490 Questions
What is the most common cause of SIADH?
Ectopic secretion of ADH
What is the main effect of high levels of ADH in SIADH?
Increased water reabsorption by the kidneys
What type of hyponatremia is present in SIADH?
Euvolemic hypotonic (dilutional) hyponatremia
Which of the following is a clinical manifestation of SIADH?
increased total body water
What is the basic pathophysiology of hypopituitarism?
Decreased production of pituitary hormones
What are the typical deficiencies seen in panhypopituitarism?
Decreased production of all pituitary hormones
What is the primary function of the esophageal sphincters?
To prevent air from entering the esophagus during respiration
Which of the following hormones is MOST responsible for enhancing the relaxation of the stomach?
Cholecystokinin
What is the main function of salivary amylase?
To initiate the digestion of carbohydrates
Which of the following factors MOST delays gastric emptying?
Fats
What is the main function of the vagus nerve in relation to the stomach?
To stimulate gastric secretion and motility
Which of the following is a true statement about the composition of gastric juice?
Potassium levels are lower in gastric secretions than in plasma
What is the primary function of the lower esophageal sphincter?
To prevent regurgitation of stomach contents into the esophagus
Which of the following hormones is MOST responsible for enhancing gastric peristalsis?
Gastrin
What is the main function of the stomach's muscle layers?
To mix the food with the digestive juices
What is the primary function of the taste buds and olfactory nerves in the mouth?
To initiate the secretion of saliva
What is the primary function of the small intestine?
To absorb vitamins, minerals, fats, sugars, carbohydrates, and proteins
Which part of the small intestine absorbs carbohydrates and proteins?
Jejunum
What is the primary function of the colon?
To serve as a reservoir for fecal matter and absorb water and electrolytes
Which enzyme is responsible for breaking down starches in carbohydrate digestion?
Amylase
How are amino acids absorbed from the small intestine?
Through active transport with sodium cotransport
What is the role of the defecation reflex?
To create the urge to defecate by relaxing the internal anal sphincter
Which of the following is NOT a risk factor for the development of type 2 diabetes mellitus?
Vitamin D deficiency
Which of the following is a characteristic of gestational diabetes mellitus?
Is a type of diabetes that develops during pregnancy
Which of the following is NOT a component of the metabolic syndrome?
Vitamin D deficiency
In type 2 diabetes mellitus, which of the following is observed in pancreatic alpha cells?
Less responsiveness to glucose inhibition resulting in increased glucagon release
Which of the following is a characteristic of type 1 diabetes mellitus?
Autoantibodies are produced against islet cells and other cytoplasmic proteins
Which of the following is a complication of diabetes mellitus?
All of the above
What is the primary cause of hypoparathyroidism?
Autoimmune destruction of parathyroid glands
Which hormone deficiency leads to a lack of secondary sex characteristics in both males and females?
FSH and LH deficiency
What is the most common cause of hyperthyroidism that develops autoantibodies towards the thyroid?
Graves' disease
In hypothyroidism, what is the primary cause of central (secondary) hypothyroidism?
Conditions causing pituitary or hypothalamic failure
What is the primary manifestation of hyperparathyroidism?
Hypercalcemia and hypophosphatemia
Which condition is characterized by decreased LOC, hypothermia, hypoventilation, hypotension, and coma?
Myxedema coma
Acromegaly is primarily caused by the hypersecretion of which hormone in adulthood?
GH
Thyrotoxic crisis (thyroid storm) can result from excessive stress on patients with:
Hyperthyroidism
Which component of the digestive system is responsible for the initial voluntary phase of swallowing?
Oropharynx
What is the primary function of the salivary glands?
To produce saliva that aids in digestion
Which of the following factors MOST enhances gastric peristalsis?
Motilin
What is the primary function of the lower esophageal sphincter (cardiac sphincter)?
To prevent regurgitation of stomach contents back into the esophagus
Which of the following is a key component of the composition of gastric juice?
Potassium
What is the primary function of the vagus nerve in relation to the stomach?
To stimulate gastric secretion and motility
Which hormone is MOST responsible for enhancing the relaxation of the stomach?
Cholecystokinin
What is the primary function of the taste buds and olfactory nerves in the mouth?
To stimulate the secretion of saliva
Which factor MOST delays gastric emptying?
Fats
What is the primary function of the stomach's muscle layers?
To store and mix food with digestive juices
Which enzyme is primarily responsible for breaking down starches in the small intestine?
Amylase
Which nutrient is primarily absorbed in the ileum of the small intestine?
Bile salts and vitamin B12
What is the primary function of the cecum and appendix in the large intestine?
Connection between the small and large intestines
How are fatty acids and monoglycerides made water-soluble for absorption in the small intestine?
Through emulsification with bile salts
Which part of the small intestine is primarily responsible for the absorption of carbohydrates and proteins?
Jejunum
What is the primary function of the defecation reflex in the colon?
To create the urge to defecate by relaxing the internal anal sphincter
Which of the following substances is secreted by parietal cells of the stomach?
Hydrochloric acid
Which of the following is responsible for breaking down proteins in the stomach?
Pepsin
What is the primary function of mucus secreted in the stomach?
To protect the mucosal barrier
Which of the following substances stimulates the secretion of hydrochloric acid in the stomach?
Caffeine
Which of the following is primarily responsible for the strongest stimulation of pepsin secretion?
Acetylcholine via vagal stimulation
What is the primary factor that inactivates pepsin in the duodenum?
Alkaline environment
What is the main function of the hepatocytes in the liver?
Synthesize bile and secrete it into the bile canaliculi
Which of the following is NOT a function of the liver?
Producing insulin
What is the main role of bile salts in the digestive process?
Emulsifying and aiding in the absorption of fats
What is the main function of the gallbladder?
Storing and concentrating bile between meals
What is the main function of pancreatic enzymes in the digestive process?
All of the above
How does the liver help regulate blood glucose levels?
All of the above
What is the main consequence of impaired bile production on vitamin K absorption?
Decreased clotting factor synthesis and increased risk of bleeding
What is the main function of the ileogastric reflex?
Inhibits gastric motility when the ileum is distended
What is the main function of the Kupffer cells in the liver?
Phagocytize foreign substances and bacteria
What is the main function of the stellate cells in the liver?
Regulate sinusoidal blood flow and participate in liver fibrosis
What is the primary risk factor for the development of gastroesophageal reflux disease (GERD)?
Obesity
Which type of pain is usually poorly localized, diffuse, and vague, in the context of abdominal pathologies?
Visceral pain
What is the typical presentation of an upper esophageal obstruction?
Discomfort 2-4 seconds after swallowing
In the context of gastrointestinal pathologies, what does frothy and fatty stool indicate?
Problems with fat digestion
Which region of the abdomen is most commonly associated with discomfort from gallbladder or liver disease?
RUQ
What is the primary cause of narrow or ribbon-like stools in the lower GI tract?
Inflammatory bowel disease
What symptom is typically associated with malabsorption syndromes?
Steatorrhea and diarrhea
Which glandular disorder is commonly associated with difficulty beginning swallowing both solids and liquids?
Pancreatic disease
In the context of gastrointestinal bleeding, what does black, tarry stool typically indicate?
Pepto Bismol intake
What is the primary manifestation of an acute bacterial or viral infection affecting the GI tract?
Fever with or without cramping pain
What is the primary function of gastrin?
To stimulate the secretion of hydrochloric acid in the stomach
Which cells are responsible for secreting pepsinogen in the stomach?
Chief cells
What is the primary function of the ileocecal valve?
To admit chyme from the ileum into the cecum and prevent its reflux
Which phase of gastric secretion is stimulated by the presence of digested protein in the stomach?
Gastric phase
Which cells are responsible for secreting somatostatin in the stomach?
