Pathophysiology 2 Final Exam

motility, secretion of digestive juices, digestion of nutrients, absorption of nutrients

What are the general functions of the GI tract (4)

tracheoesophageal fistula

GI embryonic disorder characterized by Abnormal connection of trachea and esophagus

esophageal atresia

foregut developmental disorder where esophagus is closed off in a blind pouch

False - results from failure of normal partitioning between foregut and midgut

true or false: intestinal atresia results from failure of normal partitioning between foregut and hindgut

moistening action, taste perception, salivary amylase release

functions of the oral cavity (3)

false - breaks down sugars only

true or false - oral cavity breaks up food particles and starts enzymatic break down of sugars, proteins but not fatty acids

lower esophageal fistula

this structure remains constricted, preventing highly acidic gastric contents from moving up from the stomach into the esophagus

chief cells

which gastric cells secrete pepsinogen

glossopharyngeal, vagus, and trigeminal

cranial nerves controlling swallowing and are responsible for gag reflex (3)

false

as fats enter the stomach, biles salts break up large fat globs into droplet process called emulsification

gastrin

molecule secreted by stomach mucosa when food enters stomach to activate motility

chylomicron

during absorption, these molecules pass through a series of lymph vessels that eventually drain into the general circulation

False

true or false - stomatitis is an ulcerative inflammation of the stomach mucosal lining

false - stomach

gastritis is an ulcerative inflammation of the oral mucosa

peptic ulcer disease

this disease results from an overly active vagus nerve which stimulates pyloric antrum cells to release gastrin to act on gastric parietal cells to release HCl. Resulting low pH leads to ulcerations in stomach, esophagus, and duodenal areas

diverticulitis

presence of inflamed diverticula (herniations) in the colon is called ___

cecum and sigmoid colon

what are the common sites for volvulus

GERD

This disorder results in backflow of gastric contents into esophagus through LES

true

true or false - para-esophageal hernia describes a defect in diaphragm allowing part of the greater curvature of stomach to roll through the diaphragmatic defect

peptic ulcer disease

disorder of upper GI tract caused by action of acid and pesin

true

true or false - nonfunctional Uridine diphosphate glucuronosyltransferase (UDPGT) will cause jaundice

dysfunction of liver cells: increased levels of conjugated bilirubin; immature UDPGT: physiologic newborn jaundice, UDPGT mutations

hepatic causes for jaundice

hepatic encephalopathy

complex neuropsychiatric syndrome from too much ammonia associated with hepatic failure or severe chronic liver disease

previous hepatitis A infection

what is a positive Anti-HAV IgG test an indication of

HDV

this hepatitis, an incomplete virus is responsible for the infection but requires the help function of HBV to replicate

Wilson disease

excessive amounts of copper accumulate in liver and other organs and a mutation in ATP7B gene

False

true or false - HDV is an incomplete virus that requires the helper function of HCV to replicate

false

true or false? endocrine refers to secretion of hormones into the same cells that produced them

all except neurocrine

which of the following functions does estrogen have

False - only bind water soluble hormones

True or false? G-protein-linked receptors bind lipid and water-soluble hormones and convey their signal to a secondary intracellular messenger

amplification

very small amounts of hormones are able to produce rapid effects at the cellular and systemic levels. Which term describes this process?

catecholamines

these hormones result from series of steps modifying tyrosine molecule

steroids

these hormones are formed on demand from cholesterol that is stored in the cell or retrieved from circulating lipoproteins

by altering the receptor number, affinity, and efficiency of coupling to intracellular responses

how are target cells able to regulate their responsiveness to hormones?

hormone antagonist

a chemical that binds to a receptor without initiating the typical intracellular change is called

false - they are produced by the hypothalamus and stored in the posterior pituitary gland

true or false? oxytocin and antidiuretic hormone (ADH) are produced and secreted by the posterior pituitary gland

this causes pores (aquaporins) to move from the cytoplasm to the tubular cell membranes, allowing free diffusion of water from the tubular fluid into the cell

