth and reproduction?
  85. what is defined as staph aureus one of the most common bacterial pathogens residing on the skin
  86. In lay terms, what is streptococcal-group A?
    bacterial sore throat
  87. What can follow untreated strep throat?
    scarlet fever
  88. what is defined as acute inflammation of the skin and subcutaneous tissue with resultant lymphangitis and systemic s/s of fatigue, malaise, and HA?
    streptococcal celluitis
  89. what is descibed as something that can cause pneumonia and menigitis in adults and sepsis. Causes 70% of community acquired pneumonia
    streptococcal pneumonaie
  90. what is defined as a form of bronchopneumonia caused by legionella pneumonhila; freq. found in warm standing water
    legionnaires disease
  91. what are the hormones resposnible for metabolism?
    • T4: thyroxine 
    • T3: tri-iodothyronine
  92. What are some common disorders of the thyroid?
    goiter, graves, hypothryroidism
  93. what is defined as thyroid enlargment due to iodine deficienc in diet; inhibts normal thyroid production causing hypersecretion of TSH from pituitary.
  94. Tachycardia with increased cardiac output; (-) nitrogen balance and lipid depletion; nervousness due to stimulation of sympathetic nervous sytem; mild thyroid enlargement; heat intolerance; increased appeitite; sweating and diarrhea; tremor and heart palpations; exophthalmos

    These are descriptions for what disease?
  95. what is the most common disorder of the thyroid?
  96. T/F: some very common s/s for GI issues are also constitutional s/s?
  97. a burning sensation in the esophagus usually felt in midline below the sternum in the region of the heart
    heart burn
  98. What may be caused by mechanical, inflammatory, ischemic or referred and is related to the GI
    abdominal pain
  99. what is often not detectable by the pt. and can be caused by gastritis, peptic ulcers or lesions of the intestines and often produce occult blood in the stool
    GI bleeding
  100. What is defined as difficulty swallowing; causes include neurological dysfunction, local trauma or mechanical obstruction
  101. what is described as the lower esophageal sphincter  becomes enlarged allwoing stomach to pass through the diaphragm into the the thoracic cavity
    diaphragmatic hernia
  102. lifting, straining, bending over, chronic or forceful cough, obesity, preggo, CHF, low fiber diet, constipation, delayed bowel movements can all cause what?
    increased intra-abdominal pressure
  103. scleroderma, smoking, caffeine, chocolate, alcohol, CNS depressants, fatty foods, cardiac meds that act as smooth muscles relaxers, and hiatal hernias are among the many causes for what?
  104. Heartburn, reflux, dysphagia, painful swallowing, pain described as "burning" that moves up and down and can also radiate to the jaw, neck, and back and can typically occur 30-60 minutes after eating describes what?
  105. what is described as inflammation of the lining of the stomach that represents a group of the most common stomach disorders. usually self-limiting and heals within several days
    acute gastritis
  106. what is described as loss of tissue lining the lower esophagus, stomach (GU) and most commonly the duodenum?
    peptic ulcer
  107. _________ and other _________ can cause ulerations, hemorrhage, perforation, stricture formation, exacerbation of inflammatory bowel disease.
    aspirin; NSAIDS
  108. what the most common gastric cancer?
  109. what is defined as gluten sensitive enteropathy; genetically predisposed immune mediated disorder
    celiac disease
  110. what is defined as inflammation of the vermiform appendix?
  111. what is defined as severe, life threatening disorder that occurs when activated enzymes escape into the pancreas and surrounding tissue
  112. acute pancreatitis
  113. what is defined as progressive desruction of the pancreas mostly due to alcoholism?
    chronic pancreatitis
  114. what are the two types of inflammatory bowel diseases?
    • ulcerative colitis
    • crohns disease
  115. what is defined as inflammation and ulceration of the inner lining of the large intestine and rectum?
    ulerative colitits
  116. what is described by saying it attacks the terminal end of small intestine and colon but can occur anywhere from the mouth to anus and usually in young adults and adolescents
    crohns disease
  117. what is referred to as the "common cold of the stomach"
    irritable bowel syndrome
  118. where can the liver refer pain to?
