Cook Patho Final Exam Review PDF

Exam Review Diagnosis of breast cancer Pneumonia - signs/symptoms Cough Fever Shortness of breath Chest pain Fatigue Fever - what to consider Definitions Diagnosis vs Prognosis Diagnosis = identifies a clear disease or condition, comes before the prognosis P...

Exam Review Diagnosis of breast cancer Pneumonia - signs/symptoms Cough Fever Shortness of breath Chest pain Fatigue Fever - what to consider Definitions Diagnosis vs Prognosis Diagnosis = identifies a clear disease or condition, comes before the prognosis Prognosis = the prediction about the outcome of a disease, it is all contingent upon disease, patient factors, environment, resources, etc. “Probably will….” Normal range of Bicarb HCO3- = 22 to 26 mEq/L What is Apoptosis? Apoptosis = genetically programmed degenerative change that results in cell death - Ex: ovaries undergo apoptosis at age 55 for females Signs and Symptoms of Pyelonephritis Pyelonephritis = infection of the kidney Signs/Symptoms: abdominal tenderness, vomiting and nausea, chills and fever, dysuria, urinary frequency, microscopic hematuria, pyuria (WBCs in urine) Polydipsia Polydipsia = excess thirst Polyphagia Polyphagia = excessive hunger Diabetes insipidus Lack of antidiuretic hormone (ADH) Causes hypernatremia, dehydration, polyuria, and highly dilute urine Monitor sodium levels, monitor fluid intake Parathyroid Hormone Parathyroid hormone (PTH) secreted in response to hypocalcemia and break down bone to re-establish normal calcium in the blood Vitamin D Kidneys Synthesize a component of vit D → patients with renal disease will have decreased vit D and deficiency in vit D is related to cancers Coronary Artery Disease Signs and symptoms of left vs. right sided heart failure (what would I see each side) LVEF: volume of blood pumped with each ventricular contraction Lower than 40% of blood volume in the LV is pumped out with each contraction Dyspnea Cough Orthopnea Crackles in the lungs Paroxysmal nocturnal dyspnea (PND) RVEF:  Lower body: Swelling in the feet, ankles, and legs Abdomen: Distended abdomen Chest: Chest discomfort or pain Role of Cortisol in the body Cortisol = steroid hormone produced by adrenal cortex that has anti-inflammatory properties = “stress hormone” = regulates body’s response to stress and danger Flight or fight mechanism → release of cortisol when body responds to stress Cushing’s Disease Adrenal overactivity → hyperadrenalism or hypercortisolism Endocrine disorder caused by high levels of cortisol in the blood Caused by a hyperactive adrenal gland that secretes excessive cortisol Can occur because of: adrenal adenoma, adrenal carcinoma, or adrenal hyperplasia Elevated sodium + low potassium Can also be caused by secretion of ACTH from tumors of the lung of other cancers Administration of exogenous steroids can lead to the development of Cushing’s syndrome Symptoms can occur with the administration of oral, injected, or inhaled steroids Symptoms = osteoporosis, hypertension, immunosuppression, glucose intolerance, hyperglycemia Hepatitis A - precautions they are placed on - infectious process of it Contact precautions - treated for virus precautions (RNA virus) → benign self-limited disease Fecal-oral transmission, drinking contaminated milk or water, and eating shellfish from infected waters is most common routes of transmission (from textbook) What are the Cardinal Signs of Inflammation? Cardinal Signs of Inflammation: ❖ Redness (Rubor) ❖ Edema (Tumor) ❖ Heat (Color) ❖ Pain (Dolor)  ❖ Loss of function (Functio laesa) What is a shift to the left? Related to wound healing Immature neutrophils = bands → high number of bands = “shift to the left” → indicates an increase in newly formed neutrophils → indicates acute inflammatory process ★ Increase in newly formed neutrophil ★ Indicates an increase in the number of immature white blood cells (WBCs), particularly neutrophils, in a blood test, often signifying an active infection or inflammatory process in the body; essentially, the bone marrow is producing more immature white blood