ADH binding to vasopressin 2 (V2) receptor of distal renal tubule results in what

growth hormone

somatotrope cells of the anterior pituitary gland secrete which hormones

ACTH

This hormone is released by the anterior pituitary gland and binds receptors on adrenal cortex cells to stimulate the production of cortisol and adrenal androgens

false - they are made on demand and are not stored in cells

true or false? steroids are not made on demand; they are premade and stored in the adrenal cortex cells

inner zona reticularis is adjacent to the adrenal medulla

which zone produces the androgen, DHEAS, in response to ACTH

can cause an amplification cascade inside the cell.

• Only protein-based hormones can cause an amplification cascade

what is not true about steroid hormones

• travel in circulation bound to proteins: corticosteroid-binding globulin (transcortin) and albumin

• regulate the 3 S’s: sugar, salt, sex

• lipid soluble

• cause an amplification cascade inside the cell

by decreasing glucose uptake by many body cells (decreased glycogenesis) and increasing glucose synthesis in the liver from glycogen and amino acid and glycerol substrates in fat stores (glycogenolysis, gluconeogenesis)

how does cortisol oppose the effects of insulin

increase protein storage and muscle fiber build up is wrong.

what is not a function of cortisol

• increase plasma glucose

• regulates immune and inflammatory reactions

• inhibits bone and collagen synthesis

• increase protein storage and muscle fiber build up

primary endocrine disorder

in this type of endocrine disorder, the gland fails, inadequate hormone is produced, but corresponding trophic hormone levels are high

secondary endocrine disorder

in this type of endocrine disorder, the pituitary gland fails to produce trophic hormone which results in corresponding gland failing to produce their hormones

true

true or false? defective IGF-1 (somatomedin) generation can cause GH deficiency

A & D

what is not a sign of GH deficiency in adults

• hypocholesterolemia

• hypercholestolemia

• decreased bone density

• increased bone density

false - pituitary gigantism occurs in childhood

True or false? acromegaly occurs in childhood before the skeletal epiphyses

primary - issue with thyroid gland

this type of hypothyroidism is associated with elevated TSH and low T3 and T4

Graves Disease

this disorder is associated with increased T3 and T4 release by autoantibodies-stimulated TSH receptor activation

anterior pituitary/cortisol insufficiency

inadequate secretion of ACTH from ____ will cause ______

decreased CRH, ACTH, and cortisol

tertiary adrenal insufficiency is associated with decreased ____ (3)

true

true or false? a non-pituitary tumor resulting in ectopic ACTH production is an example of Cushing syndrome etiology

Conn syndrome

this syndrome is caused by aldosterone-secreting tumors

False - it results from an over expression of Renin from the kidneys

true or false? secondary hyperaldosteronism results from an over expression of Renin from the anterior pituitary

false - benign tumor

true or false? pheochromocytoma is an adrenal medulla aggressive (malign) tumor resulting in excessive production and release of catecholamines

bone resorption to release calcium, its absorption in the GI and reabsorption in the kidney

decrease in calcium causes PTH released which causes

calcitonin

molecule secreted by the thyroid gland that increases bone formation by osteoblasts and inhibits bone breakdown by osteoclasts

hyperparathyroidism

hyperplasia of parathyroid glands will cause ___

true

true or false? congenital lack of parathyroid tissue will cause hypoparathyroidism

diabetes insipidus has nothing to do with diabetes. It causes excessive water loss in urine

what is untrue about this statement? Diabetes insipidus results from anomaly in ADH production leading to diabetes-like symptoms?