    • T-spine
    • R UT
    • R shoulder
  119. Where can the gall bladder refer pain to?
    • R UT
    • R shoulder
    • R interscap area
    • R subscap area 
  120. What is defined as yellowness of skin, sclerae, mucous membranes, and excretions (dark urine, light stools) due to bilirubin staining 
  121. How intense should the exercise be for a pt. with jaundice or any other liver disease?
    low level
  122. What are white bands across the nail plate called?
  123. what are spoon nails called?
  124. What are opaque nail beds called?
    nails of terry 
  125. what are also known as schamroths window nails?
  126. What are permanently enlarged & dilated capillaries due to impairment of estrogen detoxification by he liver?
    spider angiomas 
  127. what is defined as acute or chronic inflammation of liver due to viral, chemical, drug reaction, or alcohol abuse? And, how many forms does it have?
    hepatitis; 3
  128. which form of hep is desribed below:
    oral-fecal contamination; often acquired in childhood and mimics the flu. vaccine now available 
    hep A
  129. which form of hep is described below:
    blood borne; health care workers at risk; s/s jaundice, arthralgias, rash, very serious, high mortality rate-vaccination available
    hep B
  130. which form of hep is described below:
    exposure to blood or blood products; transfusions, needlesticks, IV drugs, no vaccine available; can progress to chronic hepatitis and cirrhosis
    hep C
  131. What is described as inflammation of liver for 6 months or more after unresolved viral hepatitis or unknown etiology; steroids may be used to treat
    chronic hepatitis 
  132. What represents the end stage of chronic liver disease?
  133. What defines a male alcoholic?
    14 drinks/week or >4 drinks/occasion 
  134. what defines a female alcoholic?
    7 drinks/week or 3/occasion 
  135. what is "a drink"?
    • 12oz beer
    • 5-6oz wine
    • 1-1.5oz shot 
  136. what are  5 health risks of chronic alcoholism?
    • HTN
    • Hepatitis
    • Cirrohis
    • Hemorrhagic stroke
    • Pancreatitis 
  137. T/F: with Liver CA, primary tumors are rare, usualy due to metastasis from colorectal, breast, lung, or urogenital. 

    Why is this true/false?
    True; everything goes through the liver 
  138. in lay terms what is cholelithiasis?
    gall stones
  139. in lay terms what is cholecystitis?
    inflammlation of the gall bladder due to gall stones 
  140. in lay terms what is pyelonephritis?
    kidney infection
  141. what is defined as infectious inflammatory disease or renal parenchyma (cells of kidney) to bacteria entering via urethra?
  142. Who is more at risk for kindey/UT infections? why?
    Elderly; most commonly use cath's on a regular basis and their ability to clean the area appropriately has declined. Also, may be in depends underwear and dont get change PRN. 
  143. what is defined as inflammation of glomeruli of both kidneys; acute or chronic?
  144. what is the technical anme for kidney stones?
  145. T/F: you will probably never see patients directly for renal failure, but will treat them for musculoskeletal problems and other complications.
  146. T/F: lupus can also cause chronic renal failure
  147. what is the technical name for bladder infection?
  148. what is the technical name for inflammation of urethra?
  149. what is a bladder infection typically caused from?
    ascending UTI, acute or chronic, bacterial. 
  150. what is urethritis typically caused from?
    several organisms, some STD's and kidney stones
  151. if you have a pt. come in and they c/o these s/s: lower abdomen and upper thigh pain that comes in waves and is excruciating and severely intense. what would you suspect they have?
  152. bacterial commonly associated with bladder infections typically comes from where?
  153. there are three types of incontinence, what are they?
    • stress
    • urge
    • neurogenic 
  154. is any form of incontinence normal?
  155. what is incontinence?
    impairment of voluntary bladder control.
  156. when someone has urine leakage while laughing, jumping or coughing/sneezing, what type of incontinence do they have?
  157. When someone has a real strong desire to urinate and eventually that desire takes over and they have an "accident" what type of incontinence is this?