D cells
What is the primary function of the myenteric plexus in the small intestine?
To mediate intrinsic motor innervation
Which cells are responsible for secreting histamine in the stomach?
Enterochromaffin-like cells
What is the primary function of the villi in the small intestine?
To facilitate the absorption of nutrients
Which hormone is responsible for stimulating the secretion of digestive enzymes from the pancreas?
Cholecystokinin
What is the primary function of the external anal sphincter?
To regulate the voluntary release of feces from the rectum
Which of the following is NOT a characteristic of duodenal ulcers?
They are characterized by chronic, persistent pain
Which of the following is the primary cause of gastric ulcers?
H. pylori infection leading to increased mucosal permeability
Which type of ulcer is related to severe illness, neural injury, or systemic trauma?
Stress ulcer
Which of the following is NOT a clinical manifestation of gastroesophageal reflux disease (GERD)?
Abdominal cramping
Which type of gastritis is associated with autoantibodies to parietal cells and intrinsic factor?
Fundal gastritis
Which of the following is a characteristic of physiologic reflux?
The regurgitated gastric contents are neutralized and cleared within 1-3 minutes
Which of the following conditions is characterized by symptoms of reflux disease but no visible mucosal injury?
Nonerosive reflux disease (NERD)
Which of the following is a risk factor for the development of peptic ulcer disease (PUD)?
All of the above
Which type of gastritis is associated with H. pylori infection and NSAID use?
Antral gastritis
Which of the following is a clinical manifestation of peptic ulcer disease (PUD)?
All of the above
What stimulates the secretion of pepsinogen in the stomach?
Histamine
Which hormone acts to inhibit the secretion of hydrochloric acid in the stomach?
Prostaglandins
What is the primary purpose of intrinsic factor secreted in the stomach?
Enhancing iron absorption
Which substance acts as a protective barrier against acidic damage in the stomach?
Nitric oxide
What is the main function of gastroferrin secreted in the stomach?
Enhancing iron absorption
Which substance is responsible for breaking down food fibers in the stomach?
Pepsin
Which of the following is the MAIN function of the duodenum in the small intestine?
To receive chyme from the stomach and absorb vitamins, minerals, fats, and sugars
Which enzyme is primarily responsible for the hydrolysis of large protein molecules in the small intestine?
Trypsin and chymotrypsin
What is the MAIN purpose of the micelle formation process in fat digestion and absorption?
To facilitate the passive diffusion of fatty acids and monoglycerides into the intestinal epithelium
Which of the following processes is PRIMARILY responsible for the absorption of amino acids in the small intestine?
Active transport using sodium-dependent carriers
What is the MAIN function of the appendix in the large intestine?
To act as a lymphoid organ and play a role in the immune system
What is the MAIN function of the defecation reflex in the colon?
To control the voluntary contraction and relaxation of the external anal sphincter
Which nerve allows relaxation of the esophagus during swallowing?
Vagus nerve
What is the primary function of the lower esophageal sphincter?
Preventing regurgitation from the stomach
What is the composition of saliva that contains substances aiding in carbohydrate digestion?
Potassium, chloride, and salivary a-amylase
What is the primary function of the pancreatic enzymes secreted into the duodenum?
To break down carbohydrates, proteins, and fats for digestion
Which cell type in the liver is responsible for the storage and regulation of vitamin A?
Stellate cells
What is the primary function of the ileogastric reflex in the gastrointestinal tract?
To inhibit gastric motility when the ileum is distended
What is the primary function of the Kupffer cells in the liver?
To phagocytose and remove foreign substances and bacteria from the blood
Which of the following is the primary function of bile produced by the liver?
To emulsify and facilitate the absorption of fats in the small intestine
What is the main function of the gallbladder in the digestive system?
To store and concentrate bile between meals for release into the duodenum
What is the primary function of the stellate cells (Ito cells) in the liver?
To store and regulate the levels of vitamin A in the liver
What is the primary mechanism by which the liver helps regulate blood glucose levels?
By releasing glucose during hypoglycemia and taking up glucose during hyperglycemia
What is the primary function of the defecation reflex in the colon?
To relax the internal anal sphincter and allow for the expulsion of stool
What is the main function of the ileogastric reflex in the gastrointestinal tract?
To inhibit gastric motility when the ileum is distended
What is the primary function of gastroferrin secreted by the parietal cells in the gastric glands?
Prevention of inflammation and ulceration in the stomach
Which phase of gastric secretion is stimulated by the presence of digested protein in the stomach?
Gastric phase
What is the primary function of the peritoneal cavity?
To provide a space for the movement of abdominal organs
Which of the following is NOT a function of the villi in the small intestine?
Regulation of intestinal motility
What is the primary function of the ileocecal valve?
To prevent reflux of chyme from the cecum into the ileum
Which of the following is NOT a function of the stomach's muscle layers?
Absorption of nutrients from the chyme
What is the primary function of the mucosal plexus in the small intestine?
Innervation of the intestinal smooth muscle
Which of the following is NOT a function of the salivary amylase in the mouth?
Breakdown of proteins in the food
What is the primary function of the enterochromaffin-like cells in the gastric glands?
Secretion of histamine
Which of the following is the primary function of the ileogastric reflex?
Inhibition of gastric motility
Which of the following is a characteristic of visceral pain in the gastrointestinal tract?
It is poorly localized, diffuse, and vague.
Which of the following stool characteristics may indicate a lower gastrointestinal bleed?
Bloody stools
Which biochemical mediator, released during the inflammatory response, can stimulate pain nerve endings in the gastrointestinal tract?
All of the above
Which region of the abdomen is typically associated with pain originating from the appendix?
Right lower quadrant (RLQ)
Which of the following is a characteristic of an extrinsic mechanical obstruction of the esophagus?
It is caused by structures outside the esophageal lumen pressing inward and narrowing the esophagus.
Which of the following is a clinical manifestation of gastroesophageal reflux disease (GERD)?
All of the above
Which of the following conditions can contribute to gastroesophageal reflux disease (GERD) by increasing abdominal pressure?
All of the above
Which of the following factors is a risk factor for the development of gastroesophageal reflux disease (GERD)?
All of the above
Which of the following stool characteristics may indicate a problem with fat digestion or absorption?
Frothy, fatty stools (steatorrhea)
Which of the following is a clinical manifestation of dysphagia (difficulty swallowing) caused by a lower esophageal obstruction?
Discomfort 10-15 seconds after swallowing
Which of the following is the most common cause of duodenal ulcers?
H. pylori infection causing increased acid and pepsin concentrations in the duodenum
What is the primary characteristic that distinguishes nonerosive reflux disease (NERD) from other forms of reflux?
Absence of visible mucosal injury despite symptoms of reflux disease
Which type of gastritis is associated with autoimmune mechanisms, involving autoantibodies against parietal cells and intrinsic factor?
Fundal (upper) gastritis, also known as type A gastritis
Which of the following factors is primarily responsible for the development of stress ulcers?
Decreased mucosal blood flow and overstimulation of the vagal nerve
Which of the following statements about the clinical manifestations of gastric ulcers is true?
Pain from gastric ulcers tends to occur immediately after eating and is chronic rather than intermittent.
Which of the following is the primary defect in the pathogenesis of gastric ulcers caused by H. pylori infection?
Increased mucosal permeability to hydrogen ions
Which type of ulcer is characterized by the formation of 'curling ulcers' within hours of trauma, hemorrhage, sepsis, or burns?
Stress ulcers, specifically ischemic ulcers
Which of the following statements about the clinical manifestations of duodenal ulcers is true?
Chronic, intermittent pain in the epigastric area, relieved by food or antacids, is a common presentation.
Which of the following statements about the pathogenesis of peptic ulcer disease (PUD) is true?
