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Patho Exam 3 Arar
| Question | Answer |
|---|---|
| Which gland controls many endocrine organs? | Pituitary |
| True or False: Nonendocrine conditions can cause excessive production of endocrine hormones | True |
| Overstimulation of target organs by endocrine hormones can cause what signs/symptoms? | Target organ enlargement and overproduction of its hormones |
| What accounts for most manifestations of endocrine disease? | Overproduction of endocrine hormones |
| What types of diseases can cause overproduction of hormones? | Hyperplasia or neoplasia |
| What is underproduction of hormones usually related to? | Disease of the target organ |
| Does the posterior pituitary produce hormones? | No, it stores them |
| Which two hormones does the posterior pituitary store? | Oxytocin and ADH |
| Where are oxytocin and ADH produced? | Hypothalamus |
| Which hormones does the anterior pituitary produce? | TSH, ACTH, FSH, LH, GH, Prolactin |
| Which hormones does TSH stimulate the thyroid to produce? | T3 and T4 |
| What does ACTH do? | Acts on the adrenal cortex to produce cortisol |
| What do FSH and LH do in women? | FSH - roll in the maturation of the ovarian follicle. LH - spikes at day 14 in a woman's cycle to promote ovulation |
| What do FSH and LH do in men? | FSH - involved in spermatogenesis LH - Involved in testosterone production |
| What is the difference between mass effect and stalk effect? | Mass effect is when there's a mass pressing up against something causing symptoms or dysfunction. Stalk effect is if something is pressing on the stalk, compressing the capillaries. Signals don't make it to anterior pituitary, resulting in underproduction |
| What is the most common type of hyperfunctioning pituitary adenoma? | Prolactinoma |
| What is a common correlating symptoms to a prolactinoma in females? | Amenorrhea |
| What is the only hormone that functions under inhibitory control? | Prolactin (The presence of dopamine inhibits prolactin production) |
| What are some signs and symptoms of prolactinoma? | Amenorrhea in females, weight gain, depression and in severe cases, milk production |
| What is the second most common type of functioning pituitary adenoma? | GH-secreting hormone |
| What is the difference between pituitary giants and acromegaly? | Pituitary giants experience an increase in [GH] prior to skeletal maturity. Acromegaly is caused by an increase in [GH] AFTER the growth plates have fused. |
| How is hypopituitarism classified? | When ~75% of the parenchyma is lost or absent (often after it's been surgically removed, or after a stroke) |
| What is Sheehan syndrome? | A stroke that occurs during labor when a woman bears down |
| What type of pituitary pathology is diabetes insipidus? | Posterior pituitary - ADH deficiency |
| What is diabetes insipidus characterized by? | Excessive renal loss of water d/t the kidney's inability to resorb water properly from urine |
| Which hormone, T3 or T4, is more metabolically active? | T3 |
| What are the two types of hypo/hyper-thyroidism? | Primary and secondary |
| What are the levels (low vs. high) of TRH, TSH and T3/T4 in primary hypothyroidism? | T3/T4 are low, making [TRH] and [TSH] high |
| What are the levels (low vs. high) of TRH, TSH and T3/T4 in primary hyperthyroidism? | [TRH] and [TSH] are low, T3/T4 are high |
| What are the levels (low vs. high) of TRH, TSH, and T3/T4 in secondary hyperthyroidism? | [TRH] is low and [TSH] and T3/T4 are high |
| What are the levels (low vs. high) of TRH, TSH, and T3/T4 in secondary hyperthalamus? | All levels are high |
| What are the levels (low vs. high) of TRH, TSH, and T3/T4 in secondary hypothalamus? | All levels are low |
| What type of immune response is autoimmune induced hyperthyroidism? | Type II immune response |
| Which type of thyroid gland neoplasm is the most common (and most easily treated)? | Papillary carcinoma (80%) |
| What type of behavioral changes will you see with hypothyroidism? | Depression, sluggish nerve conduction |
| What type of behavioral changes will you see with hyperthyroidism? | Anxiousness, nervousness, mania. Action potentials are increased in the CNS, patient can almost become/appear schizoid |
