ADVANCED PATHOLOGY NR 507-
FINAL EXAM
7th cranial nerve - answer-innervates the sublingual and submandibular glands
innervates the lacrimal gland
controls facial expressions
A diagnosis of psoriasis may be made based on - answer-the distribution of the
skin damage.
A tissue biopsy can be done to confirm the diagnosis by looking for classic
changes in the epidermal layers.
A hemorrhagic stroke confined to the subarachnoid space will present with -
answer-no local signs.
A hiatal hernia is - answer-a diaphragmatic hernia that protrudes (herniates)
through the upper part of the stomach through the diaphragm and into the
thorax due to dilation of the gastroesophageal junction (GJ).
There are four types of hiatal hernias:
-Sliding hiatal hernia. This is where the junction of the esophagus slides up past
the GE junction.
-Paraesophageal hernia. In a paraesophageal hernia, the contents of the
abdomen slide up around the esophagus and into the chest. The GE junction in
the type 2 hernia does not go up into the chest.
-Mixed hiatal hernia. This is a combination of both Type 1 and Type 2 hernias.
The GE junction slides up into the chest and the fundus of the stomach slides up
and around.
-The type 4 hernia is an aggravated Type 3 where other organs other than the
stomach slide up into the chest including the colon and small bowel and spleen.
Symptoms include acute, severe chest of epigastric pain, nausea, vomiting and
GI bleeding.
A mood disorder is a - answer-mental illness that causes the individual to have
dramatic shifts in emotions, mood and energy levels.
A pseudo obstruction - answer-does not involve actual matter that causes an
obstruction. Rather, it is related to myopathy (bowel does not function) or
neuropathy (innervation of the nerves is altered).
Abducent: - answer-motor - external rectus muscle
Accessory: - answer-motor - sternocleidomastoid and trapezius muscles
,ACTH (adrenocorticotropic hormone) - answer-Stimulates adrenal cortex to
release glucocorticoids (cortisol)
cortisol = regulates glucose metabolisim, maintaines blood pressure, and
general well being
also makes adrenal androgens
ACTH-dependent hypercortisolism involves excess - answer-ACTH that stimulates
excess production of cortisol due to the loss of feedback control of ACTH
secretion.
Actinic keratosis is - answer-a precursor to squamous cell carcinoma where
keratinocytes are damaged by radiation and begin to overproduce keratin.
Over time, the damaged keratinocytes can develop into squamous cell
carcinoma.
active phase of schizophrenia - answer-psychotic symptoms surface
-sometimes brought on by psychosocial stressors, delusions, hallucinations,
disorganized speech, disorganized behavior, catatonic behavior
Addison's Disease Diagnosis - answer-Laboratory findings include:
-Plasma cortisol level of less than 3 mcg/dL at 8 AM is diagnostic, especially if
accompanied by a simultaneous elevation of the plasma ACTH level greater than
200 pg/mL.
-Cosyntropin stimulation test will confirm the diagnosis. Cosyntropin is a
synthetic ACTH. A dose is administered intramuscularly followed by attaining a
serum cortisol level 45 minutes later. Under normal circumstances the serum
cortisol level rises to at least 20 mcg/dL. Individuals with adrenal insufficiency
will have stimulated serum cortisol levels less than 20 mcg/dL.
-Serum DHEA levels less than 1000 ng/mL is seen in 100% of patients with
hypocortisolism.
-Serum anti-adrenal autoantibodies will be present.
-Elevated plasma renin activity (PRA) is an indicator of depleted intravascular
volume and the need for fludrocortisone administration.
-Acute adrenal crisis precipitated by a bacterial infection may reveal positive
blood, sputum or urine cultures.
Other laboratory results may include:
-WBC count: there will be moderate neutropenia,
lymphocytosis and eosinophilia count of over 300/mcL.
-Hyponatremia and hyperkalemia.
-Fasting hypoglycemia.
-Hypercalcemia.
