Path-Ew-Logy Exam 2 L4 WAaaaaaaaaah!

lunalovegood's version from 2015-10-14 02:18

Section 1

Question Answer
Primary destruction of neurons followed by disintegration of its myelin sheath due to either trauma/ischemia or neuropathy.Denervation atrophy
What muscles fibers does denervation atrophy involve?1 & 2
Denervation atrophy - muscle appears ___ and ___ on cross sectionsmall and angular
What muscle fibers does disuse atrophy involve?primarily type 2
Disuse atrophy - ___ atrophyangular
Autoantibodies against acetylcholine receptors?myasthenia gravis
Weak muscles of extremities, facial and swallowing muscles, ocular muscles, respiratory failure may be seen...myasthenia gravis (difficulty chewing, speaking, swallowing. Ptosis or diplopia)
70-80% of myasthenia gravis pts. have ___ ___. 15% have ___. thymic hyperplasia, thymoma
Acetylcholine-esterase inhibitors, surgical thymectomy, immunosuppressive agents, corticosteroids, azathioprine or cyclosporine all treat...myasthenia gravis
Degeneration of skeletal muscle, profound wasting and weakness, geneticmuscular dystrophy
Increased serum creatine kinasemuscular dystrophy
Duchenne MD - X linked or autosomal?X-linked recessive (almost ALWAYS seen in boys)
Duchenne MD occurs in 1 in ___ births.3500
Deletion/point mutation on dystrophin gene on the short arm of the X-chromosomeDuchenne MD
Duchenne MD - weakness of respiratory muscles leads to _________ and death.pneumonia
1 year old boys, clumsiness, immoblization, wasting, muscle tissue replaced by fibrous tissue and fat...Duchenne MD

Section 2

Question Answer
You lose _________% of your bone each year.0.7% (holy crap)
Skeletal growth is faster in ___ (girls, boy)girls (both end by early 20s)
A seam of unmineralized matrixosteoid
T/F - Osteoporosis factors include age (osteoblasts working?), physical activity, genetics, Ca nutrition, and hormonal influences.T
In the 1st postmenopausal DECADE you lose _________% of cortical bone and _________% of cancellous bone.2%, 9%
In the 30-40 years postmenopause, you lose _________-___% of your bone.35-50% (why am I studying! I should be running! To increase my bone mass!!!)
When estrogen goes down, what bone terrorizers go up?IL-1, IL-6, TNF (stimulates osteoclasts)
Is primary or secondary osteopororsis MORE COMMON?primary osteoporosis
Name 2 reasons for primary osteoporosis.postmenopausal, senile
Endocrine disorders, neoplastic disorders, GIT disorders, certain drugs and other things are associated with ___ osteoporosis.secondary
Prevention, Ca and Vit D, estrogen, bisphosphonates and calcitonin, and surgery can all treat...osteoporosis
____ may be used to treat osteoporosis, Paget's disease, multiple myeloma and metastatic breast cancerbisphosphonates
PTH increases urinary excretion of...phosphate (increases renal tubular reabsorption of Ca)
The liver turns cholecalciferol into _________-hydroxycholecalciferol and the kidney makes it _________,_________ dihydrocholecalciferol.25 and 1, 25 (PTH helps the latter)
What's the range of serum Ca?8.6-10.4 mg/dL
A functional tumor of parathyroid leads to primary hyperparathyroidism ---> ____hypercalcemia
In secondary hyperparathyroidism there is renal failure ---> _____hypophosphatemia (the renal failure you lose Ca - hyperplasia PTH to get Ca - more loss)
Von Recklinghausen aka...hyperparathyroidism
The parathyroid tumor causing primary hyperparathyroidism is usually ____.adenoma (80-90% - hyperplasia is 10-15% and carcinoma is 1%)
Renal failure, not eating your calcium, and poor intestinal absorption can all lead to...secondary hyperparathyroidism
MEN 1 or 2a, or hyperparathyroidism-jaw tumor syndrome cause hyperparathyroidism ____ (rarely, on the reg)rarely
Name 4 problems cause by high Ca levels.kidney stones, nephrocalcinosis, CNS, cardiovascular
Glomerulonephritis, pyelonephritis and HTN can all cause ...renal failure (and thus secondary hyperparathyroidism)
Name the 2 main causes of HYPERCALCEMIA.#1 malignancy 34.4% and #2 Hyperparathyroidism 34.2% (BUT the malignancy is not parathyroid - because that would be primary hyperthyroidism)
Loss of lamina dura around teeth can be caused by...hyperparathyroidism
Renal osteodystrophy can be caused by...hyperparathyroidism (enlargement of bone with ground glass)
Can hyperparathyroidism SERIOUSLY cause "groans" and "moans"?yes.......... (peptic ulcers - psychic moans from neuropsychiatry, depression disorientation dementia)
Osteolytic lesions - brown tumors, which are giant cell lesions, occur in ADVANCED...hyperparathyroidism

Section 3

Question Answer
Pain - vertebral fractures in ___ and ___ regions.thoracic and lumbar
Loss of height plus various deformities including...lordosis, kyphosis
Bone fracture - multiple ... femoral neck, pelvis spine
Can radiographically detect when _________-_________% reduction of bone mass30-40%
Can bone scanners detect early stages of osteoporosis?yes
Are blood levels of calcium, phosphorus and alkaline phosphatase normal?yes

Section 4

Question Answer
Age 1-3500mg
Age 4-8800mg
Age 9-181300mg
Age 19-501000mg
Age 51 + 1200 mg