Lesson 16 bro

Term Definition
Saga A story about heroic deeds
Embodied Physical shape or form
Unearthed Dug up from ground
Ancestral Inherited from family members in the past
Ruthless No pitty or compassion for others
Destiny Persons fortune fate
Recreational Relaxing or amusing activities
Forge To shape or form
Artistry Artistic quality or ability

Nephrology

Question Answer
When do we dialyze the pt ? AEIOU, Acidemia, Electrolyte abnormalities w/ EKG changes (hyperkalemia), Intoxication and infection related to uremia, Overload fluid not responsive to diuretics, Uremia complications (pericarditis,encephalitis, GI bleed)
Causes of increas BUN Renal failure, proteins, tissues catabolism (fever, burns,steroids), shock, CHF, dehydration, UT obstruction
Acute tubular necrosis ATN cause Ischemic hypoperfusion of kidneys, toxins
Acute tubular necrosis ATN sx Azotemia, uremia (mental status change, edema, fatigue, nausea/vomiting)
Acute tubular necrosis ATN dx Urinalysis, muddy brown casts, CMP to asses potassium, ekg if K high
Acute tubular necrosis ATN tx No acute therapy as kidneys dont work, admit to observation, monitor electrolyte, dialysis (if necessary)
Allergic interstitial nephritis AIN cause Drugs : allpurinol , penicillin, cephalosporin, quinolones, rifampin, sulfas.Infection. Autoimmune disorder
Allergic interstitial nephritis AIN sx Fever, rash shortly after first dose
Allergic interstitial nephritis AIN dx Urinalysis (drug +fever/rash), WBC+, esinophilia, hensel stain detect urine eosinophils
Allergic interstitial nephritis AIN tx Stop drug admit for observation and get serial CMP, if renal failure persists after 3 days may start IV prednison
Toxin-mediated renal insufficiency causes Drugs, unlike AIN, will not occur after 1st dose.
Toxin-mediated renal insufficiency sx Uremic sx, no fever, no rash
Toxin-mediated renal insufficiency dx Sx by exclusion, may find specific toxin by hx
Toxin-mediated renal insufficiency tx Dependent on drug
Atheroembolic disease of the kidneys cause Multiple small infarction of renal parenchyma, genarally secondary to recent vascular prosedure
Atheroembolic disease of the kidneys sx Uremix sx, signs of vascular congestion(bluish discoloration, livedo reticularis) blue/purplish skin lesions
Atheroembolic disease of the kidneys dx Hx, clinical
Atheroembolic disease of the kidneys tx No tx
Rhabdomyolysis causes Trauma, snake bites, seizures, crash injuries
Rhabdomyolysis dx Always first EKG and CMP to check K, then UA to check myoglobin, RBC+, cinfirm w/ CPK level
Rhabdomyolysis tx Icu admission, if elevated k w/ EKG changes (peaked T waves) admininstier calcium glucanate, hydrate saline pt, along w/ osmotic diuretic( mannitol) and alkalinization w/ sodium bicarbonate
Renal insufficiency secondary to multiple myeloma causes Patholgic B cell clonal population in MM results in excessive production of bence jones protien wich cause tubular damage
Renal insufficiency secondary to multiple myeloma dx 24 hr urine protein
Crystal mediated renal insufficiency cause Oxalate and urate crystales (stones)
Crystal mediated renal insufficiency sx Uremic sx, poising, elevatef anion gap metabolic acidosis
Crystal mediated renal insufficiency dx Hx (sweet odor on breath, found unrespnosive, suicidal, pt undergoing chemotherapy) must get UA and see stones
Crystal mediated renal insufficiency tx Hydration and for oxalate IV ethanol or fompezole and dialysis. For urate alkalinization w/ soudim bicarbonate
Renal insufficiency secondary to hypercalcemia cause Calcium stones, usually in pt w/ hyperparathyroidism
Renal insufficiency secondary to hypercalcemia sx Bone pain, osteoporosis, abdominal pain, constipation, polyuria, polydipsia
Renal insufficiency secondary to hypercalcemia dx Uremic sx in pt w/ hyperparathyroidism
Renal insufficiency secondary to hypercalcemia tx All pt w/ hyperparathyroidism and decreased renal function should be surgical treatment ( parathyroidectomy)
Papillary necrosis cause Pt w/ DM cirrhosis or SCD following ingestion of acetaminophen or NSAID
Papillary necrosis sx Fever and flank pain