| True or false: The operation of the parathyroid glands is dependent on the functioning of the thyroid gland | False |
| Under which circumstance is calcitonin secreted from the parathyroid glands? What type of bone activity does this induce? | When [Ca2+] levels in the blood are too high; Osteoblastic activity (the deposition of bone) |
| What occurs when [Ca2+] levels in the blood are too low? | An increase in bone resorption (breakdown of bone to increase blood levels of [Ca2+] |
| What occurs in hyperparathyroidism? | Extreme fatigue. A global suppression of the CNS as a result of increased blood [Ca2+] drives the internal charge of nerves down so that it takes more energy for neurons to reach threshold |
| How many hormones are produced by the adrenal cortex? What are they? | Mineralocorticoids, glucocorticoids, and sex hormones |
| What is a side effect of increased glucocorticoid levels? | Decreased bone density. It causes a negative calcium imbalance that leeches calcium from the bones |
| Which hormones are produced by the adrenal medulla? | Epinephrine and norepinephrine |
| What two types of Cushing's disease are there? What is the difference? | ACTH dependent and ACTH independent. ACTH dependent is a dysfunction at the level of the pituitary gland (or lung); ACTH independent is the result of a local issue at the adrenals |
| What is Addison's disease? | Chronic adrenal cortex insufficiency |
| What hormone is affected, and how, in Addison's disease? | Aldosterone, levels are decreased. |
| Why is Addison's disease called "bronzed diabetes"? | Low blood levels of cortisol cause the pituitary gland to secrete large amounts of ACTH, which is broken down into melanocyte stimulating hormone, and this turns the skin orange |
| What is Conn's syndrome? | An adrenocortex adenoma hypersecretes aldosterone, causing astronomically high BP |
| Which cells are destroyed in the case of Type I diabetes? | The beta cells of the pancreas |
| What occurs in Type II diabetes? | Failure of a cell receptor to recognize/react to insulin (NO PANCREATIC PROBLEMS) |
| What is dysuria? | Painful urination |
| What is pyuria? | Cloudy urination |
| What is oliguria? | Decreased urinary output |
| Is acute renal failure generally reversible or irreversible? | Reversible |
| What can cause acute renal failure? | Ischemia, direct toxic injury, acute tubulointerstitial nephritis (often d/t a hypersensitivity to drugs), disseminated intravascular coagulation (miniscule clots), and urinary obstruction |
| What is interstitial nephritis? | A disorder in which the spaces b/w the kidney tubules becomes swollen |
| What are common causes of interstitial nephritis? | Analgesic nephropathy and use of NSAIDS |
| With what compound is renal function tested? Why? | Inuline, because it is cleared 100% by the body |
| What is the GFR (glomular filtration rate) in diminished renal reserve? | 50% of normal |
| What is the GFR in renal insufficiency? | 20%-50% of normal |
| What is the GFR in renal failure? What symptom might you see? | Less than 20%-25% of normal; Anasarca (wide-spread edema) |
| What is the GFR in end-stage renal disease? | Less than 5% of normal |
| Which bacteria is the most common cause of a UTI? | Escherichia coli |
| What are the two types of renal infection? | Hematogenous and ascending infection |
| What is acute pyelonephritis? | Suppurative inflammation of the kidney (pus formation) |
| What's the most common way that acute pyelonephritis will present? | With WBC in the urine |
| What clinical signs indicates renal involvement in acute pyelonephritis? | Leukocyte casts, because they are only formed in tubules |
| In what type of population are viral infections of the kidneys normally seen? | Immunocompromised patients |
| What sign is indicative of chronic pyelonephritis? | Scarring |
| What is "thyroidization" of the kidney tubules? Why is this a problem | An attempt to wall off the kidney & prevent the spread of infection. It's a problem because it also stops urine output |
| What are renal calculi? | Stones of the renal system |
| What type of syndromes can increase the risks for renal caliculi? | Gout, cystinuria and primary hyperoxaluria |