,Addison's Disease symptoms - answer-Adrenal glands - not produce sufficient
steroid hormones
Skin - hyperpigmentation - vitiligo
Low blood pressure
Weakness
Weight loss
Nausea, Diarrhea, Vomiting. Constipation, Abdominal pain
Adrenal crisis
Fever, Syncope, Convulsions, Hypoglycemia, Hyponatremia, Severe vomiting and
diarrhea
Specific symptoms of mineralocorticoid deficiency include hypovolemia, postural
hypotension and dizziness, dehydration, hyperkalemia, and salt craving.
adipocytes release hormones altered by obesity that - answer-reduces the
individual's reaction to insulin.
adrenal gland cortex - answer-cortisol, corticosterone, aldosterone, androgens
adrenal gland medulla - answer-secretes epinephrine and norepinephrine
Adrenal Medulla - answer-the adrenal medulla works with the sympathetic
nervous system to exert its effects.
cells of the adrenal gland called Chromaffin cells (pheochromocytes) store
epinephrine and norepinephrine (catecholamines) in the adrenal medulla.
Some circulating epinephrine is secreted from the adrenal medulla while the
most is released from nerve terminals.
Aldosterone - answer-Angiotensin II stimulates aldosterone synthesis and
secretion from the adrenal cortex as well as increased serum potassium.
Aldosterone maintains extracellular volume and blood pressure through its
actions on the distal nephron epithelial cells.
Aldosterone also enhances cardiac contraction, stimulation of ectopic ventricular
activity, increased vascular resistance of blood vessels and decreased
fibrinolysis.
Abnormal levels of aldosterone are associated with changes related to heart
failure.
Alzheimer's disease - answer-Although there are theories on what causes it, the
cause of Alzheimer's disease is unknown.
In Alzheimer's disease, the microtubules become misfolded and tangled which
alters their function.
Alzheimer's disease is the most common neurogenerative disease in the world.
Ten percent of individuals over the age of 65 have Alzheimer's disease.
, Alzheimer's, like dementia, is a progressive disorder associated with impaired
cognitive function and impaired cortical skills. The speed by which it develops
varies among individuals and can occur over many years (4, 8 or 20 years). It is
associated with neuronal loss (dying or atrophy of the neurons). This results in a
smaller brain.
In the brain of a patient with Alzheimer's disease as compared with the normal
brain, there is cortical atrophy and overall reduction in brain size and weight
which causes an overall reduction in cortical mass. There is also enlargement of
the ventricles and reduction in size of the hippocampus.
A reduced hippocampus size is associated the decreased short-term memory,
but the individual's long-term memory may be intact
long-term memory can become altered when it spreads from the hippocampus to
more cortical regions of the brain
Increased Sylvan fissure = language impairment
Amitriptyline (Elavil) is - answer-tricyclic antidepressant (TCA)
Amylin is very closely related to - answer-insulin. It is a peptide hormone that is
secreted at the time insulin is secreted by the beta cells when an individual
consumes food.
Its main function is to regulate blood glucose concentration by delaying gastric
emptying and suppressing glucagon secretion for a meal. It also reduces food
intake due to its satiety effect.
Amyloid hypothesis of Alzheimer's - answer-This hypothesis involves the
formation of senile plaques (amyloid plaques).
Beta-amyloid is a metabolic waste disorder found in the fluid between the brain
cells. It induces neuroinflammation and disrupts communication between the
neurons.
On the plasma membrane, there are numerous proteins. Some proteins ensure
appropriate neurotransmitter function at the synapse.
Other proteins, like the neurofibrillary tangles also misfold, malfunction and then
get released into the extracellular fluid and come together to form an even
larger misfolded protein (Beta-amyloid clump). This is a senile plaque. .
An example of a closed comedone lesion is - answer-an example of a whitehead.
an extra adrenal function is - answer-stimulation of melanocytes.
An individual with an intracranial hemorrhage due to a leaking or ruptured
aneurysm may present with one of the three sets of symptoms below: -
answer-"Worst headache of my life"-excruciating generalized headache with
onset of immediate unresponsive state
Onset of headache with no loss of consciousness
