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Chp. 10

Fundamentals of Disease

Acute glomerulonephritis is an inflammation of the kidneys primarily affecting children and young adults.
Acute glomerulonephritis usually occurs 1-4 weeks after a streptococcal infection (throat/skin)
Signs and symptoms of acute glomerulonephritis include: chills, pyrexia, anorexia, wakness, edema (face/ankles), albuminuria, hematuria, casts in the urine
The Px for acute glomerulonephritis is generally good if a chronic degeneration of nephrons don't occur
Chronic glomerulonephritis is an inflammation of the kidneys that may persist for years with remissions and relapses
Chronic glomerulonephritis is usually accompanied by HTN
A sign of chronic glomerulonephritis is low specific gravity (spec. grav.) of the urine
The end result of chronic glomerulonephritis can be renal atrophy (no development) and RF
RF renal failure
RF causes uremia
Uremia (azotemia) means a blood condition of excessive nitrogenous (N) waste
RF prevents the kidneys from eliminating: nitrogenous (N) wastes
Blood tests used to detect RF include: BUN, Cc, Cys C, GFR
BUN blood urea nitrogen
Cc creatine clearence
Cys C cystatin C
GFR glomerular filtration rate
ARF acute renal failure
Causes of ARF: hypovolemic shock, blood type/Rh incompatibility, kidney disease, trauma, poisoning
Signs and symptoms of ARF: oliguria, anuria, uremia, ammonia breath, hyperkalemia, muscle weakness
Oliguria scanty urine <500 cc/day
Anuria no urine production
Uremia azotemia
Hyperkalemia excessive potassium
Tx of ARF: remedy the cause, HD (hemodialysis)
CAPD continuous ambulatory peritoneal dialysis
CRF chronic renal failure
CRF is usually caused by long standing kidney disease such as: chronic glomerulonephritis, chronic HTN, DN (diabetic neuropathy)
Tx for CRF: HD and kidney transplantation
CRF can also be caused by: ATN (acute tubular necrosis)
Causes of ATN include nephrotoxic agents such as: certain antibiotics (Gentamicin), dyes used in diagnostic procedures
polyonephritis a suppurative inflammation of a renal pelvis
Pyelonephritis is usually caused by pyogenic organisms such as: E. coli, strep, staph; they can causes abscesses to form
Signs/symptoms of polyonephritis include: chills, pyrexia, back/abdonminal pain, dysuria, pyuria, bacteruria, hematuria
Tx for polyonephritis includes the use of: antibiotics (Bactrim)
The Px for polyonephritis is good
Renal carcinoma occurs more frequently in 50-6o yr old men
The incidence of renal carcinoma doubles for smokers
The Px for renal carcinoma is poor because metastases (spread) to the lungs, liver, bone, and brain usually occur before signs and symptoms appear
The chief sign of renal carcinoma is painless hematuria
A WT (Wilm's tumor) is a: malignant fast growing renal tumor in very young children.
The Px for WT is poor but remission rates are increasing
The medical terms for kidney stones are nephrolithiasis and urinary (renal) calculi
Urinary calculi occur more frequently in 20 to 40 year old men (4 to 1 men/women)
Signs and symptoms of nephrolithiasis occur when a calculus obstructs a ureter
Signs and symptoms of nephrolithiasis include: Sharp severe retroperitoneal pain radiating to the inguinal region, hematuria
Causes of nephrolithiasis include: dietary Ca excess, dietary protein and Na excess, hyperparathyroidism
A calculus that fills the renal pelvis completely is called a: staghorn calculus
Tests commonly used to detect a renal calculus include: KUB, renal ultrasound, CT, IVP
KUB kidneys, ureters, bladder
IVP IV pyelogram
Tx for a calculus that impedes the flow of urine is a: ESWL (extra corpeal wave lithotripsy)
Hydronephrosis occurs when a kidney becomes extremely dilated with urine
Causes of hydronephrosis include: renal calculus, tumor, BPH (benign prostatic hypertrophy)
Tx for hydronephrosis involves removal of the obstruction before permanent damage to a kidney(s) occurs.