| What do calcium oxilate renal stones look like? | Brain coral |
| What do calcium phosphate renal stones look like? | Round & smooth |
| What compound composes struvite/triple stones? In what percentage do they occur? | Magnesium ammonium phosphate; 15% |
| Calcium containing stones make up what percentage of stones? | 70% |
| What percentage of stones are uric acid stones? | 5%-10% |
| What percentage of stones are made up of cystine? | 1%-2% |
| Which stones are considered "stag horn calculi" | Struvite stones |
| What is adult polycystic kidney disease? | A hereditary disorder consisting of the formation of cysts on the kidneys |
| How many live births does APCKD affect? | 1 in every 400-1000 |
| Most diseases involving blood cells are the result of what two pathologies? | Too many or too few blood cells |
| What percentage of blood consists of red and white blood cells? | 45% |
| What are the average percentages for WBC in the blood? | 60% neutrophils, 30% lymphocytes, 8% myocytes, 2% eosinophils, 0% (<1%) basophils |
| Where is albumin produced? | In the liver |
| What does albumin control? | Osmolarity |
| What is the average life span of a RBC? | ~120 days |
| What is hematocrit? | The percentage of RBC in blood |
| What are the percentages of hematocrit in men vs. women? | Men - 45% + or - 5% Women - 42% + or - 5% |
| What is a red cell count (RBC)? | The specific number of RBCs in a sample |
| How is the mean cell hemoglobin (MCH) calculated? | Hemoglobin/RBC |
| What is mean cell hemoglobin concentration? How is it calculated? | A measure of how "red" blood is. Hemoglobin/hematocrit |
| How is mean cell volume (MCV) calculated? | Hematocrit/RBC |
| What are the two types of hemorrhagic anemias? | Acute and chronic |
| What is an example of acute hemorrhagic anemia? | Extreme trauma |
| What's an example of chronic hemorrhagic anemia? | Anemia secondary to a GI bleed |
| What are the two types of GI bleeding? | Malena (black, tarry stools) and hematochezia (frank, red blood) |
| What will RBCs look like in iron deficient anemia? | Small and pale red |
| What fails to occur in Vit B12/Folic Acid deficiency anemia? | The nucleus fails to divide, creating a macrocytic RBC |
| What type of anemia is Vit B12/Folic Acid deficient anemia? | Megoblastic anemia |
| Is the iron binding capacity of RBCs in iron deficient anemia high or low? Why? | High. There are lots of proteins available to bind iron because circulating iron levels are very low. |
| What are two iron transport proteins that exist in blood? | Albumin and transferrin |
| What is polycythemia? | Too many red blood cells |
| What is the difference between relative and absolute polycythemia? | Relative: Lower plasma levels, normal RBC levels. Absolute: Normal plasma levels |
| What is the difference between primary and secondary polycythemia? | Primary: proliferative diease (CA, benign or malignant). Secondary: usually d/t increased EPO secretion (as the result of a tumor or blood doping) |
| What is leukopenia? | Too few WBCs |
| What is neutropenia? | A decrease in neutrophils (associated with acute inflammation) |
| What is lymphopenia? | A decrease in lymphocytes (associated with chronic inflammation) |
| What is agranulocytosis? | An increase in lymphocytes or monocytes, usually lymphocytes |
| What is leukocytosis? What is its most common cause? | A NON-NEOPLASTIC increase in WBCs, most commonly due to infection |
| What is granulocytosis? | A non-neoplastic increase in neutrophils, eosinophils or basophils |
| What is neutrophilia? What is its most common cause? | An increase in neutrophils, usually as the result of a bacterial infection |
| What is lymphocytosis? | The most common form of agranulocytosis, usually the result of a viral infection (increase in B-lymphocytes) |
| What are band cells? | Immature neutrophils |
| What is lymphocytic leukemia? | Proliferation of cells in bone marrow |
| What is lymphoma? | Proliferation of cells in lymph nodes |
| What is myeoloid leukemia? What is an example? | Proliferation of myeloid cells; Polycythemia vera |
Created by:
eippolito
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