GU Patho Endocrine & Neuro

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GU Patho Endocrine & Neuro
2015-10-18 17:23:47
Patho Endocrine
GU,Patho,Exam 2
Exam 2 Neuro & Endocrine
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  1. Causes ischemic necrosis and hypopituitarism (anterior).
    Sheehan syndrome
  2. Hypo- or Hyperpituitarism? Prolactinoma
  3. Hypo- or Hyperpituitarism? Growth hormone adenoma
  4. Hypo- or Hyperpituitarism? ACTH adenoma
  5. Hypo- or Hyperpituitarism? Gonadotroph cell adenoma.
  6. Hypo- or Hyperpituitarism? TSH cell adenoma
  7. Hypo- or Hyperpituitarism? Null cell adenoma
  8. What is a null cell adenoma?
    • The anterior pituitary is not functioning b/c the cells are not producing
    • Hypopituitarism
  9. Hypo- or Hyperpituitarism? Ischemic necrosis/Sheehan syndrome
  10. Hypo- or Hyperpituitarism? ablation of pituitary
  11. What needs to exist to dx SIADH? Why?
    • normal renal, adrenal and thyroid fxn
    • adrenals could be producing too much or thyroid could be encouraging too much release
  12. What is neurogenic DI?
    insufficient amounts of ADH
  13. What is Nephrogenic DI?
    inadequate response to ADH by kidneys
  14. What's the big deal about ACTH deficiency?
    • It causes reduced or no cortisol secretion, which will cause decreased BGL b/c:
    •  * increased insulin sensitivity
    • *decreased glycogen stores
    • *decreased gluconeogenesis
  15. Hypersecretion of GH during adulthood.
  16. Hypersecretion of GH during childhood (before epiphyseal plates close).
  17. What is Conn's Syndrome?
    Excess secretion of aldosterone from adrenal cortex
  18. Result of Conns Syndrome.
    • increased Na+ and H20 retention = hypervolemia & HTN
    • decreased K+ (d/t renal excretion)
  19. What is virilization?
    hypersecretion of androgens = development of male sex characteristics in a female
  20. Part of brain that controls coughing, sneezing, swallowing, vomiting and the CN nuclei it contains.
    • Medulla oblongata (part of Myelencephalon)
    • CN 9-12
  21. Part of brain that controls respiration & the CN nuclei it contains.
    • Pons
    • CN 5-8
  22. Part of brain that maintains balance & posture.
  23. Part of brain that controls reflex activies (HR, RR, BP) & the CN nuclei it contains.
    • Medulla oblongata (part of myelencephalon)
    • CN 9-12
  24. What is Galea aponeurotica?
    covers the cranium directly under the bone
  25. Sympathetic or Parasympathetic? Paravertebral ganglia
  26. Sympathetic or Parasympathetic? Steady State
  27. Sympathetic or Parasympathetic? Thoracolumbar outflow
  28. Sympathetic or Parasympathetic? postganglionic fiber is adrenergic
  29. Sympathetic or Parasympathetic?  target organs are stimulated by NE
  30. Sympathetic or Parasympathetic?  fight or flight
  31. Sympathetic or Parasympathetic?  postganglionic fiber is cholinergic
    both! (only to sweat glands for sympathetic)
  32. Sympathetic or Parasympathetic? target organs are stimulated by ACh
  33. Sympathetic or Parasympathetic? craniosacral outflow
  34. Sympathetic or Parasympathetic? effects are more WIDESPREAD and PROLONGED
  35. What is the corticobulbar motor pathway responsible for?
    • movement of eyes, face, tongue, throat
    • (same as lateral cortcospinal)
  36. For what are basal ganglia responsible?
    • fine-tuning motor movement 
    • (motor pathway)
  37. The ____________ tract of the motor pathway causes extensor muscles to move.
    • vestibulospinal 
    • (like when you start to fall backward)
  38. What is the nucleus pulposus?
    • absorbs shock & prevents damage to vertebrae
    • mass of elastic fibers
  39. Back pain is usually due to?
    nucleus pulposus becomes calcified = bone on bone
  40. _____ is the primary regulater for CNS BF.