True ulcers extend through the muscularis mucosae and can damage blood vessels, causing hemorrhage or perforation.
Which of the following conditions is characterized by the presence of a gastrinoma, leading to increased gastrin secretion and subsequent hypersecretion of gastric acid?
Zollinger-Ellison syndrome
What is the primary cause of diverticulitis?
Reduced fecal bulk and increased pressure within the colon
Which of the following is a characteristic clinical manifestation of irritable bowel syndrome (IBS)?
Symptoms are relieved with defecation
What are orexins?
Molecules that stimulate eating
Which of the following is the primary cause of obesity?
Increase in body fat mass
Which of the following best describes the clinical manifestations of diverticulitis?
Cramping pain of the lower abdomen, exacerbated by eating and defecation
What is the primary cause of irritable bowel syndrome (IBS)?
The cause is unknown
What is the primary cause of the clinical manifestations associated with pyloric obstruction?
Impaired gastric emptying and accumulation of undigested food
Which of the following is the primary mechanism underlying early dumping syndrome after gastric surgery?
Rapid emptying of chyme into the small intestine due to loss of gastric capacity and feedback control
Which of the following is the most common cause of lower gastrointestinal bleeding?
Hemorrhoids
What is the primary physiologic response to significant gastrointestinal bleeding?
Increased peristalsis and diarrhea due to intestinal irritation
Which of the following is a key difference between maldigestion and malabsorption?
Maldigestion involves impaired breakdown of food, while malabsorption involves impaired nutrient absorption
Which of the following is a characteristic of melena, a sign of upper gastrointestinal bleeding?
Dark, tarry stools due to the breakdown of blood
Which hormone is responsible for promoting the secretion of melanin and lipotropin, resulting in darker skin?
Melanocyte-stimulating hormone (MSH)
Which hormone is responsible for regulating the production and secretion of thyroid hormones, as well as promoting iodine uptake and thyroid cell growth?
Thyroid-stimulating hormone
Which hormone plays a crucial role in ovulation, progesterone production in women, and testicular growth and testosterone production in men?
Luteinizing hormone
Which hormone is essential for normal tissue growth, maturation, and aging processes, and also affects sleep, nutritional status, stress, and reproductive hormones?
Growth hormone
Which hormone is responsible for promoting the production of cortisol, androgenic hormones, and aldosterone by stimulating the adrenal cortex/gland?
Adrenocorticotropic hormone (ACTH)
Which hormone is responsible for follicle maturation, estrogen production in women, and spermatogenesis in men?
Follicle-stimulating hormone
Which gland plays an important role in circadian rhythms and immune regulation?
Pineal gland
Which hormone regulates the metabolic rate of all cells and processes cell growth?
Triiodothyronine (T3)
Which cells in the pancreas release a hormone that stimulates T cell development in the immune system?
Delta cells
What is the primary function of parathyroid hormone in the body?
Increases calcium concentration
Which nervous system stimulates alpha cells of the pancreas to release glucagon?
Sympathetic nervous system
What is the function of somatostatin in carbohydrate, fat, and protein metabolism?
Prevents excess insulin secretion
What is the primary role of pancreatic polypeptide released by F cells/PP cells?
Signals satiety and increases gastric acid secretion
Which gland releases hormones that control rates of metabolic processes within the body?
Thyroid gland
What stimulates beta cells of the pancreas to release insulin and amylin?
Parasympathetic nervous system
Which hormone acts as an antagonist to calcitonin and regulates serum calcium levels?
Parathyroid hormone
What is the most common surgical emergency of the abdomen?
Appendicitis
Which type of gallstone is primarily composed of calcium bilirubinate polymer?
Black pigmented stones
What is the primary cause of intolerance to fatty foods in cholelithiasis?
Decreased resorption of bile salts from the ileum
Which enzyme is elevated in acute pancreatitis and remains high?
Lipase
What is the characteristic that indicates chronic changes in pancreatitis?
Pancreatic parenchymal fibrosis
Which sign is associated with cholecystitis and indicates abdominal muscle guarding?
Murphy's sign
What is the primary cause of cirrhosis?
Chronic alcohol abuse
What symptom indicates that a stone has lodged in the cystic or common duct in cholelithiasis?
Biliary colic
Which disease is characterized by abnormally high blood pressure in the portal venous system?
Portal hypertension
What is the main symptom of hepatic encephalopathy?
Confusion
Which type of hepatitis is commonly transmitted through contaminated food or water?
Hepatitis A
What is a common risk factor for pancreatic cancer?
Alcohol consumption
Which condition results from severe impairment or necrosis of liver cells?
Acute liver failure
What is a consequence of portal hypertension?
Splenomegaly
What is the primary difference between maldigestion and malabsorption?
Maldigestion is the failure of the intestinal mucosa to absorb digested nutrients, while malabsorption is the failure of the chemical processes of digestion.
Which condition is characterized by an inability to breakdown lactose due to a congenital defect in the lactase gene?
Lactase deficiency
What is the consequence of bile salt deficiency in relation to nutrient absorption?
Fatty stools, diarrhea, and loss of fat-soluble vitamins
Which vitamin deficiency can lead to symptoms such as night blindness?
Vitamin A
In which condition does the failure of the chemical processes of digestion occur?
Pancreatic insufficiency
What is a common cause of malabsorption that results in weight loss?
Pancreatic insufficiency
What is the primary characteristic of diverticular disease?
Herniations of mucosa through muscle layers of the colon wall
"Cobblestone" appearance due to skip lesions and transverse inflammatory fissures are characteristic of which gastrointestinal disorder?
Crohn's disease
Which type of anorexin is typically associated with a pear-shaped body type?
Peripheral anorexin
What is the most common cause of obstruction leading to appendicitis?
Inflammatory process
Which type of gallstone is primarily composed of calcium bilirubinate polymer from hyperbilirubinemia?
Black pigmented stones
What is the most specific lab test for diagnosing acute pancreatitis?
Elevated lipase
Which of the following is the MAIN function of the defecation reflex in the colon?
To relax the internal anal sphincter
Which type of gallstone is typically associated with bacterial infection of the bile ducts?
Brown stones
What is the MAIN function of bile salts in the digestive process?
To emulsify fats
Which hormone is MOST responsible for enhancing gastric peristalsis?
Motilin
What is the MAIN function of the ileocecal valve?
To prevent the backflow of colonic contents into the small intestine
Which cells in the pancreas release a hormone that stimulates T cell development in the immune system?
Islet cells
What is the primary pathophysiologic mechanism underlying diverticulitis?
All of the above
Which of the following is NOT a typical clinical manifestation of irritable bowel syndrome (IBS)?
Symptoms interfering with sleep
What is the primary molecule responsible for stimulating eating behavior?
Orexins (hypocretins)
Which of the following is NOT a common complication of diverticulitis?
Gastroesophageal reflux disease (GERD)
What is the primary cause of the clinical manifestations associated with irritable bowel syndrome (IBS)?
Unknown, but may be related to any of the above
Which of the following is the most accurate definition of obesity?
BMI greater than 30 kg/m²
In pyloric obstruction, what is the cardinal sign that occurs several hours after eating?
Nausea and vomiting containing undigested food but no bile
Which of the following is the primary cause of early dumping syndrome after gastric surgery?
Rapid emptying of chyme into the small intestine due to loss of gastric capacity and emptying control
Which of the following is the most likely cause of melena (dark, tarry stools)?
Bleeding from the esophagus or stomach due to peptic ulcers
What is the primary physiologic response to significant gastrointestinal bleeding?
Increased peristalsis leading to diarrhea and dehydration
Which of the following is the primary mechanism by which bile salts aid in nutrient absorption?