syndrome of inappropriate ADH (SIADH)

excessive ADH from ectopic production from tumors is called

glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1)

which hormones are responsible for the incretin effect

exercise

the process of glycogenolysis is highest during which state

corticosteroids and catecholamines

stress hyperglycemia is caused by an increase in release of what

false - it is indicative of pre-diabetes

true or false? impaired glucose tolerance (IGT) with values of 170mmhg is indicative of DM type 2

diabetes mellitus

what is an elevated HgbA1C above 6.5 an indication of

DM type 2

this type of DM is associated with decreased number of insulin receptors or decreased action of glucose transporters leading to insulin resistance

false - in response to decreased insulin production

true or false? ketoacidosis result from increased FFAs conversion to ketone bodies in response to increased insulin production

retinopathies and nephropathies

examples of microvascular pathologies associated with DM

suppress hepatic gluconeogenesis and enhances glucose uptake by peripheral tissues

what is Metformin’s mode of action

dura, arachnoid, pia

from external to internal, what is the name and order of meninges

astrocytes

which glial cells make up the blood brain barrier

ependymal cells

these cells are responsible for the production and maintenance of the CSF

brainstem

which structure contains the midbrain, pons, and medulla

false - it’s the parietal lobe

True or false? the frontal lobe contains the somatosensory cortex

temporal lobe

this lobe contains the auditory and vestibular centers (balance and hearing)

limbic system

parts of the cerebrum most closely associated with memory and emotion

false - it’s part of the central nervous system

true or false - the spinal cord is part of the peripheral nervous system

dermatome

segment of the body innervated by a spinal nerve is called ___

thoracic nerves

all spinal nerves merge into a large group called a plexus EXCEPT

false - it contains neurons in the CNS and PNS

true or false - autonomic nervous system is composed of neurons in the PNS that mediate automatic or involuntary function

somatic nervous system, PSNS, and preganglionic neurons of the SNS

which divisions of the nervous system secrete Acetylcholine (3)

muscarinic receptor

acetylcholine receptor on the effectors cells of the PSNS is ___

false - potassium efflux and chloride influx

true or false - inhibitory neurotransmitters create inhibitory postsynaptic potentials (IPSPs) caused by opening of channels that allow potassium influx or chloride efflux

free radical production which induce cell toxicity

reperfusion can be detrimental to cell survival because it increases ___

A slight increase in one component can be offset by a reduction in volume of the other two (increase in blood is offset by decrease in CSF and brain tissue)

what is the compensatory mechanism for ICP

false - Mild (GCS score 13-15), moderate (GCS score 9-12) and severe (GCS score 8 and under)

true or false - severity of TBI is classified by the Glasgow coma scale (GCS) with the highest scores corresponding to more severe TBI lesions

polar injury

type of primary TBI injury caused by acceleration-deceleration movement of the brain within the skull, resulting in double injury (usually opposite focal injury)

subdural and subarachnoid hemorrhages

which intracranial hematomas involved rupture of bridging veins

thrombotic stroke

this type of stroke is associated with atherosclerosis and coagulopathies

aneurysm

lesion of an artery that results in dilation and ballooning of a segment of the vessel

true

true or false - meningitis and cerebral abscess are commonly associated with bacterial infections while encephalitis is associated with viral infections

meningitis where bacteria invades leptomeninges causing accumulation of inflammatory exudate leading to obstructive hydrocephalus

which infection can precipitate obstructive hydrocephalus

false - only hyperactive; neuronal hypoactivity does not result in seizure

true or false - seizure disorder results from alterations in membrane potential that makes certain neurons abnormally hyperactive and hypersensitive or hypoactive to changes in their environment

petite mal seizures

this type of seizure usually occurs in children and is associated with abrupt onset and termination

false

true or false dementia can be described as an abrupt onset of disturbed consciousness and awareness, becoming worse at night, incoherence, and hallucinations

alzheimer disease

accumulation of amyloid plaques and neurofibrillary tangles is associated with which disorder

to decrease Ach degradation which is already depleted in Alzheimer’s patients

why are acetylcholinesterase inhibitors preconized for Alzheimer’s patients