  158. There are 3 types of involvement with neurogenic incontinence, what are they?
    • Flaccid: LMN dysfunction
    • Spastic: UMN dysfunction
    • Uninhibited: neither flaccid or spastic
  159. what type of incontinence is described by lack of control or sensation of bladder activity resulting in incontinence; due to CVA or head injury
  160. New lesions, unexplained lesions, the physician is unaware and the lesion is changing are ___________ for skin rash physician referral.
    general rule 
  161. Rapidly spreading rash that is accompainied by systemic c/o fever, fatigue, and/or malise and joint pain are ______________ for physician referral. 
    urgent rule 
  162. Anemia, lead poisoning, vasospasm, syncope, stress, internal bleeding, CA, GI disease and TB are causes for what skin color?
  163. Central color change due to inadequate pulmonary gas exchange or peripheral slowing of cutaneous blood flow are causes for what skin color change?
    cyanosis (blue)
  164. Excessive levels of bilirubin cause what color skin change?
  165. disturbance of the adrenocortical hormone cause what skin color change?
  166.  A hyperpigmentation or disturbance of adrenocortical hormone cause what change in skin color?
  167. What is described as common, chronic, relapsing, pruritic type of eczemaous disorder that has no known cause?
    atopic dermatitis 
  168. Where is atopic dermatitis typically found in adults?
    folds of extremities on flexor surfaces (elbow, knee)
  169. what type of skin disorder is described as acute or chronic skin inflammation caused by exposure to chemical, mechanical, physical or biologic agent and what type of hypersensitivity is is?
    contact dermatitis; type IV
  170. what skin disorder is described as superficial inflammation of skin due to irritant exposure, allergic sensitization or genetics?
  171. what are two examples of bacterial skin infections?
    • impetigo
    • cellulitis 
  172. what are 3 types of viral skin infections?
    • herpes 1 & 2
    • varicella zoster
    • warts 
  173. what are 2 types of fungal skin infections
    • tinea corpora (ring worm)
    • tinea pedia (athletes foot)
  174. which skin infection is most common in infants and elderly and is contagious and spreads easliy and what is it caused by?
    impetigo;  staph or strep 
  175. What skin infection in suppurative inflammation of the dermis and subcutaneous tissues and is caused by staph or strept pyogens?
  176. what is described as common, benign, viral infections of skin caused by human papilloma viruses (HPVS)
  177. T/F: tinea pedis (athletes foot) can lead to cellulitis
  178. Basal cell carcinoma, squamous cell carcinoma, malignant melanoma, and karposis sarcoma are cancers of what?
  179. What cancer is described as slow growing surface epithelial skin tumor originating from undifferentiated basal cells in epidermis
    basal cell carcinoma 
  180. What is the second most common skin cancer in whites and usually occurs on rim of ear, face, lips, mouth, dorsum of hands where exposed to skin
    squamous cell carcinoma 
  181. What is the most serious form of skin cancer that arises from pigmented cells in skin called melanocytes that synthesize melanin pigment
    malignant melanoma 
  182. Those with a family Hx of it, have blonde or red hair and have marked freckling on the upper back are at risk for what type of skin cancer?
    malignant melanoma 
  183. What is the ABCD method for early detection of melanoma?
    • A: asymmetry
    • B: border
    • C: color
    • D: diameter 
  184. What type of skin cancer presents as a skin disorder that used to occur in jewish and italian men and now is more common in patients with AIDS, more specifically homosexual males
    karposi's sarcoma
  185. What is chronic, inherited, recurrent, inflammatory dermatosis characterized by well defined erthematous plaques covered with silvery scales
  186. what type of arthritis can patients develop if they have psoriasis?
    psoriatic arthritis
  187. What is the term that refers to a large group of diseases characterized by uncontrolled growth and spread of abnormal cells
  188. What is descibed as abnormal growth of new tissues that serves no useful purpose, does not respond to normal body controls and may harm the host organism by competing for blood and nutrients
  189. what is either an "overgrowth" or neoplasm; benign or malignant
  190. what is the process of describing the extent of disease (cancer) at the time of diagnosis
  191. what is the purpose in staging cancer?