Papillary necrosis dx 1st get UA red , white cell and may necrotic kidneys tissue, most accurate test is CT
Papillary necrosis tx Stop offending agent
Wegener granulomatosis def Multisystemic vascular disease characteristics by prominent renal, respiratory and skin involvement
Wegener granulomatosis sx Anemia, sinusitis, otitis media, mastoiditis
Wegener granulomatosis dx Best initial test is C-ANCA
Wegener granulomatosis tx Prednisone and cyclophosphamide
Churg- straus syndrome def Asthma, eosinophelia > 10%
Churg- straus syndrome dx P-ANCA
Churg- straus syndrome tx Prednisone and cyclophosphamide
Goodpasture syndrome def Present with lung and kidney but there is no skin or GI issues
Goodpasture syndrome dx First step AntiGBM levels, accurate biposy renal or lung
Goodpasture syndrome tx plasmapheresis and steroids
Polyarteritis nodosa px Can involve any organ
Uremia px Metabolic acidosis, fliud overload, encephalopathy, hyperklaemia, pericarditis
Most common cause of ESRD Diabetes and hypertension
Classifyng CKD Stage 1 – GFR = 90-120. Stage 2= 60-89.Stage 3 = 30-59. Stage 4 = 15-29. stage 5 <15 (ESRD)
Manifestation of renal failure Anemia, hypocalcemia, osteodystrophy, bleeding , infection, pruritus, hyperphophatemia, hypermagnesemia
Tx hyperphosphatemia Sevelamer , lanthanum
Syndrome of anappropriate ADH (SIADH) def To much ADH secretion, over-reabsorption of h2o resulting in decreased plasma concentration of sodium
Syndrome of anappropriate ADH (SIADH) causes Infection, tumors, antidepressants, haloperidol, carbamazpeine, chemotherapeutics
Syndrome of anappropriate ADH (SIADH) tx Demeclocycline or lithium
Mangment of hyponatremia Mild – no symptoms- restrict fluids.Moderate- minimal confusion- saline and loop diuretic. Sever- lethargy, seizure, coma- hypertonic saline 3%
Complications of tx hyponatremia Central pontine myelinolysis, osmotic demyelinization
Diabetes insipidus tx Administrator ADH
Hypokalemia causes Vomiting, diuretics, insulin, high aldosterone, hypomagnesemia, any kind of alkalosis
Hyperkalemia causes Salt-replacement, acidotic state, any kind of renal failure, low aldesterone ( addison), rhabdomyolysis, pt on KCL drip
Hypokalemia px Weakness , paralysis, loss of reflexes
Hypokalemia ECG Flattend t wave and st depression
Hypokalemia mangment If asymptomatic- oral potassium replacement. Otherwise maintenance fluids w/ kcl .Replacment magnisum if low, monitoring k.
Hyperkalemia EKG Peaked t wave, wide qrs, pr prolngation
Hyperkalemia mangment Abnormalities EKG- IV calcium chloride,fluids and add glucose and insulin. Bicarbonate. Diuretics-kayexalate. Dialysis
Nephrolithiasis sx Flank pain radiating to groin
Nephrolithiasis tx 1st step paind medication ( ketorolac)
Nephrolithiasis labs Spiral ct, ua , check calcium, HTN
Nephrolithiasis <5 mm Can pass on own, strain urine .> 7 mm surgery
Nephrolithiasis 5-7 mm Nifedipine + tamsulosin
vCa numbness, Chvostek or Troussaeu, prolonged QT interval.
^Ca bones, stones, groans, psycho. Shortened QT interval.
vK paralysis, ileus, ST depression, U waves.
^K peaked T waves, prolonged PR and QRS, sine waves.
Acute Renal Failure def >25% or 0.5 rise in creatinine over baseline
prerenal Acute Renal Failure def BUN/Cr ratio >20/1. FENA < 1% . diuretic measure FENurea?is <35%
prerenal Acute Renal Failure tx tx Prerenal causes, tx w/ fluids
“terminal hematuria” + tiny clots? Bladder cancer or hemorrhagic cystitis (cyclophosphamide!)
Painless hematuria? Bladder/Kidney cancer until proven otherwise
Best 1st test? Urinanalysis
Dysmorphic RBCs or RBC casts? Glomerular source
Definition of nephritic syndrome? Proteinuria (but <2g/24hrs), hematuria, edema and azotemia
1-2 days after runny nose, sore throat & cough? Berger’s Dz (IgA nephropathy). MC cause.
1-2 weeks after sore throat or skin infxn? Post-strep GN- smoky/cola urine, best 1st test is ASO titer. Subepithelial IgG humps
Hematuria + Hemoptysis? Goodpasture’s Syndrome. Abs to collagen IV
Hematuria + Deafness? Alport Syndrome. XLR mutation in collagen IV
Henoch-Schonlein Purpura. IgA. Supportive tx +/- steroids Kiddo s/p viral URI w/ Renal failure + abd pain, arthralgia and purpura.