CKD chronic kidney disease
The leading risk factors for CKD include: DM, HTN, weight gain, smoking
Women who drink two or more cans of regular soda per day are twice as likely to develop CKD
Cystitis is an: inflammation of the urinary bladder AKA urinary infection
Cystitis is more common in women because the female urethra is shorter than in males
The chief causative agent of cystits is E. Coli (eschericha coli)
Signs/symptoms of cystitis include: urinary frequency, urgency, dysuria, bacteriuria, pyuria
Tx for cystitis includes: forcing fluids, antibiotics
The Px for cystitis is good
Methods to decrease the incidence of cystitis include: Wiping from front to back after a BM, Take showers instead of baths, dont douche, dont wear tight pants, cotton underwear, urinate after coitus, increase fluid intake, vitamin C
Urethritis is: inflammation of the urethra
Urethritis in males may be caused by: GC (gonococci)
Signs/symptoms of urethritis: dysuria, balanorrhea, testicular edema
Urethritis in females commonly accompanies: cystitis
Tx for urethritis includes: antibiotics (amoxcillian)
PID stands for: pelvic inflammatory disease
PID refers to an: inflammation of the female pelvic reproductive organs.
Common causes of PID: STDs, GC and chlamydia
Signs/symptoms of PID: lower abdominal pain, pyrexia, dysuria, pungent leukorrhea, dyspareuria
A complication of untreated PID is: infertility
Tx for PID includes: antibiotics, ASA, bed rest, and fluids
Vaginitis is an inflammation of the vagina commonly caused by Candida albicans, trichomonas (sexually transmitted parasite)
Candidiasis is AKA: yeast infection
Signs and symptoms of vaginitis include: pungent leukorrhea, vaginal pruritus, vaginal burning/soreness
The incidence of yeast infections can be reduced by drinking 2 or more glasses of milk daily
Atrophic vaginitis is caused by atrophy (no development) of the vaginal septa (walls).
Atrophic vaginitis is commonly caused by a decrease in estrogen associated with menopause
A common complaint of atrophic vaginitis is: dyspareunia (painful copulation)
Tx for atrophic vaginitis includes: ERT AKA HRT, Antibiotic creams, steroid creams, water soluble lubricants
Puerperal sepsis is an infection of the endometrium occurring after: parturition or abortion
The most common cause of puerperal sepsis is: poor aseptic technique during parturition/abortion
The poor aseptic technique allows pathogens such as: staphlococci, streptococci, or E.coli to enter the uterine wall; causes necrosis of the endometrium
A complication of puerperal sepsis is: septic shock
Signs/symptoms of puerperal sepsis include: pyrexia and chills, profuse or pungent lochia (smelly discharge after birth)
Tx for puerperal sepsis is: antibiotic therapy
Cervical cancer refers to a: malignancy of the Cx
Cervical cancer has a good Px if: detected before metastasis
The most common test to detect cervical malignancy is the PAP test every two years
After age 30 and after 3 consecutive negative PAP tests: every three years
Pap tests should begin within : 3 years of becoming sexually active or by age 21
CIS Carcinoma in situ - A cervical lesion detected before metastasis
Tx for CIS: conization, cryosurgery, cauterization, hysterectomy
Risk factors for cervical malignancy include: poor hygiene, HPV, x sexual partners, early intercourse, smoking
Fibroid tumors are: benign tumors of the myometrium
Fibroid tumors are also called: leiomyomas
The risk of developing leiomyomas is 1 in 5 women under the age of 50
Signs and symptoms of fibroid tumors include: pelvic pain, menorrhagia, metrorrhagia, dyspareunia
Tx options for leiomyomas include: myoectomy, myolysis, hysterectomy
The most common ovarian neoplasm is an ovarian cyst
An ovarian cyst is usually: benign, fluid filled sac
An ovarian cyst will usually resolve with time but a large cyst that interferes with blood flow can be: removed surgically
PCOS polycystic ovary syndromes - characterized by androgen (testosterone) and insulin imbalance
Signs/symptoms of PCOS include: wt gain, HTB, increased facial/body hair, alopecia, irregular menses, MDD, infertility
PCOS can increase risk for: cardiovascular disease and DM
Tx for PCOS include: healthy diet, regular exercise, BCPs, stop smoking
Signs and symptoms of an ovarian malignancy include: Prolonged abdominal bloating and pelvic pain, chronic fatigue, anorexia, wt loss, prolonged urinary frequency
