UWSA 1 – Questions & Solutions
Save
Terms in this set (144)
Hypoxemia and b/l pulmonary edema in the absence of
ARDS is charac by
fluid overload or HF
Pseudohypoparathyroidism is a group of disorders
characterized by end-organ resistance to parathyroid
hormone (PTH) due to defects in the PTH receptor and
downstream signaling pathways. Patients have
hypocalcemia and hyperphosphatemia despite elevated
PTH levels.
Albright hereditary osteodystrophy is an autosomal
dominant form of pseudohypoparathyroidism
associated with skeletal defects (eg, short stature, short
Pseudohypoparathyroidism metacarpal and metatarsal bones). It is caused by
vs defects in GNAS1, which codes for the alpha subunit of
Pseudopseudohypoparathy the G protein (Gsα) that mediates the effects of PTH.
roidism
The manifestations of pseudohypoparathyroidism
depend on whether the disease is maternally or
paternally inherited because the expression of GNAS1 in
various tissues is imprinted. Imprinting is an epigenetic
phenomenon that causes tissue expression of certain
genes dependent on maternal or paternal inheritance.
Because the kidneys express only the maternal allele for
GNAS1, paternal transmission causes the typical skeletal
defects but with normal calcium, phosphorus, and PTH
levels (termed pseudopseudohypoparathyroidism).
, Severe trauma that results in bilateral pulmonary
contusions or fat embolism following long bone
fractures can cause substantial injury to alveolar
pneumocytes and the pulmonary endothelium, resulting
in the release of inflammatory cytokines that recruit
neutrophils to the lungs. Once in the pulmonary tissue,
neutrophils release inflammatory mediators (eg,
proteases and free radicals) that cause further
Mechanism of Respiratory
inflammation and alveolar epithelial damage, resulting
failure in ARDS
in a self-perpetuating cycle of worsening injury. This
process leads to increased pulmonary capillary
permeability (allowing fluid to enter the alveoli),
diminished surfactant production (causing alveolar
collapse), and inspissation of protein-rich fluid and
necrotic debris (hyaline membrane formation). The net
effect is impaired alveolar gas exchange and respiratory
failure.
Diabetic nephropathy (DN) is a common complication
of both type 1 and type 2 diabetes mellitus. Prolonged
hyperglycemia in diabetes results in glycosylation of
endothelial proteins, inflammation, and increased
production of growth factors, collagen, and fibronectin.
Over time, this results in mesangial expansion,
glomerular basement membrane thickening, and
glomerular sclerosis. When the glomerular sclerosis is
nodular (arrow), it is described as a Kimmelstiel-Wilson
(KW) lesion and is pathognomonic for DN. KW lesions
diabetic nephropathy
consist of dense hyaline deposits and commonly arise
from the glomerular arterioles. As the disease
progresses, increased mesangial matrix proteins can
lead to global glomerulosclerosis.
The first clinical sign of DN is albuminuria, which can
progress to overt nephrotic syndrome (eg, peripheral
edema, heavy proteinuria, fatty casts) and renal failure.
The urine sediment is typically bland (ie, no red or white
blood cells or casts).
, Paget disease of bone (osteitis deformans) is
characterized by excessive and disordered bone
formation. Long-term complications of Paget disease
include fracture due to weakness of the disordered
bone; femur fractures and spinal compression fractures
are common. Cranial lesions can lead to hearing loss
*Paget's d. due to compression of the cochlea or involvement of
CN VIII. The high vascularity of pagetic lesions can lead
to high-output heart failure or vascular steal from
surrounding organs (eg, cognitive dysfunction).
Malignant transformation to osteosarcoma is another
common complication of Paget disease.
Osteoporosis is common in older adults, and the risk is
Description of
increased in patients with corticosteroid exposure
Radiographic feature of
(including inhaled corticosteroids). x-ray would show
Osteoprosis
trabecular thinning and possible fracture
Globus sensation (also called globus hystericus and
globus pharyngeus) is a common abnormal sensation of
a foreign body, tightness, or fullness in the throat. It is
often worse when swallowing saliva and may be
alleviated with food or liquid. Globus is a functional
disorder of the esophagus and by definition is not due
to a structural abnormality or motility disorder. It is
frequently associated with anxiety or other underlying
Globus sensation
psychological distress, but it also happens commonly in
patients with no ongoing emotional symptoms.