Week 11 VOCAB.

Term Definition
Affable Characterized by ease and friendliness
Agog full of intense interest or excitement
Bemoan to express deep grief or distress over
Beseech to be gfor urgently or anxiously
Contumacious stubbornly disobedient
Convivial relating to or fond of feasting and good company
Disputation Verbal controversy
Extricate to free or remove from an entanglement or difficulty
Hypochondriac One who faces extreme depression of mind or spirits often centered on physical ailments
Hypocritical Characterized by an appearance of false character of beliefs

Second Year Review

Question Answer
Saliva provides enzymes called Amylase
Enzymes in the mouth digest Fats and proteins
In the small intestine, pancreatic and intestinal enzymes finish the digestion of Proteins
What does the gall bladder release? It allows fats to break down into glycerol and fatty acids in the small intestines Bile
Water and electrolytes are produced here, vitamin K and B12 are produced Large Intestines
What are macronutrients Nutrients that provide calories or energy

Fold mountains Formation of a fold mountain

Question Answer
How is a fold mountain formed? A fold mountain is formed when two plates collide and fold up the crust.
What are the upfolds and downfolds called? Upfolds are anticlines and downfolds are synclines.
Give examples of fold mountains? The Alps, the Himalayas and the Andes.
How many years ago were the Armorican foldings? Two hundred and fifty million years ago.
Give Irish examples of Armorican foldings. The Comeragh, Caha and Macgillycuddy's Reeks.
What are the youngest fold mountains called? Alpine
What are the middle fold mountains called? Armorican
What are the oldest fold mountains called? Caledonian
If the mountain is high is it younger or older? Younger – the older ones have weathered down over time.
What two plates collided to make the Irish fold mountains? African and Eurasian.