    • treatment planning
    • prognosis
    • comparing outcomes 
  192. what are the most important predictors for recurrent CA?
    • stage at initial Dx
    • histological findings
  193. Carcinoma in situ is what stage of cancer?
    stage 0
  194. early stage of local CA is what stage of CA?
    stage I
  195. increased risk of spread due to tumor size is what stage of CA?
    stage II
  196. local cancer that has spread but may not be spread to distant sites is what stage of cancer? 
    stage III
  197. metastasis; has spread and disseminated to distant sites is what stage of CA>
    stage IV
  198. What is the TMN staging system of CA?
    • T: primary tumor
    • N: regional lymph nodes
    • M: distant metastasis 
  199. What type of cells differ from normal cells in structure, size, function, rate of growth and occurs due to a basic disturbance in cellular DNA?
    cancer cells 
  200. what are discrete stages that suggest a single alteration can only partially push a cell to carcingenesis?
    stages of tumor development 
  201. what are 5 potential carcinogens?
    • viruses
    • chemical agents
    • drugs
    • hormones
    • exessive alcohol consumption 
  202. what are the 5 most common sites of mets?
    • lymph nodes
    • liver
    • lung
    • bone
    • brain 
  203. what are the two ways the mechanism of metastasis can occur?
    • break away from the primary tumor and:
    • travel through the blood and lymph to lodge 
    • penetrate into adjacent structures
  204. what is the cancer gene that can contribute to development of cancer after pathologic activation (often activated by a virus) that can transform normal cells into malignant cells
  205. Cancer has been found not to have just 1 causative factor, but has a ________________.
    interplay of causative agents 
  206. What is the single most significant risk factor for cancer?
    age; doubles at 25 and increase every 5 years 
  207. T/F: diet and lifestyle plays a small role in the development of CA?
  208. what are the 4 most common forms of CA that show a familial pattern?
    • breast 
    • ovarian
    • prostate
    • colon 
  209. What are the top 3 modifiable risk factors for CA development?
    • alcohol
    • smoking
    • obesity 
  210. T/F: pain is an early symptom for CA. 
  211. What do curative treatment options for CA consist of?
    • surgery 
    • radiation
    • chemo
    • biotherapy/biological response modifiers (BRM)
    • hormonal therapy 
  212. in lay terms what is palliative Tx?
    when there is no cure, it is used to make the pt. more comfortable for the remainder of their life, to control to s/s. 
  213. What is the caution Acronym?
    • C: changes in bowel and bladder
    • A: a sore that does not heal in 6 weeks
    • U: unusual bleeding/discharge
    • T: thickening or lumps
    • I: indigestion/difficulty swallowing
    • O: obvious changes in wart/mole
    • N: nagging dry cough or hoarseness
  214. what are the two most common local and systemic s/s of CA?
    • low grade fever at night; 99-100 degrees and cyclic
    • unchanging, unreproducable, deep, boaring pain
  215. After how long of no recurrence of CA after initial Dx is a pt. considered "cured"?
    5 years
  216. You would not exercise a CA pt.if their platelet count was ______, their hemoglobin was ________ and if the WBC was ___________
    • platelet: <50,000/ml
    • hemoglobin: <10g/dl 
    • WBC: <3,000/ml OR >10,000 with fever
  217. Which is the most preventable form of all CA's?
  218. small cell or oat cell carcinoma, squamous cell, odenocarcinoma, and large cell carcinomas are what type of cancer?
  219. what type of medication is most effective in treating moderate to severe pain that is fairly constant (typically after MVA, MI, surgery) and is also used in treating chronic pain associated with CA.
  220. morphine, codeine, oxycodone, hydocodone, and demerol are what type of medication?
  221. what type of medication has sedative properties and induce some degree of mental slowness and drowsiness. Can cause constipation, induce euphoria and may produce addiction.
  222. What does NSAID stand for?
    non-steroidal Anti-inflammatory
  223. NSAIDS are used to do what?
    reduce pain, inflammation, fever, and excessive blood clotting 
  224. Cox inhibitors, acetopmenophen, ibuprofen, and aspirin are what type of medication?
  225. what type of medication has a limited delay of soft tissue healing, impairment of bone and cartilage healing, is a renal vasoconstrictors, and may not be effective in mod-severe pain
  226. what hormone is naturally produced by the adrenal cortex and is involved with cortisol/hydrocortisone?