Most individuals experience the globus sensation
intermittently, although it can be persistent. Significant
pain, dysphagia, vocal abnormalities, or systemic
symptoms (eg, weight loss) are not typical for globus
and suggest another condition.
, This patient, with acute inflammatory monoarthritis,
neutrophilic effusion, and numerous needle-shaped
crystals, has typical findings of acute gout. Gout is a
common disorder of uric acid metabolism characterized
by episodic inflammatory arthritis, and joint destruction
can occur if the disease is left untreated. Synovial fluid
analysis will typically show numerous neutrophils with
slender, needle-shaped, and negatively birefringent
monosodium urate crystals.
Gouty arthritis is caused by precipitation of urate
*Gout
crystals in joints and is most common when uric acid
levels are elevated or fluctuating (eg, initiation of
diuretic therapy). Normally, the urate crystals have a
protective coating of apolipoprotein E or B. When uric
acid levels fluctuate or microtrauma occurs, bare urate
crystals are shed and exposed to IgG antibodies. The
subsequent antibody binding leads to neutrophil
phagocytosis and release of inflammatory cytokines
(primarily IL-1). This leads to infiltration by neutrophils
and macrophages and subsequent inflammatory
changes.
Characteristic features of an osteoarthritic joint include
degeneration of the articular cartilage, narrowing of the
Osteoarthritis joint space, and bony outgrowths (osteophytes) at the
articular margins. Symptoms are usually chronic rather
than acute.
Rheumatoid arthritis is characterized by immune
complex deposition, neutrophil accumulation in the
Rheumatoid arthritis synovial fluid, and perivascular inflammation of the
synovial stroma. Symptoms are usually subacute to
chronic and preferentially involve the peripheral joints.
Acute septic arthritis frequently affects the knee and
may produce a neutrophilic effusion. However, synovial
#Joint infection
fluid would show microorganisms rather than numerous
crystals.
Save
Terms in this set (144)
Hypoxemia and b/l pulmonary edema in the absence of
ARDS is charac by
fluid overload or HF
Pseudohypoparathyroidism is a group of disorders
characterized by end-organ resistance to parathyroid
hormone (PTH) due to defects in the PTH receptor and
downstream signaling pathways. Patients have
hypocalcemia and hyperphosphatemia despite elevated
PTH levels.
Albright hereditary osteodystrophy is an autosomal
dominant form of pseudohypoparathyroidism
associated with skeletal defects (eg, short stature, short
Pseudohypoparathyroidism metacarpal and metatarsal bones). It is caused by
vs defects in GNAS1, which codes for the alpha subunit of
Pseudopseudohypoparathy the G protein (Gsα) that mediates the effects of PTH.
roidism
The manifestations of pseudohypoparathyroidism
depend on whether the disease is maternally or
paternally inherited because the expression of GNAS1 in
various tissues is imprinted. Imprinting is an epigenetic
phenomenon that causes tissue expression of certain
genes dependent on maternal or paternal inheritance.
Because the kidneys express only the maternal allele for
GNAS1, paternal transmission causes the typical skeletal
defects but with normal calcium, phosphorus, and PTH
levels (termed pseudopseudohypoparathyroidism).
, Severe trauma that results in bilateral pulmonary
contusions or fat embolism following long bone
fractures can cause substantial injury to alveolar
pneumocytes and the pulmonary endothelium, resulting
in the release of inflammatory cytokines that recruit
neutrophils to the lungs. Once in the pulmonary tissue,
neutrophils release inflammatory mediators (eg,
proteases and free radicals) that cause further
Mechanism of Respiratory
inflammation and alveolar epithelial damage, resulting
failure in ARDS
in a self-perpetuating cycle of worsening injury. This
process leads to increased pulmonary capillary
permeability (allowing fluid to enter the alveoli),
diminished surfactant production (causing alveolar
collapse), and inspissation of protein-rich fluid and
necrotic debris (hyaline membrane formation). The net
effect is impaired alveolar gas exchange and respiratory
failure.