Ch. 26 The Heart

Question Answer
Name a vein that transports blood out of the heart Coronary vein
Name a vein that brings blood away from the kidneys Renal vein
Name a vein that carries very little carbon dioxide Pulmonary vein
Name a vein that brings blood to the right atrium Vena cava
Name a vein that has capillaries at both ends Hepatic portal vein
How does blood move through the veins? Blood moves smoothly by involuntary muscles contracting. The veins have valves to prevent backflow.
Give the name of a a??small arterya?? Arteriole
How do veins and arteries differ? Veins have valves / Arteries dona??t have valves Veins have a wide lumen / Arteries have a narrow lumen Veins have narrow walls / Arteries have thick walls
In what cavity is the heart located in? Thoracic cavity
How does the heart muscle differ from other muscles in the body? The heart is made of cardiac muscle which does not tire
How would you expose the semi lunar valve when dissecting a sheep heart? Cut open the aorta or the pulmonary vein
Name the two circuits in the circulatory system Pulmonary circuit Systemic circuit
Which system in the circulatory system pumps blood to the left ventricle? Systemic circuit
What is a pulse? The alternate expansion and contraction of the arteries
What is blood pressure? The force exerted by the blood against the walls of the blood vessels
What is the role of the SA and the AV nodes in the heart? Cause the contraction of the heart through electrical impulses
What is the effect of diet on the circulatory system? A high saturated fat / cholesterol diet may lead to blockages in the heart resulting in a heart attack. A high salt diet may lead to high blood pressure putting stress on the heart.
What is the function of heart valves? To prevent the back flow of blood
Name the two periods of muscle activity in the cardiac cycle Cardiac systole Cardiac diastole
Give lifestyle changes that a person could undergo to improve heart health Exercise / Eat less fat / Eat less salt / Do not smoke / Lose weight / Destress
What is the function of the heart? To pump blood around the body
Name the artery that supplies blood to the heart Coronary artery
What is meant by a closed system? A closed system is where blood remains in a continuous system of blood vessels. Blood is moved at a faster rate, it is a more efficient system, it allows blood flow to be increased or decreased.
What is meant by an open system? Occurs when blood leaves blood vessels and enters body cells
What is a portal system? A portal system is where a systems begins and ends in capillaries
Name the blood vessel that returns blood to the heart from the lungs Pulmonary vein
Name the 3 types of blood vessels Arteries, veins and capillaries
What is the function of the capillaries? To link veins and arteries
What is the function of arteries? To carry blood away from the heart
What does diastole mean? This is when the heart chambers relax
What does systole mean? This is when the heart chambers contract
By what vessel is blood drained from the heart? Coronary vein
What is the difference between the tricuspid valves and the bicuspid valves? The tricuspid valves have 3 flaps, the bicuspid valves have 2
What side of the heart is oxygenated? Left side (LORD)
What side of the heart is deoxygenated? Right side (LORD)
Outline the events of blood flow in the pulmonary circuit Heart -> Lungs -> Heart
Outline the events of blood flow is the systemic circuit Heart -> Body -> Heart
Why does the left side of the heart have a thicker wall than the right? Must pump blood all around the body in the systemic circuit
Why is double circulation more beneficial than single circulation? 1. Allows oxygen rich and oxygen poor blood to be kept separate 2. Ensures that blood pressure is high enough to reach all parts of the body
What is the SA node more commonly known as? Pacemaker
Where is the pacemaker located? Right atrium