  227. What are the "other" attribute for glucocorticoids?
    • decrease inflammation
    • suppress the immune system
  228. medrol, topicort, dexamethasone,lidex, predinsone are what type of medication?
  229. Which chambers of the heart receive the blood?
  230. which chambers of the heart send the blood?
  231. where do the right side of the heart send/receive blood?
  232. where does the left side of the heart send/receive blood?
  233. what is the heart enclosed by?
  234. what is the muscle of the heart?
  235. what is the inner layer of the heart?
  236. what are the blood vessels on the surface of the heart that supply the heart muscle with blood?
    coronary arteries 
  237. where do the coronary arteries arise from?
  238. which coronary artery supplies the inferior heart and a ___________ MI can happen here.
    right; medium
  239. which coronary artery supplies the anterior heart and a _________ MI can happen here
    left; major 
  240. what do valves of the heart maintain?
    unidirectional blood flow through the heart
  241. what valve is between the right atrium and right ventricle and what type of valve is it?
    tricuspid; atriventricular
  242. what valve is between the left atrium and left ventricle and what type of valve is it?
    bicuspid (mitral); atrioventricular
  243. what is the valve between the left ventricle and aorta and what type of valve is it?
    aortic; semilunar
  244. what is the valve between the right ventricle and the pulmonary artery and what type of valve is it?
    pulmonary; semilunar
  245. arteries are _____________ due to ___________.
    X-sectionally thick; musculature 
  246. what are smaller arteries that control the amount of blood flowing into specific areas?
  247. what are very small vessels  in networks that are the site for nutrient exchange between blood and tissues?
  248. what are capacitance vessels that are poorly organized and have less smooth muscle?
  249. what helps veins propel blood?
  250. what is the pacemaker of the heart?
    SA (sinoatrial) node 
  251. what receives its impulses for the SA node?
    atrioventricular (AV) node
  252. what is fused with the AV node near the top of ventricles?
    bundle of his 
  253. what is located in the left and right septum between the ventricles?
    bundle branches
  254. what are some common conditions of the cardiovascular system impact?
    • heart muscle
    • heart nervous system
    • heart valves
    • pericardium
    • blood vessels 
  255. what do you call it when an artery hardens?
  256. what do you call it with an artery becomes congested with plaque?
  257. Which are good and which are bad LDL or HDL when it comes to coronary artery disease (CAD) 
    • LDL: BAD
    • HDL: GOOD
  258. what are the modifiable risk factors for CAD?
    exercise, smoking, cholesterol, HBP
  259. what are the non-modifiable risk factors for CAD?
    age, male, family history, race 
  260. what is chest pain due to a deficit of oxygen for the heart muscle?
    angina pectoris 
  261. what are the four types of angina?
    • nocturnal: wake up from sleep
    • prinzmetals: occurs at rest
    • Stable: know what triggers it
    • unstable: whenever, where ever 
  262. what is caused by obstruction of coronary artery, leading to prolonged ischemia, cell death/necrosis
  263. what are the main s/s of MI?
    • light headedness, dizziness
    • SOB
    • nausea
    • profuse perspiration 
  264. what is an alteration in cardiac rate or rhythm, manifested on ECG?
  265. what is a physiologic state in which the heart is unable to pump enought blood to meet the metabolic needs of the body at rest or during exercise?
    congestive heart failure (CHF) 
  266. when the ______________ fails to propel blood forward normally, congestion occurs in the pulmonary circulation
    left side of heart 
  267. when the _____________ fails, it results in peripheral edema and organ enlargement 
    right side of heart 
  268. what is the "hallmark" of right sided heart failure?
  269. what are the three most common forms of congenital heart defects?
    • ventricular septal defect
    • pulmonary stenosis
    • tetralogy of fallot 
  270. what do pericarditis, endocarditis, and rheumatic disease all have in common?
    causes of valvular issues 
  271. what is inflammation of the parietal and viseral pericardium?