Risk factors for an ovarian malignancy include: high fat diet, nulliparity, family hx of cancer, childbearing after 30, delayed menopause
Ovarian malignancies occur more frequently: perimenopausal and postmenopausal
Tx for ovarian malignancy include: oophorectomy, hysterectomy, chemotherapy, radiation
If caught before metastasis, the five year survival rate for an ovarian malignancy is : 93%
If caught after metastasis the five year survival rate for an ovarian malignancy is : 20-30%
A chemical in the blood that can elevate with the presence of an ovarian malignancy is: Ca-125
The risk of ovarian neoplasms decreases with the use of: BCPs
The most common breast malignancy is an: adenocarcnioma
Adenocarcinomas occur more often in: nulliparity, women w/ a family hx of breast Ca
Adenocarcinomas frequently occur around the time of: menopause
Common signs of a breast malignancy include: A hard fixed lump in the upper outer quadrant of a breast, Axillary lymphadenopathy , dimpling skin, papillary retraction, papillary discharge
ACS mammogram recommendations include: annually for 40-49 yr olds if hx exists, ages 50-74 every 2 yrs
BSE should be preformed every month starting at age 20
A woman’s lifetime risk of developing a breast malignancy is 1 in 8
Confirmation of the suspected tumor can be made with a: stereotactic needle biopsy
Malignant breast tumors can metastasize to the lungs, liver, brain, and bone via the : lymphatic system
Tx for breast malignancy includes: lumpectomy, mastectomy, radiation, chemotherapy
Factors that increase the incidence of a breast malignancy include: ETOH,smoking, sedentary lifestyle, sugar, ERT, BCPs, nulliparity, folate deficiency
Breast malignancy risk can be significantly reduced by : moderate exercise, healthy weight, and breastfeeding
Breast malignancies are more common in women over the age of : 45
The younger a person is with a breast malignancy: the more aggressive the disease
The most common benign tumor of a breast is called a: fibroadenoma
Fibroadenomas are usually solid, round, rubbery, painless and: move freely
A second type of benign tumor of a breast is called : FCC (fibrocystic changes), AKA lumpy breasts
FCC usually occur in both breasts and increase in size and tenderness just prior to: menses
A third type of benign breast tumor is a fluid filled: cyst
Breast cysts are round, moveable, and may increase in size and become tender just prior to: menses
TSS is commonly caused by proliferation of : staph (toxic shock syndrome)
TSS is associated with: tampon use
Signs of TSS include: hyperthermia, rash, peeling skin, GI distress, hypotension
Tx for TSS includes: fluid replacement, antibiotic therapy
Women who use tampons are encouraged to: change them frequently and avoid super-absorbent
PMS is a group symptoms that start 1 to 2 weeks : before menstruation and usually cease with the onset of menses
Signs and symptoms of PMS include: lower abdominal bloating and pain,Breast swelling and tenderness,Cephalalgia,WT gain,Acne,Insomnia,Mood swings, anxiety, MDD, irritability, hostility, crying spells, cravings, clumsiness, fatigue
Tx for PMS includes: increase water intake, exercise, support groups, stress management, avoid ETOH, caffeine and sugar, OTC analgesics
MDD is a severe form of: PMS
The signs and symptoms of PMDD are severe enough to : interfere with work, social activities, and relationships.
Tx for PMDD includes: sedatives and antidepressants.
Endometriosis is a condition caused by: ectopic endometrium
The ectopic endometrium responds to the cyclic hormonal stimulation and can cause: pelvic pain/bloating, menorrhagia, metrorrhagia, fatigue, sterlity
Tx for endometriosis includes: laparoscopic excisions of the ectopic endometrium, OCPs causing anmenorrhea
An EP occurs when a fertilized ovum implants in tissue other than the : uterus
The most common site for an EP is a: fallopian tube AKA tubal pregnancy
Causes of Eps: salpinitis associated with STDs causing fallopian adhesion's, endometriosis
Signs/symptoms of an EP usually appear w/in 2 months include: unilateral abdominal pain, vaginal bleeding, vertigo, weakness/syncope, N+V
Tx for an EP includes: Termination of pregnancy with methotrexate or laparoscopic salpingostomy.
A spontaneous abortion is AKA a misscarriage
A spontaneous abortion during the first trimester is often caused by a fetal gentic abnormality
A spontaneous abortion usually occurs between the: 7th and 12th weeks of gestation (pregnancy).