Emulsification of fats, increasing their surface area for enzymatic digestion
Which of the following is the primary function of the myenteric plexus in the small intestine?
Regulation of intestinal motility and peristalsis
Which of the following is the primary function of somatostatin secreted by the pancreatic delta cells?
Regulate carbohydrate, fat, and protein metabolism
What is the MAIN role of the parasympathetic nervous system in regulating pancreatic function?
Stimulates beta cells to release insulin and secretion of pancreatic juice
Which of the following hormones secreted by the pancreatic islet cells is PRIMARILY responsible for lowering blood glucose levels?
Insulin
What is the MAIN function of the thymus gland in the body's immune system?
Releases thymosin that stimulates T cell development
What is the MAIN function of the pineal gland in regulating the body's circadian rhythms?
Secretes melatonin
Which of the following is the MAIN mechanism by which the thyroid gland is regulated?
Negative feedback from high levels of thyroid hormones
What is the MAIN function of calcitonin secreted by the parafollicular cells of the thyroid gland?
Inhibit osteoclast activity and lower serum calcium levels
Which of the following is the MAIN function of the parathyroid hormone (PTH) secreted by the parathyroid glands?
Increase serum calcium levels
What is the MAIN function of the pancreatic polypeptide (PP) secreted by the F/PP cells of the pancreatic islets?
Increase gastric acid secretion
Which of the following is the MAIN function of the sympathetic nervous system in regulating pancreatic function?
Stimulates alpha cells to release glucagon
Which hormone is responsible for promoting the secretion of melanin and lipotropin, leading to darker skin pigmentation?
Melanocyte-stimulating hormone (MSH)
Which hormone plays a role in both ovulation and progesterone production in women, as well as testicular growth and testosterone production in men?
Luteinizing hormone (LH)
Which hormone secreted by the anterior pituitary gland is essential for normal tissue growth and maturation, and also affects aging, sleep, nutritional status, stress, and reproductive hormones?
Growth hormone (GH)
Which hormone secreted by the anterior pituitary gland is responsible for increasing the production and secretion of thyroid hormones, as well as promoting the hypertrophy and hyperplasia of thymocytes?
Thyroid-stimulating hormone (TSH)
Which hormone secreted by the anterior pituitary gland targets the granulosa cells in women and the Sertoli cells in men, regulating follicle maturation, estrogen production, and spermatogenesis, respectively?
Follicle-stimulating hormone (FSH)
Which hormone secreted by the anterior pituitary gland is responsible for increasing steroidogenesis, leading to the production of cortisol, androgenic hormones, and aldosterone?
Adrenocorticotropic hormone (ACTH)
Which of the following clinical manifestations is NOT typically associated with pancreatic cancer?
Weight gain
What is the leading cause of acute liver failure characterized by severe impairment or necrosis of liver cells?
Acetaminophen overdose
Which of the following is NOT a type of alcoholic liver disease?
Alcoholic pancreatitis
What is the primary cause of the accumulation of toxins and disruptions in neurotransmission leading to clinical manifestations like confusion and coma?
Hepatic encephalopathy
Which of the following factors is NOT mentioned as a potential cause of jaundice?
Alcoholic cirrhosis
Which of the following types of hepatitis is transmitted through a different route compared to the others mentioned?
Hepatitis E
Which of the following gastrointestinal cancers is NOT mentioned in the text?
Pancreatic carcinoma
Which of the following statements about the hypothalamic-pituitary axis is correct?
All of the above.
Which of the following is NOT a consequence of portal hypertension mentioned in the text?
Liver failure
Which of the following statements about the composition of gastric juice is FALSE?
It contains bile salts.
Which condition is characterized by the inability to absorb glutens from wheat, barley, rye, and oats due to an inborn error of metabolism?
Celiac disease
In malabsorption conditions involving bile salt deficiency, which vitamin deficiency can lead to prolonged prothrombin time, purpura, and petechiae?
Vitamin K
In the context of intestinal obstruction, what does the term 'skip lesions' refer to?
Lesions that alternate between affected and unaffected segments
Which condition is characterized by herniations of the mucosal layer through the muscle layers of the colon wall?
Diverticular disease
In the context of intestinal obstruction, what type of vomit is indicative of an obstruction in the proximal small intestine?
Bile-stained fluid
Which condition is characterized by massive dilation of the large bowel in critically ill patients and immobilized older adults, without a mechanical obstruction?
Ogilvie syndrome
Which enzyme deficiency is commonly associated with pancreatitis, pancreatic carcinoma, pancreatic resection, and cystic fibrosis, leading to fat maldigestion?
Lipase
Which clinical manifestation is associated with lactase deficiency, where lactose is not properly broken down?
Gas, cramping pain, and osmotic diarrhea
Which condition is characterized by continuous lesions limited to the mucosal layer of the colon, without skipping segments?
Ulcerative colitis
Which of the following is a common clinical manifestation of Crohn's disease?
Diarrhea with blood and mucus, weight loss, and right lower quadrant tenderness
What type of hyponatremia is present in SIADH?
Euvolemic hypotonic hyponatremia
Which of the following hormones is typically deficient in panhypopituitarism?
All of the above
What is the primary clinical manifestation of SIADH?
Euvolemic hypotonic hyponatremia
Which of the following is the MAIN cause of hypopituitarism?
Ischemia and infarction of the pituitary gland
What is the main clinical manifestation of acromegaly?
Excessive growth of the extremities
Which of the following is a characteristic of gigantism?
Excessive growth of the long bones
What is the primary function of insulin?
To regulate blood glucose levels
Where is insulin synthesized and secreted from?
The pancreatic beta cells
What is the primary function of glucagon?
To increase blood glucose levels by stimulating glycogenolysis and gluconeogenesis
Which zone of the adrenal cortex is responsible for the secretion of aldosterone?
Zona glomerulosa
What is the primary function of the catecholamines secreted by the adrenal medulla?
To induce the 'fight-or-flight' response
Which hormone secreted by the pancreas is responsible for suppressing glucagon secretion and delaying nutrient absorption after meals?
Amylin
What is the primary function of the mineralocorticoid hormones secreted by the adrenal cortex?
To cause sodium retention and potassium/hydrogen loss
Which hormone secreted by the anterior pituitary gland stimulates the adrenal cortex to release glucocorticoids?
Adrenocorticotropic hormone (ACTH)
What is the main function of the glucocorticoid hormones secreted by the adrenal cortex?
To increase blood glucose levels and protein breakdown
Which hormone secreted by the adrenal medulla is responsible for the 'fight-or-flight' response?
Epinephrine (adrenaline)
Which type of diabetes is characterized by a relative lack of vitamin D, genetic predisposition, and destruction of pancreatic beta cells leading to a loss of insulin production?
Type 1 diabetes mellitus
What occurs in both type 1 and type 2 diabetes due to abnormal functions of alpha and beta cells resulting in hyperglycemia and a relative excess of glucagon?
Lack of insulin and amylin
In type 2 diabetes mellitus, what contributes to increased hepatic production of glucose, further worsening hyperglycemia?
Pancreatic alpha cells being less responsive to glucose inhibition
Which hormone is decreased in both type 1 and type 2 diabetes mellitus, contributing to the pathophysiology of the diseases?
Amylin
What are common risk factors for developing type 2 diabetes mellitus?
Family history, metabolic syndrome
In which type of diabetes does glycose intolerance occur during pregnancy, increasing the risk for developing type 2 diabetes?
Gestational diabetes
What is the primary cause of giantism?
Growth hormone hypersecretion in childhood and adolescence
What is the most common cause of acromegaly?
Growth hormone hypersecretion in adulthood due to pituitary adenoma
What is the most common cause of Graves' disease?
Autoimmune reaction against the thyroid gland
Which of the following is a clinical manifestation of Graves' disease?