  272. what is the result when micro-organisms attach to the endocardium and invade the heart valves?
    infective endocarditis
  273. what is persistant elevation of systolic blood pressure called?
  274. how many stages are there for HTN?
    3; pre, 1 & 2 
  275. how many stages are there for HTN and what are they called?
    • 1: essential
    • 2: secondary
    • 3: labile HTN
    • 4: malignant
    • 5: isolated systolic HTN 
  276. what are some possible causes for secondary HTN?
    preggo, alcohol abuse, endocrine disease, acute stress 
  277. what is a heteroenous group of diseases of the myocardium associated with mechanical and/or electrical dysfunction that usually exhibit inappropriate ventricular hypertrophy or dilation and are due to a variety of causes
  278. what are the three types of cardiomyopathy?
    dilated, hypertrophic, restricitve 
  279. what is described as relatively uncommon acute or chronic inflammaton of the heart muscle?
  280. what is defined as any abnormality in the arteries or veins excluding the heart?
    peripheral vascular disease 
  281. what is the leading cause of amputation?
    peripheral artery disease 
  282. on the wells DVT <2 equals what?
    low probability
  283. on the wells DVT 2-6 points equals what?
    moderate probability
  284. on the wells DVT >6 points equals what?
    high probability 
  285. what is common lab value for HGB for males?
  286. what is the common lab value for HGB for females?
  287. what is the common lab value for HCT for females?
  288. what is the common lab value for HCT for males?
  289. what is the common lab value for glucose?
  290. what is the common lab value for INR?
  291. hemiglobin is the _______ number and hematacrit is the _______ number. 
  292. what are the three most common s/s with PE?
    • dyspnea
    • pleuritic chest pain with cough
    • tachypnea
  293. what is the most common s/s with a pulmonary disorder?
    • cough
    • dyspnea
  294. a dry cough can suggest?
    • tumor
    • congestion
    • hypersensitive airways 
  295. a productive cough with purulent sputum suggests?
  296. a productive cough with non-purulent sputum suggests?
    airwat irritation
  297. a productive cough with rust colored sputum suggests?
  298. a productive cough with blood in it may suggest?
    tumor, infection, inflammation, infarction, or abscess
  299. repeated cycles of deep breathing, followed by shallow and/or cessation
  300. abnormally long and deep inspiration
  301. a decrease of air entering alveoli
  302. chest wall falls in during inspiration
  303. shrill, harsh sound during inspiration
  304. high pitched whistling sound with expiration
  305. discontinuous low-pitched sounds predominatly during inspiration
  306. what are some common causes of nail clubbing related to pulmonary issues?
    CF, COPD, lung CA, bronchiectasis 
  307. What are the two most common obstructive dieseases (COPD)
    chronic bronchitis, emphysema 
  308. what are 2 common restrictive pulmonary diseases?
    • pneumonia
    • adult RDS
  309. what is cor pulmonale?
    right sided heart failure
  310. How does COPD typically present?
    • dyspnea 
    • chronic productive cough with excessive mucous 
  311. What is the main goal when treating pt.'s with COPD?
    better uptake of oxygen into the tissues and maximizing status 
  312. What are the basics for COPD rehab?
    • pulmonary rehab: breathing exercises and techniques
    • exercise: whole body; 45 min/daily- intense 
    • education: immunity, energy conservation, hydration
  313. what is defined as a chronic productive  cough >3 months per year for 2 consecutive years?
    chronic bronchitis 
  314. what is defined as pathological retention of air in tissues, particularly in the lungs?
  315. with emphysema, destruction of the __________ leads to permanent, irreversible damage of the __________. 
    elastin; alveoli 
  316. what is defined as reversible obstructive lung disease characterized by inflammation and smooth muscle contraction that has a hereditary component?
  317. what is described as a progressive form-characterized by irreversible destruction and dilation of airways generally associated with chronic bacterial infections
  318. what is described as inflammatory pulmonary response to the offending organism or agent?
  319. what does pneumonia often follow?
  320. what are the 4 types of pneumonia?