Boones unit 1 test

Question Answer
Which country or empire was the first to practice democracy? Greece
Greece moved to practicing democracy to avoid what? Dictatorship
What smaller government systems was Greece divided into? City-states
What kind of democracy did Greece practice? Direct democracy
What kind of democracy did Rome practice? representative democracy
What does democracy most closely translate to? rule of the people
Who was not allowed to vote in Rome? women and slaves
What two classes did rome have? High class (rich landowner)and Low class(workers farmers merchants)
How many leaders did Rome elect? two
What were the three examples of Roman laws? (not certain) Can cut down a neighbor's tree if it bends into your yard, if you hurt you neighbor’s arm you must pay for the bill or cut your off, If your road is not kept well others may drive across your land.
What were the two governing bodies in Rome? the assembly and senate
what did romans organize their laws into? codes
What was important about the Magna Carta? Who was forced to sign it? It states that people have certain rights and they cannot be taken away. King John.
What country did the United States get most of its laws from? England
In the United States who has the power to veto laws? president
What were three important concepts carried over to early colonial law? representative government, law and order, limit government.
What company brought colonists to America? How many years were they required to work? london company, 7
What was the document that Pilgrims signed before going to shore? Mayflower compact
What were the first two English colonies in America? massachusetts and virginia
What was the first governing body in Virginia? house of burgess
Where did the Massachusetts colonists meet to discuss policies? plymouth OR churches
Several colonists left Massachusetts to form what colonies? Connecticut and rhode island for churches
What were some examples of Roman codes? Fights between citizens, carrying out trade, buying and selling goods.
What colonies created the concept of “Freedom of Religion”? Connecticut and Rhode Island
What colonies were the first to write a constitution? Connecticut and Rhode Island
What is a charter? Who is capable of granting a charter? Give the people the right to govern themselves. Signed by the king.
What form of democracy did Massachusetts practice? What form of democracy did Virginia practice? Massachusetts used direct democracy and Virginia used representative democracy.
Who or what still controlled the colonists? What is a constitution? What is in a constitution? The king. Written plan of government. Rights of the people/how the government should be run.
How long did it take to get information from England to the Colonies? 2 months
What costly war left a tax burden on the colonists? French and Indian War
What did the Declaration of Rights mention? The colonists right to govern themselves, decide their own taxes, and manage their own affairs.
What did the Continental Congress do during the Revolutionary War? Supplying the armyBorrowing moneyPrinting moneyMaking contracts with other countries.
When does an accused person’s 5th Amendment rights begin? At time of custody and must be released after 24 hours
What are your Miranda Rights? Right to remain silentAnything you say can ad will be used against you in a court of lawYou have the right to an attorneyIf you cannot afford one, one will be appointed
What rights did the English Bill of Rights add to the Magna Carta? Cruel and unusual punishment Right to bear armsTaxation without representation
What is the group closest to the president known as? Cabinet
What were the “qualities” that Adams brought to the Presidency? Helped write the deceleration of independence, negotiated end of revolutionary war, and had been a delegate to the constitutional convention. NOT HIS GOOD LOOKS
What might be considered as Jefferson’s greatest accomplishment? the Louisiana Purchase
What was one of the most important contributions that John Adams offered the office of the Presidency? he accepted defeat on his second run for presidency.
What was the Monroe Doctrine? The Monroe Doctrine was a US policy during the Western Hemisphere. This meant that that the doctrine warned European nations that the United states would not tolerate colonizations or monarchs.
Define Theocracy A government that is controlled by one or more religious leaders who claim to follow and do God's will.
Define Sovereignty The authority of a state or country to govern itself.
Define Constitution A written plan of government.
Define Oligarchy A government where all power is consolidated into a small group of people.
Define Monarchy An empire that is ruled by a queen or king
what was monroe doct for to say europeans cant colonize america

vocabulary 2

Term Definition
detonate verb to explode
flabbergasted adjective astonished
incredulous adjective disbeliving
meticulous adjective careful and thorugh
mundane adjective everyday, ordanary
perfidy untrustworthinessnoun
requisition to request or ordernoun
resolute in a determined wayadjective
spurious false or fakeadjective
strife angry or bitter disagreementnoun

Stack #2668844

Question Answer
Saga A story about heroic deeds
Majestic Grand, magnificent, impressive
Embodied Represented in physical shape and form
Unearthed Uncovered; dug up from the ground
Ancestral Inherited from family members in the past

quiz13

Term Definition
inch A unit of measure that is about the length of a paper clip
trapezoid A four sided polygon with exactly two parallel sides
variable A letter that represents a mystery number
array rows and columns of numbers in order
cube 3D shape all sides square
rectangular prism A 3D shape 3 or more sides rectangles
term Any single number or variable between operation signs
like terms all same variables
coefficients The number next to a variable
unlike terms 3y 2x k 31q