Exophthalmos (protruding eyeballs)
What is the primary cause of primary hypothyroidism?
Inability of the thyroid gland to produce thyroid hormones
Which of the following is a clinical manifestation of hypothyroidism?
Constipation
What is the most common cause of primary hyperparathyroidism?
Parathyroid adenoma
Which of the following is a clinical manifestation of primary hyperparathyroidism?
Kidney stones
What is the primary cause of type 1 diabetes mellitus?
Autoimmune destruction of pancreatic beta cells
Which of the following is a clinical manifestation of uncontrolled diabetes mellitus?
Polyuria (excessive urination)
Which of the following is NOT a function of insulin?
Promotes protein breakdown
What is the primary function of amylin when co-secreted with insulin?
Delays nutrient uptake
What stimulates the release of glucagon from alpha cells?
Low glucose levels
Which hormone increases blood glucose levels by stimulating glycogenolysis and gluconeogenesis?
Glucagon
Which adrenal hormone is responsible for sodium retention and potassium loss?
Aldosterone
What is the primary function of epinephrine secretion from the adrenal medulla?
Increase blood sugar levels
Which hormone stimulates the adrenal cortex to release cortisol?
ACTH
What is the most common cause of primary hyperthyroidism?
Graves' disease
Which of the following is the MAIN clinical manifestation of acromegaly?
Enlargement of the tongue and facial bones
What is the most common cause of secondary hypothyroidism?
Pituitary or hypothalamic dysfunction
Which of the following is the MOST life-threatening complication of hyperthyroidism?
Thyroid storm
What is the MAIN risk factor for the development of thyroid cancer?
Exposure to ionizing radiation
Which of the following is the MOST common cause of primary hyperparathyroidism?
Parathyroid adenoma
What is the MAIN clinical manifestation of hypoparathyroidism?
Muscle spasms and convulsions
What is the MOST common cause of type 2 diabetes mellitus?
Obesity and insulin resistance
Which of the following is the MAIN function of the stellate cells (Ito cells) in the liver?
Storage and regulation of vitamin A
What is the MOST common cause of SIADH (syndrome of inappropriate antidiuretic hormone secretion)?
Lung cancer
Which of the following is the primary pathophysiological mechanism underlying type 1 diabetes mellitus?
Autoimmune destruction of pancreatic beta cells leading to insulin deficiency
Which of the following is a key feature of type 2 diabetes mellitus?
Insulin resistance and decreased insulin secretion by beta cells
Which of the following factors is NOT associated with an increased risk of developing type 2 diabetes mellitus?
Hyperthyroidism
What is the primary pathophysiological mechanism underlying gestational diabetes mellitus?
Insulin resistance and inadequate insulin secretion
Which of the following hormones is decreased in both type 1 and type 2 diabetes mellitus?
Amylin
Which of the following is a common complication associated with uncontrolled diabetes mellitus?
All of the above
Which of the following is the primary pathophysiological mechanism underlying the syndrome of inappropriate antidiuretic hormone (SIADH)?
Excessive production of antidiuretic hormone (ADH) leading to water retention
Which type of hyponatremia is characteristic of SIADH?
Euvolemic hypotonic hyponatremia
In panhypopituitarism, which hormone deficiency is responsible for the lack of growth in children?
Growth hormone (GH) deficiency
What is the primary pathophysiological mechanism underlying acromegaly?
Excessive production of growth hormone (GH) by the pituitary gland
Which condition is characterized by excessive growth of the extremities and facial bones due to excessive growth hormone secretion during childhood?
Gigantism
Which hormone deficiency in panhypopituitarism is responsible for the lack of secondary sex characteristics?
FSH and LH deficiency
What is the primary function of the corpus luteum during pregnancy?
To secrete estrogen and progesterone to support the developing fetus
What is the main role of gonadotropins and hormones in regulating ovarian function?
They ensure the continuous maturation and release of ova from puberty to menopause
What is the primary function of LH (luteinizing hormone) in the ovarian cycle?
LH causes the release of the mature ovum from the ovary
What is the primary function of estrogen in the ovarian cycle?
Estrogen regulates the maturation and release of ova from the ovary
What is the primary trigger for the menstrual cycle if the ovum is not fertilized?
The degeneration of the corpus luteum and the subsequent drop in progesterone levels
What is the primary cause of precocious puberty in 5% of cases?
Disruption of the HPG axis
What is the main difference between primary and secondary dysmenorrhea?
Primary dysmenorrhea occurs during the first 48 hours of menstruation, while secondary dysmenorrhea can occur at any time
What is the main function of the GPR54 receptor in the GnRH axis?
It acts as the gatekeeper for activating the GnRH axis
Which form of precocious puberty involves the development of only one secondary sex characteristic?
Partial precocious puberty
What is the primary pathological mechanism underlying primary dysmenorrhea?
Excess prostaglandin production in the endometrium
What is the main difference between primary and secondary amenorrhea?
Primary amenorrhea is the absence of menstruation by age 16, while secondary amenorrhea is the absence of menstruation for 3 or more months in a woman who previously had regular cycles
Which hormone is responsible for maintaining the thickened endometrium during the secretory phase of the menstrual cycle?
Estrogen
What induces ovulation by causing the granulosa layer to produce progesterone?
Luteinizing Hormone (LH)
Which male reproductive organ is responsible for producing fructose as a source of energy for sperm?
Prostate Gland
What is the primary function of Leydig cells in the testes?
Produce androgens, chiefly testosterone
Which structure in the penis contains the opening of the urethra?
Glans
What is the function of the follicular or proliferative phase in the menstrual cycle?
Causes endometrium to proliferate
Which cells are responsible for promoting spermatogenesis in males?
Sertoli cells
Which hormone is primarily responsible for maintaining pregnancy in females?
Progesterone
What hormone inhibits pituitary FSH secretion in males?
Inhibin
What is the primary hormone responsible for virilization in males?
Dihydrotestosterone
Which female sex hormone is the most potent and plentiful?
Estradiol
What happens to the ovaries during perimenopause?
They increase estrogen production
Which male sex hormone is primarily produced in the Leydig cells of the testes?
Testosterone
'Thyrotoxic crisis' or 'thyroid storm' can result from excessive stress on patients with what condition?
Hyperthyroidism
'Androgens' are mainly associated with which sex?
Male
At what age does menopause typically occur?
51.4 years old
What is the most common cause of pelvic inflammatory disease?
Chlamydia and gonorrhea
Which of the following is a common symptom of Bartholin cyst?
Inflammation and obstruction of the Bartholin gland ducts
What is the primary cause of cystocele?
Trauma from childbirth
Which type of ovarian cyst is more likely to be associated with malignancy?
The more solid (less fluid-filled) a follicular cyst is, the more likely it is to be malignant
What is the primary symptom associated with uterine leiomyomas (fibroids)?
Abnormal uterine bleeding
Which of the following is a characteristic of adenomyosis?
It involves the presence of endometrial glands and stroma within the myometrium
What is the primary cause of endometriosis?
Retrograde menstruation
Which of the following is a common symptom of endometriosis?
Dysmenorrhea (painful menstruation)
What is the main function of the vaginal pH in preventing vaginal infections?
It provides an acidic environment that inhibits the growth of pathogens
Which of the following factors can lead to changes in vaginal pH and increase the risk of vaginal infections?
All of the above
What is the primary characteristic that distinguishes primary amenorrhea from secondary amenorrhea?
The absence of menstruation by a specific age
In which compartment is the disorder likely to be located if a woman experiences a disruption in the function of the anterior pituitary?
Compartment III
What is the key feature that differentiates dysfunctional uterine bleeding (DUB) from other menstrual disorders?