    • aspiration
    • fungal
    • viral
    • bacterial
  321. what is defined as acute respiratory failure secondary to a systemic or pulmonary insult; often a fatal complication of serious illness, trauma, or major surgery
    ARDS: acute resp. distress syndrome
  322. what is defined as an autosomal recessive inherited disorfer of ion transport in the exocrine glands?
    cystic fibrosis 
  323. increased viscosity of secretions in multiple organ systems and patchy atelectasis with hyperinflation of the lungs is associated with what?
    cystic fibrosis 
  324. cystic fibrosis can affect what organ systems of the body?
    • pancreas
    • GI
    • pulmonary
    • liver
    • GU
    • musculoskeletal 
  325. T/F: pt's with CF are always susceptible to infection and airway clearance several times a day or as often as possible is indicated
  326. what are the categories for CNS involvement?
    • infectious diseases
    • neoplasms 
    • degenerative diseases
    • stroke
    • TBI
    • spinal cord injury 
  327. meningitis, encephalitis, brain abscesses are what type of brain diesase?
  328. altered level of consciousness, confusion, convulsions, HA's photophobia, memory loss, stiff neck, myalgia are s/s of what?
    CNS infection
  329. what is defined as the meninges becomes inflamed due to infectious agent crossing the blood brain barrier and entering the CSF
    viral meningitis
  330. which is more deadly, viral or bacterial meningitis?
  331. what is described as acute inflammatory disease of the parenchyma of the brain caused by direct viral invasion or hpersensitivity cause by a virus 
  332. what are the three categories of neoplasms?
    • primary tumors
    • paraneoplastic syndromes
    • leptomeningeal carcinomatosis 
  333. what are the 3 types of primary tumors?
    • gliomas
    • meningiomas
    • neurons 
  334. what are 5 degenerative diseases of the CNS?
    • ALS
    • MS
    • parkinsons
    • alzheimers
    • huntingtons 
  335. what type of disease is ALS?
    motor neuron disease; devastatingly fatal for the LMN and UMN
  336. degeneration of the motor neurons involved with ALS happens where?
    corticospinal tracts, motor cortex, and brainstem 
  337. ALS presenting with muscle weakness, hyporeflexia, hypotonicity, atrophy, muscle cramps and fasiculations are dysfunctions with which motor neurons?
  338. ALS presenting with spsticity, pathologic reflexes, hyper-reflexia, and muscle weakness is a dysfunction with which motor neuron?
  339. what is the great crippler of younger adults and is a chronic demyelinating disease of the CNS?
  340. what triggers production of T-cells and macrophages that produces a cytotoxic effects in the CNS resulting in the destruction of myelin leading to MS?
    viral infection
  341. What are the direct impairments of MS?
    sensory, visual, motor, cognitive & behavioral, bowel and bladder 
  342. what is classic triad of parkinsons?
    resting tremor, rigidity, bradykinesia, postural instability 
  343. what is one of the most disabling affects of pt.'s with parkinson's?
  344. what is commonly the first sign of parkinson's?
    resting tremor; "pill rolling" 
  345. how is alzheimers disease different from alzheimers dementia?
    disease is the pathology that leads dementia 
  346. what is defined  as a finite with a beginning & an end; can be induced in any normal brain (ie fever)- there is no single pathological lesion of the brain that can cause it
  347. how long should a seizure last?
    3-5 min. if longer call 911
  348. what are the two types of seizures?
    partial and gneralized
  349. what are the 3 different types of parital seizures?
    • simple partial
    • complex partial
    • partial seizure 2ndarily generalized 
  350. what are the 4 types of generalized seizures?
    • absence/petit-mal
    • myoclonic 
    • atonic
    • tonic-clonic/ grand mal 
  351. what is defined as sudden onset of neuorlogic s/s resulting from a disturbance of blood supply to the brain
  352. what are the variable impairments associated with strokes?
    sensory, motor, psychologial 
  353. T/F: are TIA's precursers for stroke?
  354. the common theme among early signs of stroke is what?
    that they are sudden onset 
  355. clot dissolving enzymes (t-PA) for thrombotic strokes must be given with how many hours of onset of s/s in order to be effective?