Causes of a misscarriage include: infection, drugs ETOH smoking and cafferine, poor nutrition, toxins, radiation
The surgical procedure performed to scrape the endometrium if placental tissue remains after a miscarriage is called a: D+C
Toxemia is AKA: preeclampsia
Preeclampsia only occurs during pregnancy
The principal signs of preeclampsia include: PIH, Albuminuria, edema, unusual WT gain
If seizures develop, the condition is called eclampsia
Prevention for preeclampsia include: prenantal care, proper nutrition
Prostatitis is an inflammation of the prostate commonly caused by: e.coli or GC
Signs and symptoms of prostatitis include: urgency, frequency, dysuria, hematuria, painful ejaculation
Prostatitis usually responds well to anibiotic therapy
BPH nonmalignant enlargement of the prostate,Benign prostatic hypertrophy (BPH) is more common after the age of 50.
The enlarged prostate can frequently be palpated by: DRE
The enlarged prostate squeezes the urethra and the patient will complain of: dysuria and urinary retention
Untreated urinary retention can cause : hydronephrosis
Tx for BPH includes: Avodart/Flomax, cystoscopy and TURP
A prostatic carcinoma may be small and initially: asymptomatic
Signs and symptoms of a prostatic carcinoma include: dysuria, hematuria, anorexia and WT loss, nocturia, urinary incontinence AKA enuresis
The blood test to detect a predisposition for prostatic carcinoma is : PSA
Prostatic carcinoma can metastasize to the: rectums, lymph, and bone
A good Px depends on early dection
Tx for prostatic carcinoma include: chemo, bilateral orchiectomy, radiation and prostatectomy
Cryptorchidism refers to an undescended testicle
Cryptorchidism can eventually cause sterility
Tx for cryptorchidism includes orchiopexy or orchiectomy
Impotence is the inability to achieve or maintain an erection AKA ED
Causes of ED: atherosclerosis, stress, DM, complications of prostatectomy, trauma, side effects, drug/ETOH abuse
Tx for ED: Viagra, Levitra, Cialis, penile implant
Methods to reduce incidence of STIs include: abstinence, monogamy, barriers
Chlamydia is the most common STD and the number one cause of PID
Signs and symptoms of chlamydia for women may include: dysuria, pungent discharge, dyspareunia, dysmenorrhea, abdominal pain, vaginal pruritus
Signs and symptoms of chlamydia for men may include: dysuria, balanorrhea, testis edema
Gonorrhea is caused by: GC; the 2nd most common STD
Gonorrhea transmitted to a fetus during delivery can cause: blindness/death
Signs and symptoms of gonorrhea usually appear 2-10 days after exposure
Signs and symptoms of gonorrhea for women may include: green/yellowish discharge, abdonminal/pelvic pain, pharynigitis, dysuria
Signs and symptoms of gonorrhea for men may include: green/yellow balanorrhea, dysuria, pharynigitis, testis edema
The primary stage of syphilis is characterized by one or more painless ulcers that appear on the penis, labia, lips, tongue, or anus called chancers
A chancre will develop within a 10-90 days after sexual contact, tx with PCN (penicillin)
`If primary syphilis is left untreated the secondary stage begins within : 6 weeks to 6 months after exposure and usually lasts 1 to 3 months.
The secondary stage is characterized by non prutic rash typically on palms and soles
The secondary stage is treatable with PCN (penicillin)
The tertiary stage can occur: years after primary infection
The tertiary stage occurs in approximately : 30% of ppl infected w/syphilis
Complications of the tertiary stage include heart disease, blindness, mental illness, and death.
Blood tests for syphilis: VDLR, RPR, EIA
Genital herpes is an extremely painful chronic viral disease caused by the HSV II
Symptoms of HSVII generally occur within 3 weeks of exposure
Signs and symptoms of HSV II include: multiple painful pruritic vesicles that appear on the genitalia, buttocks, and thighs, dysuria, discjarge
The active lesions appear when the immune system is compromised
This disease is more easily transmitted when the lesions are active
Outbreaks of genital herpes can be treated with antiviral drugs (there is no cure)
HPV lesions commonly appear on the: penis and scrotum in men and on the perineum in women
The primary symptoms of the HPV are pruritus and pain
Uncircumcised men are three times more likely to be infected with the HPV
A vaccine is available for these four types of the HPV called Gardasil, approved for males and females ages 9-26
Tx for HPV: antiviral meds, electrocautery, cryosygery
Created by: RBarnes86