Association with anovulatory cycles
Which hormone imbalance is commonly associated with polycystic ovarian syndrome (PCOS)?
Insulin resistance and hyperinsulinemia
What physiological event triggers the onset of physiologic perimenopause or pathologically premature ovulatory failure?
Hypomenorrhea followed by missed periods
What is the primary factor contributing to follicular failure and persistent lack of ovulation in women with PCOS?
Increased androgen secretion
What is the most common type of recurrent UTI in men?
Chronic bacterial UTI
What is the primary cause of prostadynia, a type of nonbacterial prostate inflammation?
Reflux of sterile urine into the ejaculatory ducts
Which of the following is a risk factor for prostate cancer mentioned in the text?
All of the above
What is the primary clinical manifestation of chronic bacterial prostatitis in men?
Frequency and urgency of urination
How does chronic bacterial prostatitis in men typically affect the prostate gland?
The prostate becomes irregularly shaped and firm
What is the most common cancer in American men according to the text?
Prostate cancer
What is the primary cause of cervical cancer?
Infection with high-risk HPV
Which of the following is a risk factor for endometrial cancer?
All of the above
What is the primary cause of urethral stricture?
All of the above
What is the main difference between phimosis and paraphimosis?
Phimosis is the inability to retract the foreskin, while paraphimosis is the inability to replace the foreskin
What is the primary cause of Peyronie's disease?
Fibrosis of the corpus cavernosa
What is the primary cause of varicocele?
Both a and b
What is the primary cause of a hydrocele?
Accumulation of fluid within the tunica vaginalis
What is the primary cause of cryptorchidism?
Failure of the testes to descend into the scrotum
What is the primary cause of orchitis?
Viral infection
What is the primary risk factor for penile cancer?
All of the above
Which condition is a complication of epididymitis?
Hydrocele
What is the most common cause of orchitis?
Mumps
Which condition is associated with urethral compression?
Prostatitis
What is the most curable type of cancer?
Testicular cancer
Which infection causes inflammation of the epididymis?
Sexually transmitted infection
What is the cause of cryptorchidism?
Genetic predisposition
What is a common risk factor for testicular cancer?
Cryptorchidism
What is the primary function of the corpus luteum during pregnancy?
To secrete progesterone to support the endometrium
Which hormone is primarily responsible for triggering ovulation?
Luteinizing hormone (LH)
What is the main function of estrogen during the menstrual cycle?
To thicken and prepare the uterine lining for implantation
What is the primary function of the menstrual cycle phases?
To regulate the ovarian and uterine changes throughout the reproductive years
What is the primary cause of ovarian dysfunction and infertility?
Any disorder that disrupts the hormonal process
What causes the endometrium to proliferate during the menstrual cycle?
Estrogen production by the follicle
Which phase of the menstrual cycle is characterized by the thickened endometrium developing blood vessels and secretory glands?
Secretory phase
What happens if there is no implantation during the menstrual cycle?
Menses begins
Which male reproductive organ curves over the posterior portion of each testis and is where sperm matures?
Epididymis
What is the main function of the seminal vesicles in male reproductive physiology?
Produce fructose for sperm energy
Which gland secretes a thin, milky fluid with an alkaline pH to help sperm survive in the female reproductive tract?
Prostate gland
Which of the following is the most common cause of pelvic inflammatory disease?
Neisseria gonorrhoeae
Which of the following is the main cause of Bartholin gland cyst formation?
Bacterial infection
What is the primary cause of a cystocele?
Trauma during childbirth
What is the most common symptom associated with uterine leiomyomas (fibroids)?
Abnormal uterine bleeding
Which of the following is the primary cause of adenomyosis?
Unknown
Which type of ovarian cyst is more likely to be associated with malignancy?
Dermoid cyst
What is the primary mechanism by which follicular cysts develop?
Failure of the dominant follicle to rupture
Which of the following is the most common cause of vaginal prolapse?
Trauma during childbirth
What is the primary clinical manifestation of a ruptured corpus luteum cyst?
Hemorrhage
What is the primary cause of endometriosis?
Retrograde menstruation
Which risk factor is NOT associated with prostate cancer?
Low fiber diet
What condition is characterized by prostatic inflammation without bacterial infection?
Prostatodynia
What leads to the firmness and irregularity in shape of the prostate due to repeated infections?
Fibrosis
Which symptom is characteristic of prostatodynia?
Perineal discomfort
Which bacterium is commonly found in chronic bacterial UTIs in men?
E. coli
What is the most common type of recurrent UTI in men?
'Prostadynia'
Which of the following statements accurately describes precocious puberty?
Precocious puberty can be classified as complete, mixed, or partial based on the development of secondary sex characteristics.
What is the primary mechanism underlying primary dysmenorrhea?
Excess endometrial prostaglandin production and enhanced by progesterone
Which of the following statements accurately describes secondary amenorrhea?
Secondary amenorrhea is the absence of menses for more than 3 months in a woman with previously regular cycles.
Which of the following conditions is NOT mentioned as a possible cause of delayed puberty in 5% of cases?
Polycystic ovarian syndrome (PCOS)
What is the primary function of the GPR54 receptor mentioned in the text?
Acting as a gatekeeper for the activation of the GnRH axis
Which of the following statements accurately describes the relationship between LH, FSH, and GnRH in the context of delayed puberty?
LH and FSH secretion is regulated by GnRH secretion from the hypothalamus, which controls gonad function.
What is the main complication associated with untreated cryptorchidism?
Infertility and increased risk of testicular cancer
Which of the following is the MAIN cause of acute orchitis?
Mumps virus
What is the primary treatment for testicular torsion?
Surgical detorsion within 4-6 hours
Which of the following is the MAIN risk factor for the development of testicular cancer?
History of cryptorchidism
What is the primary cause of the lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH)?
Compression of the urethra by the enlarged prostate
Which type of prostatitis is characterized by a sudden onset of malaise, fever, and urinary symptoms?
Acute bacterial prostatitis
What is the primary mechanism by which benign prostatic hyperplasia (BPH) develops?
Increased sensitivity to circulating androgens, particularly dihydrotestosterone (DHT)
Which of the following is a common symptom of chronic prostatitis?
Frequent, urgent, and painful urination
What is the primary risk factor for the development of prostate cancer?
Advancing age
Which of the following is the MAIN complication associated with epididymitis?
Infertility
What is the primary role of the Sertoli cells during spermatogenesis?
Providing nutrients and hormonal signals to developing sperm
Which of the following statements about inhibin is correct?
It is secreted by the Sertoli cells and inhibits FSH secretion
What is the primary function of dihydrotestosterone (DHT) in male sexual development?
Stimulating the development of external male genitalia and virilization
Which of the following hormones plays a crucial role in regulating testosterone biosynthesis in the Leydig cells?
Luteinizing hormone (LH)
What is the primary cause of the irregular menstrual cycles and hormonal fluctuations observed during perimenopause?
Erratic and high levels of estrogen production by the ovaries
Which of the following changes is NOT typically observed in men as they age?
Increased sperm count and improved sperm motility
What is the primary function of prolactin in the male reproductive system?
Maintaining the biosynthesis of testosterone in the Leydig cells
Which of the following is a characteristic of the changes observed in the female urogenital tract during menopause?
Shortening, narrowing, and decreased elasticity of the vagina
Which of the following statements about the effects of aging on the male reproductive system is correct?
Some seminiferous tubules may degenerate and become fibrotic
What is the primary cause of the increased risk of osteoporosis and fractures observed in postmenopausal women?
Decreased calcium absorption due to reduced estrogen levels
What is the most common cause of primary amenorrhea?
Pregnancy
In dysfunctional uterine bleeding, what is the main cause of heavy or irregular bleeding?
Ovarian dysfunction
Which compartment is associated with disorders of the CNS or hypothalamic factors?