Diabetic nephropathy (DN) is a common complication
of both type 1 and type 2 diabetes mellitus. Prolonged
hyperglycemia in diabetes results in glycosylation of
endothelial proteins, inflammation, and increased
production of growth factors, collagen, and fibronectin.
Over time, this results in mesangial expansion,
glomerular basement membrane thickening, and
glomerular sclerosis. When the glomerular sclerosis is
nodular (arrow), it is described as a Kimmelstiel-Wilson
(KW) lesion and is pathognomonic for DN. KW lesions
diabetic nephropathy
consist of dense hyaline deposits and commonly arise
from the glomerular arterioles. As the disease
progresses, increased mesangial matrix proteins can
lead to global glomerulosclerosis.
The first clinical sign of DN is albuminuria, which can
progress to overt nephrotic syndrome (eg, peripheral
edema, heavy proteinuria, fatty casts) and renal failure.
The urine sediment is typically bland (ie, no red or white
blood cells or casts).
, Paget disease of bone (osteitis deformans) is
characterized by excessive and disordered bone
formation. Long-term complications of Paget disease
include fracture due to weakness of the disordered
bone; femur fractures and spinal compression fractures
are common. Cranial lesions can lead to hearing loss
*Paget's d. due to compression of the cochlea or involvement of
CN VIII. The high vascularity of pagetic lesions can lead
to high-output heart failure or vascular steal from
surrounding organs (eg, cognitive dysfunction).
Malignant transformation to osteosarcoma is another
common complication of Paget disease.
Osteoporosis is common in older adults, and the risk is
Description of
increased in patients with corticosteroid exposure
Radiographic feature of
(including inhaled corticosteroids). x-ray would show
Osteoprosis
trabecular thinning and possible fracture
Globus sensation (also called globus hystericus and
globus pharyngeus) is a common abnormal sensation of
a foreign body, tightness, or fullness in the throat. It is
often worse when swallowing saliva and may be
alleviated with food or liquid. Globus is a functional
disorder of the esophagus and by definition is not due
to a structural abnormality or motility disorder. It is
frequently associated with anxiety or other underlying
Globus sensation
psychological distress, but it also happens commonly in
patients with no ongoing emotional symptoms.
Most individuals experience the globus sensation
intermittently, although it can be persistent. Significant
pain, dysphagia, vocal abnormalities, or systemic
symptoms (eg, weight loss) are not typical for globus
and suggest another condition.
, This patient, with acute inflammatory monoarthritis,
neutrophilic effusion, and numerous needle-shaped
crystals, has typical findings of acute gout. Gout is a
common disorder of uric acid metabolism characterized
by episodic inflammatory arthritis, and joint destruction
can occur if the disease is left untreated. Synovial fluid
analysis will typically show numerous neutrophils with
slender, needle-shaped, and negatively birefringent
monosodium urate crystals.
Gouty arthritis is caused by precipitation of urate
*Gout
crystals in joints and is most common when uric acid
levels are elevated or fluctuating (eg, initiation of
diuretic therapy). Normally, the urate crystals have a
protective coating of apolipoprotein E or B. When uric
acid levels fluctuate or microtrauma occurs, bare urate
crystals are shed and exposed to IgG antibodies. The
subsequent antibody binding leads to neutrophil
phagocytosis and release of inflammatory cytokines
(primarily IL-1). This leads to infiltration by neutrophils
and macrophages and subsequent inflammatory
changes.
Characteristic features of an osteoarthritic joint include
degeneration of the articular cartilage, narrowing of the
Osteoarthritis joint space, and bony outgrowths (osteophytes) at the
articular margins. Symptoms are usually chronic rather
than acute.
Rheumatoid arthritis is characterized by immune
complex deposition, neutrophil accumulation in the
Rheumatoid arthritis synovial fluid, and perivascular inflammation of the
synovial stroma. Symptoms are usually subacute to
chronic and preferentially involve the peripheral joints.
Acute septic arthritis frequently affects the knee and
may produce a neutrophilic effusion. However, synovial
#Joint infection
fluid would show microorganisms rather than numerous
crystals.