  356. With recovery after strokes, for beneifts to be most beneficial they must be done within the first ________ months
  357. what is a closed TBI?
    brain tissue contacts the skull forcefully
  358. what is a open TBI?
    skull is penetrated and brain is exposed 
  359. with TBI ______________ are more indicative of recovery than ________________.
    cognitive deficits; physical dysfunction
  360. what are the 3 predictors of disability with a TBI?
    • severity of injury
    • length of coma
    • length of post traumatic amnesia 
  361. primary damage associated with a TBI is a result of?
    forces acting on the brain at the time of injury
  362. secondary damage associated with a TBI is a result of?
    brain swelling or impaired blood flow to the site of injury
  363. injuries to the cervical region of the spine/vertebrae can result in?
  364. injuries to the thoracic region of the spine can result in?
  365. injuries to L1 and below can result in what?
    cauda equina 
  366. no sensory or motor function below the level of the lesion; may be dues to transection, compression or vascular impairment is what type of injury to the spinal cord?
  367. partial sensory or motor function below the level of the lesion; perianal sensation must be present is what type of injury to the spinal cord?
  368. what is caused by noxious input below level of lesion initiating mass reflex response; urinary retention from kinks in catheter
    autonomic dysreflexia 
  369. when is the peak incidence for Guillian-Barre most common?
    peaks in 20's and another peek between 5th & 8th decade
  370. what type of peripheral neuropathy involves motor weakness and atrophy (no sensory involvement)
    anterior horn cell 
  371. what type of spinal radiculopathy has both sensory and motor presentation?
    spinal nerve root
  372. what type of neuropathy has both motor and sensory involvement relative to the specific nerve entrapped?
    peripheral nerve mononeropathy 
  373. what type of neuropathy that is weaker distally than proximally; ie diabetic neuorpathy " stocking glove distribution" 
    peripheral polyneuropathy 
  374. what type of neuropathy involves motor weakness when sensory is still intact?
  375. what is defined as never fiber loss and atrophy manifested by worsening motor and sensory function in a distally symmetrical pattern that typically occurs insidioulsy?
    diabetic neuropathy 
  376. where do those with diabetic neuorpathy typically lack most of their sensation?
    extremities, especially the feet 
  377. what is defined as an inherited autosomal dominant disorder affecting motor and sensory nerves. involvement includes fibular (peroneal) nerve impacting the foot and lower long?
  378. how many forms of charcot-marie-tooth are there?
  379. What does guillain-barre typically follow?
    upper resp. infection 
  380. what is defined as acute polyneuropathy with temporary inflammation and demyelination of the peripheral nerves that can result in axon degeneration?
    guillain-barre syndrome 
  381. what presents as symmetrical motor weakness that progresses from distal to proximal, mild sensory impairment with transient paresthesia and possible respiratory paralysis?
    guillain barre syndrome
  382. T/F: the longer you are demyelinated the more residual damage there will be residual neurological deficits. 
  383. what is the progression of GBS?
    • ascending
    • plateau/static
    • descending
  384. T/F: recovery from GBS can take months to years.
  385. T/F: it is okay to work a pt. with GBS to and past fatigue.
    false!!! over working these pt.'s will make them worse and can cause severe, permanent damage.
  386. what is defined as autoimmune disorder that impacts the motor end plate: disorder of neuromuscular transmission. 
    myasthenia gravis 
  387. 1. asymptomatic
    2. non-paralytic (GI, Flu-like,etc...)
    3. paralytic that begins like the flu

    these are presentations for what?
    post-polio syndromes 
  388. what are new neuromuscular symptoms that occur decades after the initial recovery from the acute paralytic episode
    post-polio syndrome 
  389. myalgias, jt. pain, increased muscle atrophy and/or new weakness, exvessive fatigue with min. activity, vasomotor abnormalities, and diminishing endurance are clinical manifestations for what?
    post-polio syndrome 
  390. Would it be indicated to exercise post-polio pt.'s to fatigue?
    no; could be detrimental to recovery. 
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