Compartment IV
What is the hallmark feature of polycystic ovarian syndrome?
Hirsutism
In PCOS, what role does insulin play in androgen secretion?
Promotes androgen secretion
Which hormone imbalance leads to persistent lack of ovulation in PCOS?
Persistent increase in LH levels
What hormonal changes contribute to the emotional symptoms of premenstrual syndrome?
Fluctuating estrogen levels
What type of physical changes in the menstrual cycle lead to premenstrual syndrome?
Fluctuating hormone levels in the luteal phase
What is the primary outcome of high insulin levels on androgen secretion in PCOS?
Enhanced conversion of circulating androgens to estrogen
Which of the following is a common cause of endometriosis?
All of the above
In cervical cancer, what is the necessary precursor to cervical intraepithelial neoplasia (CIN) and invasive cervical carcinoma?
Infection with high-risk HPV
Which of the following cancers is considered the most common in the pelvic region of women?
Endometrial cancer
Which of the following factors is associated with an increased risk of developing ovarian cancer?
All of the above
What is the primary cause of urethritis in males?
Sexually transmitted infections
Which of the following is a common symptom of urethral stricture?
All of the above
What is the primary difference between phimosis and paraphimosis?
Phimosis involves inability to retract the foreskin, while paraphimosis involves inability to replace the foreskin
In Peyronie's disease, what is the primary cause of the lateral curvature of the penis during erection?
Fibrous plaques in the erectile tissue of the corpus cavernosa
Which of the following statements regarding penile cancer is true?
It primarily involves squamous cell carcinomas
Which of the following conditions is characterized by a painless diverticulum of the epididymis containing milky fluid with sperm?
Spermatocele
What is the common cause of lower genital tract infection in women?
Trichomonas vaginalis
Which organism causes pediculosis pubis?
Phthirus pubis
Which clinical manifestation is typically rare in Trichomonas vaginalis infection?
Rectal bleeding
How is pediculosis pubis primarily transmitted?
Intimate sexual contact
What distinguishes Trichomonas vaginalis infection in men from that in women?
In men, dysuria is the main symptom.
What distinguishes proliferative breast lesions with atypia from those without atypia?
Abnormal cell structures
Which type of breast lesion involves abnormal cell proliferation but without signs of malignancy?
Proliferative without atypia
What is a common risk factor for male breast cancer based on the text?
Gynecomastia
Which sexually transmitted infection is caused by a mite burrowing under the skin?
Scabies
Which bacterial infection can lead to pelvic inflammatory disease (PID) and disseminated infection?
Gonorrhea
What is a characteristic symptom associated with genital herpes?
Painless ulcers on genitals
Which viral infection is associated with various cancers?
HPV
What distinguishes benign breast lesions from malignant breast lesions?
Cell proliferation
What differentiates proliferative breast lesions without atypia from those with atypical hyperplasia?
Presence of atypia
What distinguishes viral HPV from genital herpes?
Associated cancers
Which parasite causes a lower genital tract infection characterized by adherence to squamous epithelial cells and copious frothy malodorous discharge?
Trichomonas vaginalis
What is the common term for Pediculosis pubis, a condition caused by Phthirus pubis transmitted via sexual contact or infested linens?
Crabs
Which clinical manifestation is rarely seen in men infected with Trichomonas vaginalis but is associated with the condition in women?
Small red marks called strawberry spots
What is the life cycle duration of the crab louse, Phthirus pubis, causing Pediculosis pubis?
20-25 days
Which term describes the allergic sensitization and secondary infections that can result from scratching in Pediculosis pubis?
Folliculitis
Which type of breast lesion has the highest risk of developing into breast cancer?
Proliferative breast lesions with atypia
What is the most common risk factor for the development of male breast cancer?
Gynecomastia
Which sexually transmitted infection is caused by the bacterium Neisseria gonorrhoeae and can lead to complications like pelvic inflammatory disease (PID)?
Gonorrhea
Which stage of syphilis is characterized by severe systemic manifestations, including cardiovascular and neurological complications?
Tertiary syphilis
Which sexually transmitted infection is associated with the development of genital warts and various types of cancer?
Human papillomavirus (HPV)
Which of the following is a benign skin infection caused by the Molluscum contagiosum virus, resulting in the formation of contagious lesions?
Molluscum contagiosum
Which sexually transmitted infection is caused by the Sarcoptes scabiei mite and is characterized by the burrowing of the mite under the skin?
Scabies
Which type of breast cancer is characterized by the proliferation of abnormal cells within the milk ducts, without invasion into the surrounding breast tissue?
Ductal carcinoma in situ
What is the primary physiological function of the enterochromaffin-like cells in the gastric glands?
Secretion of histamine
Which hormone secreted by the adrenal medulla is responsible for the 'fight-or-flight' response?
Epinephrine
Study Notes
Ovarian Cycle and Menstrual Cycle
- Ovarian cycle: continuous from puberty to menopause; after ejecting a mature ovum, the follicle develops into the corpus luteum
- Corpus luteum secretes hormones to support pregnancy if the ovum is fertilized; otherwise, it degenerates and triggers the maturation of another follicle
Menstrual Cycle Phases
- Follicular phase (days 1-14): FSH stimulates follicle and ovum maturation; estrogen causes endometrium to proliferate
- Ovulation (day 14): LH surge triggers ovulation
- Luteal phase (days 15-28): corpus luteum develops; estrogen and progesterone maintain the thickened endometrium
Hormones and Gonadotropins
- Gonadotropins: FSH, LH, and GnRH regulate the ovarian cycle
- Estrogens: primary hormone in females; estradiol, estrone, and estriol are forms of estrogen
- Progesterone: hormone of pregnancy; needs LH
Male Reproductive System
- Testes: produce gametes (sperm) and sex hormones (testosterone, androgens)
- Epididymis: where sperm matures
- Vas deferens: stores sperm; duct with muscular layers capable of powerful peristalsis
- Penis: consists of glans, prepuce, corpora cavernosa, and urethra
- Internal genitalia: conduct sperm and glandular secretions from testes to urethral opening
Spermatogenesis
- Spermatogonia: primitive male gametes; undergo continuous mitosis in the seminiferous tubules of the testes
- Develop into primary spermatocytes, then secondary spermatocytes, spermatids, and mature sperm
Aging and the Reproductive System
- Female: perimenopause, menopause, and ovarian changes
- Male: function diminishes with age, but does not cease; testes atrophy and produce less testosterone
Pathophysiology
- Endometriosis: presence of functioning endometrial tissue outside the uterus; causes inflammatory reaction
- Cervical cancer: arises from cervical epithelium; risk factors include HPV infection
- Other female cancers: vaginal, vulvar, endometrial, and ovarian cancer
- Male cancers: penile, urethral, and testicular cancer
Urological Disorders
- Urethritis: inflammation of the urethra; usually caused by an STI
- Urethral stricture: fibrotic narrowing of the urethra; caused by trauma or infection
- Phimosis and paraphimosis: inability to retract or replace the foreskin
- Peyronie disease: fibrous plaques in the erectile tissue of the corpus cavernosa; causes bent penis
- Priapism: prolonged painful penile erection; associated with spinal cord trauma and sickle cell disease
Male Infections and Inflammations
- Epididymitis: inflammation of the epididymis; caused by bacterial or viral infection
- Orchitis: inflammation of the testes; caused by bacterial or viral infection
- Prostatitis: inflammation of the prostate; caused by bacterial or viral infection