  41. How does CO2 regulate the blood supply to the brain?
    • As CO2 increases, bld supply increases to bring in more O2
    • As CO2 decreases, BV constrict to minimize bld supply
  42. Why would you hyperventilate a pt with increased ICP?
    to drive the CO2 down = vasoconstriction = decreased BF to brain = decreased ICP
  43. What compensates for reduced BF in the brain?
    • Circle of Willis
    • if a BV is occluded, others dilate to compensate
  44. The prefrontal lobe guides ________ behavior.
  45. What is the Broca's area? Where is it located?
    • motor speech area-helps in movements required to produce speech
    • Frontal lobe
  46. What is the Wernicke's area? Where is it located?
    • sensory speech area- it helps you understand speech
    • Temporal Lobe
    • (also helps in usage of correct words to express our thoughts)
  47. What causes diffuse axonal injury (DAI)?
    What kind of damage is done to axons?
    • shaking (babies) or whiplash
    • shearing, tearing, or stretching of nerve fibers
  48. What is a mild concussion?
    • causes attention and memory deficits
    • NO loss of consciousness
    • (I, II, III)
  49. In what type of concussion do you lose consciousness (< 6 hrs)? Why?
    • Classic Cerebral (grade IV)
    • there is a disconnection from the brainstem and RAS
  50. What are the ascending spinal tracts? Fxn?
    • spinothalamic (temp, pressure, pain, lt touch)
    • spinocerebellar (proprioception)
    • dorsal column (proprioception, deep pressure, vibration)
  51. What are the descending spinal tracts and their fxns?
    • Pyramidal (corticospinal):  sk muscle tone, voluntary movement
    • Extrapyramidal:  balance & posture
  52. What is proprioception?
    Sense of position
  53. Neurogenic shock causes loss of what?
    • sympathetic outflow
    • -vasodilation
    • -hypotension
    • -bradycardia
    • -hypothermia
    • -inappropriate sweating
    • -hypoxia
  54. Most common locations of spinal cord trauma.
    • cervical (1, 2, 4-7), and
    • T1-L2 thoracic-lumbar vertebrae
  55. What is primary spinal cord injury?
    injury d/t trauma
  56. What is secondary spinal cord injury?
    • a response to primary injury (w/in few min)
    • includes hemorrhaging
    • -can cause edema in white matter
    • -w/in 4 hrs = ischemia & necrosis of cord
  57. Normal ICP.
    5-15mm Hg
  58. Cause of thrombotic stroke
    • thrombi formed in arteries that supply the brain or in intracranial vessels = arterial occlusions
    • TIA
  59. Cause of embolic stroke.
    fragments break from a thrombus formed OUTSIDE brain
  60. Aneurysm that results from atrteriosclerotic changes ; found mostly i basilar arteries or internal carotid arteries.
    Fusiform (giant)
  61. Size of fusiform aneurysms
  62. Cause of mycotic aneurysms.
    • arteritis caused by bacterial emboli
    • associated w/ bacterial endocarditis
  63. What is a glioma?
    A primary intracererbral tumor
  64. What is an astrocytoma?
    • glioma that initiates from astrocytes
    • has lost its normal growth restraint
    • grows by expansion
    • (most common)
  65. Characteristics of oligodendroglioma?
    • slow-growing
    • well-differentiated
    • often w/ cysts & calcifications
    • most in frontal and temporal lobes
    • h/o temporal lobe epilepsy
  66. What is an ependymoma?
    • RARE glioma from ependymal cells
    • grow along walls of ventricles (blocks CSF pathways and increases ICP)
  67. early signs of ependymoma.
    • balance problems
    • uncoordinated muscles
  68. One of first signs of meningioma.
    focal seizures
  69. Most commonly affected area of nerve sheath tumors.
    CN VIII (also V, VII, IX)
  70. What is syringomyelic syndrome?
    inflammation of the spinal cord d/t tumor(s)
  71. What is it called when there is invastion of a spinal cord tumor?
    irritative syndrome
  72. Most common forms of encephalitis caused by?
    • mosquito viruses
    • Herpes Simplex I
    • (always involves meninges)
  73. A chronic inflammatory disease involving degeneration of CNS myelin.
  74. Demyelination in MS is thought to result from?
    • a previous viral insult to the NS in a genetically susceptible person wi/ an abnormal immune response in CNS
    • (unknown CAUSE)
  75. ________ result when peripheral nerves are affected.
  76. An acquired, acute inflammatory DEMYELINATING or axonal DO caused by an immunologic response and directed at PERIPHERAL nerves.
  77. A ______ hematoma develops from an arterial bleed of blood vessels that lie within the grooves in the skull