- Benign prostatic hyperplasia (BPH): enlargement of the prostate gland; causes lower urinary tract symptoms### Prostate Issues
- Chronic bacterial prostatitis: recurrent urinary symptoms and persistence of pathogenic bacteria (gram-) in urine or prostatic fluid
- Most common recurrent UTI in men
- Clinical manifestations: frequency, urgency, dysuria, perineal discomfort, low back pain, sexual dysfunction
- Prostate only slightly enlarged or boggy
- Fibrosis caused by repeated infections leads to firmness and irregularity in shape
Prostate Cancer
- Most common cancer in American males; 3rd most common worldwide
- Asymptomatic until advanced stages – symptoms similar to BPH
- Risk factors:
- Dietary: high fat, protein, calcium; low fiber
- Hormones: androgen sensitive cancer, anabolic steroid use
- Vasectomy: elevates circulating androgens – immunologic mechanisms involving antisperm antibodies, reduced seminal fluid levels of active metabolite of testosterone in the prostate
- Chronic inflammation
- Familial factors
Puberty
- Precocious puberty: sexual maturation before age 6 in black girls; age 7 in white girls; age 9 in boys – most common in girls
- Forms:
- Complete: sex appropriate, onset of all pubertal features
- Mixed: not sex appropriate, virilization of a girl or feminization of a boy
- Partial: development of one secondary sex characteristic only, can be in combination
- Central precocious puberty is GnRH dependent – HPG axis is working normally but prematurely
- Typically caused by neoplasms that secrete hormones
Dysmenorrhea
- Patho: result of the effects of excess endometrial prostaglandin production and enhanced by progesterone
- Primary dysmenorrhea: painful menstruation associated with prostaglandin release in ovulatory cycles but not pelvic disease
- Secondary dysmenorrhea: painful menstruation related to pelvic pathology – can occur any time in the menstrual cycle
GI System
- Anatomy: enteric nervous system (extrinsic and intrinsic)
- Autonomic (involuntary) and hormonal control [except chewing, swallowing, defecation]
- Vagus nerve: stimulates hormones that trigger or inhibit muscular contractions – GI motility; timely secretion of substances that aid in digestion
- Salivary glands: controlled by ANS; cholinergic parasympathetic fibers stimulate salivary glands; sympathetic beta-adrenergic stimulation decreases salivary secretion
- Esophagus: conducts substances from oropharynx to stomach; upper esophageal sphincter prevents entry of air into the esophagus during respiration; lower esophageal sphincter (cardiac sphincter) prevents regurgitation from the stomach
- Stomach: hollow muscular organ – stores food, secretes digestive juices, mixes food with juices – propels chyme into duodenum
- Innervated by sympathetic and parasympathetic
- Gastric motility: swallowing causes fundus to relax; gastrin and cholecystokinin enhance relaxation of stomach; gastrin and motilin and low blood glucose enhance peristalsis; sympathetic activity, secretin, cholecystokinin inhibit peristalsis
SIADH
- Patho: levels of antidiuretic hormone (ADH) are abnormally high
- Causes: ectopic secretion of ADH; after surgery and some cancers
- Clinical manifestations: euvolemic hypotonic (dilutional) hyponatremia; total body water: increased; total body sodium: unchanged; extracellular fluid: increased; edema: absent
Hypopituitarism
- Patho: failure of the pituitary gland to produce hormones
- Deficiencies: growth hormone, prolactin, ACTH, TSH, FSH, LH
- Basic results of deficiencies: growth hormone deficiency: growth retardation; prolactin deficiency: lactation failure; ACTH deficiency: adrenal insufficiency; TSH deficiency: hypothyroidism; FSH/LH deficiency: hypogonadism
Small Intestine
- Duodenum: receives chyme from the stomach through the pyloric valve; absorbs vitamins, minerals, fats, and sugars
- Chyme stimulates liver and gallbladder to deliver bile and the pancreas to deliver digestive enzymes and alkaline secretions
- Jejunum: absorbs carbs and proteins across intestinal mucosa by active transport into the villus capillaries
- Ileum: absorbs bile salts, vitamin B12, and chloride
- All nutrients are absorbed in the small intestines as well as 85% of the water and fluid intake
Colon
- Cecum pouch connects the large intestine to the small intestine which is where the appendix is
- Serves as a reservoir for fecal mass and absorbs water and electrolytes – no nutrient absorption
- Feces (excrement) enters sigmoid colon – consists of food residue, unabsorbed GI secretions, shed epithelial cells, bacteria### Diabetes Mellitus
- Definition: a group of metabolic disorders characterized by high blood sugar levels resulting from defects in insulin production, insulin action, or both
- Categories:
- Type 1: autoimmune, environmental and genetic factors trigger cell-mediated destruction of beta cells
- Type 2: insulin resistance and decreased insulin secretion by beta cells
- Gestational: any degree of glucose intolerance with the onset or first recognition occurring during pregnancy
- Clinical manifestations:
- Polydipsia, polyuria, polyphagia, weight loss, fatigue
- Fatigue, pruritis, recurrent infections, visual changes, neuropathy
- Risk factors:
- Age, obesity, HTN, physical inactivity, family history, metabolic syndrome
- Complications:
- Hypoglycemia, DKA, HHNKS, Somogye effect, dawn phenomenon
Pituitary Gland Disorders
- Hypopituitarism:
- Definition: decreased production of one or more pituitary hormones
- Causes: pituitary tumor, radiation, trauma, infection, inflammation
- Clinical manifestations: varied, depending on which hormone is deficient
- Hyperpituitarism:
- Definition: excessive production of one or more pituitary hormones
- Causes: pituitary tumor, genetic mutation
- Clinical manifestations: acromegaly, gigantism
Thyroid Gland Disorders
- Hyperthyroidism:
- Definition: excessive production of thyroid hormones
- Causes: Graves' disease, toxic multinodular goiter, toxic adenoma
- Clinical manifestations: weight loss, heat intolerance, fatigue, diarrhea, tremors
- Hypothyroidism:
- Definition: decreased production of thyroid hormones
- Causes: Hashimoto's thyroiditis, iodine deficiency
- Clinical manifestations: fatigue, cold intolerance, weight gain, constipation
- Thyroid cancer:
- Most common endocrine malignancy
- Risk factors: ionizing radiation, iodine deficiency
- Clinical manifestations: changes in voice and swallowing, difficulty breathing
Parathyroid Gland Disorders
- Hyperparathyroidism:
- Definition: excessive production of parathyroid hormone
- Causes: parathyroid adenoma, hyperplasia, cancer
- Clinical manifestations: hypercalcemia, kidney stones, bone disease
- Hypoparathyroidism:
- Definition: decreased production of parathyroid hormone
- Causes: parathyroid damage, autoimmune disorders
- Clinical manifestations: hypocalcemia, muscle spasms, tetany
Reproductive Endocrinology
- Amenorrhea:
- Definition: absence of menstruation
- Categories: primary, secondary
- Dysfunctional uterine bleeding:
- Definition: heavy or irregular bleeding in the absence of disease
- Causes: anovulation, progesterone deficiency, estrogen excess
- Polycystic ovarian syndrome:
- Definition: oligo-ovulation or anovulation and elevated levels of androgens
- Causes: insulin resistance, genetic factors
- Clinical manifestations: infertility, menstrual bleeding disorders, hirsutism, acne
Other Endocrine Disorders
- PMS:
- Definition: cyclic physical, psychological, or behavioral changes that impair interpersonal relationships or interfere with usual daily activities
- Patho: abnormal tissue response to normal changes of the menstrual cycle
- PID:
- Definition: inflammation of the upper genital tract
- Causes: bacterial infection, IUD use
- Clinical manifestations: pelvic pain, fever, abnormal vaginal discharge
Prepare for your exam on gastrointestinal physiology with this study guide covering the anatomy of the GI system, enteric nervous system, autonomic and hormonal control, vagus nerve, and muscular contractions. Test your knowledge on digestive system functions and controls.
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