cells to combat the infection rapidly ★ When theres infection or inflammation in the body Nonspecific Immunity Nonspecific defenses → general defense → effective against any harmful agent → first line of defense Non specific immunity is composed of successive lines of defense - First line of defense = barriers = skin, mucus membranes, body secretions, body reflexes - Second line of defense = internal nonspecific responses = inflammation, phagocytosis, natural killer cells (NK) WBCs - what they are and what they do - just in general Leukocytes Fight infection and pathogens Respond to allergens Create antibodies Remove damaged tissue Example of Natural Immunity (from another person) Developing antibodies after fighting the infection. Active form → Contact with the disease/infection Passive form → maternal from mom, placenta or from milk Vascular response to inflammation, the mediators Lymphatic organs and where the T cells mature Thymus = produces and matures immune cells (T-cells specifically)  Lymph system: made up of tissues and organs that help protect the body from infection and disease: tonsils, adenoids, thymus, spleen, bone marrow, lymph vessels, and lymph nodes Functions of the spleen Sequesters abnormally shaped and hemolyzed RBCs and destroys them “Graveyard of RBCs” Organ of immunity Alarm Stage of Stress 1. Alarm State of arousal characterized by the central nervous system, sympathetic nervous system, and adrenal gland stimulation Fight or flight reaction Sympathetic nervous system discharges norepinephrine Brain releases corticotropin-releasing hormone (CRH) → pituitary releases adrenocorticotropic hormone (ACTH) → adrenal gland then releases epinephrine, cortisol, aldosterone Posterior pituitary releases antidiuretic hormone (ADH) Polycythemia “The opposite of anemia” Overabundance of RBCs Can cause blood clots, have to hydrate patient Cause: loss of oxygen, hypoxic Preventive Cancer Screening Genetic screening may be indicated for individuals who have a family history of breast cancer (BRCA gene) Characteristics of malignant neoplasms Poorly differentiated They are invasive and destructive to surrounding tissue Lack adhesion to tumor mass so they easily break free to travel to distant sites in a process called metastasis, travel via lymphatic system or bloodstream Fetal Alcohol Syndrome Fetal Alcohol Syndrome (FAS) Occurs from exposure to excess maternal alcohol consumption while in utero throughout the entire pregnancy FAS infants born with retarded physical growth, intellectual disabilities, cardiac defects, and musculoskeletal abnormalities Born smaller than normal in length, weight, and head circumference Thin upper lips, flat midface, low nasal bridge, short upturned nose, elongated space between nose and lips Poor coordination, failure to thrive and low cognitive skills Purpose for taking blood samples from umbilical cord Best, one of the ways to determine health of the baby One way we can diagnose genetic abnormalities, oxygenation Determining health of baby, and the health as it relates to baby’s blood type Good place to culture stem cells Metabolic Alkalosis Signs and Symptoms Results from a loss of H+ or an addition of base to body fluid Values: - Plasma bicarb is greater than 26 - Arterial pH is greater than 7.45 Clinical manifestations: Dysrhythmias, paresthesias, lightheaded, kidney will reabsorb H+ instead of its usual K+ so hypokalemia occurs Metabolic Acidosis Metabolic Acidosis Abnormal accumulation of acids or abnormal loss of bases Arterial pH lower than 7.35  Blood bicarb (HCO3-) is decreased to lower than 22 Occurs in lactic acidosis, renal failure cursing acid waste buildup, or diarrhea with loss of bicarb Manifestations: Kussmaul’s breathing (deep fast breathing), disorientation, coma, dysrhythmias, hypotension Compensation: the lungs will try to blow off CO2, however the lungs can only increase the ventilatory rate to a certain point Nursing care: IV bicarb ABGs ABGs measure blood pH and the concentration of oxygen, carbon dioxide, and bicarb in the arterial circulation. PaO2 = 80 to 100 mmHg PaCO2 = 35 to 45 mmHg HCO3- = 22 to 26 mEq/L SaO2 = 95% to 100% Passive Diffusion Diffusion: a passive process in which the movement of particles from an area of higher to lower concentration which can occur in air or water, it doesn’t require energy Prenatal testing - why is it important Aortic valve - diagnostic tests and diagnosis Episodes of ischemia with an MI - describe what's going on Ischemia = local reduction of blood flow (oxygen) Heart is temporarily not receiving enough blood flow Specific lab/blood tests following a heart attack ECG = Electrocardiogram Troponin levels CKB-MB (Creatine kinase) Blood tests Stress test What is the Prodromal stage of disease? Stage of vague and non-specific manifestations, start feeling not-right Cyanosis Cyanosis = a bluish coloration of the skin and mucous membranes caused by hypoxia Hyperplasia - and examples Hyperplasia = increase in the number of cells May be compensatory, hormonal, or pathologic Ex: gingival hyperplasia Acidosis vs. Alkalosis Acidosis Alterations in cardiac contractions Decreased vascular response to catecholamines Decreased response to certain meds Can lead to loss of consciousness Alkalosis Impaired neurological function Impaired muscular function Tingling sensations, nervousness, muscle twitches Too much CO2 = acidotic Too little CO2 = alkalotic Respiratory acidosis/alkalosis = caused primarily by LUNGS or breathing disorders Metabolic acidosis/alkalosis = caused by imbalance in production and excretion of acids and bases by the KIDNEYS Acidosis = pH is less than 7.35 Alkalosis = pH is greater than 7.45 Inflammation and its relation to hypothalamus Hypothalamus receives signals from the immune system from circulating cytokines then influences hormonal responses through the pituitary. Acts as a thermoregulator when there’s fever Releases cytokines and hormones Know normal blood pH Normal blood pH = 7.35 to 7.45 Respiratory Acidosis Respiratory Acidosis Failure of the resp system to remove or exhale CO2, CO2 accumulates Values: - PCO2 is greater than 45 mm Hg - Blood pH is lower than 7.35 Clinical manifestations: Cyanosis, shallow or labored breathing, disorientation, and dysrhythmias Nursing action: Intubation; mechanical ventilation Patients at risk: COPD, asthma, respiratory muscle weakness/depression, suffocation Compensation: kidneys attempt to reabsorb HCO3- and excrete it Kidney Function Tests Glomerular filtration rate (GFR) = the amount of fluid filtered by both kidneys = the speed at which the kidneys are filtering → GFR going down means kidneys are slowing down Creatinine = a breakdown product of muscle that is completely excreted and can act as a measure of kidney filtration Creatinine Clearance = test used to assess the glomerular filtration rate, measuring both blood and urine creatinine, measures 24 hr urine volume, decreased creatinine clearance means impaired renal function Serum creatinine = better measurement of kidney function - High serum creatinine = kidney dysfunction Examples of primary lymphoid system - what organ are we specifically talking about The thymus and bone marrow are primary lymphoid tissues that produce lymphocytes. Hypo/Hyperglycemia Hypoglycemia = too little glucose in blood  Sweating, clammy Hunger Dizziness Nervousness, tremulousness Irritability Headache Heart palpitations Confusion, disorientation, inability to concentrate Seizures Loss of consciousness Hyperglycemia = too much glucose in blood Feeling hot and dry Glucosuria = glucose in urine Type 2 Diabetes Type 2: insulin resistance, obesity, age, lack of physical activity Ketosis Forming ketones Ketosis (ketoacidosis): often the first symptom in T1DM, occurs when there is no insulin secreted by the pancreas, requires immediate treatment, *not in T2DM* When the body is producing too many ketones, causing a dangerous imbalance of the body’s pH What would be normal hourly urinary output? 20-30 mL/hr Diagnosis of Breast Cancer Genetic screening may be indicated for individuals who have a family history of breast cancer (BRCA gene) Biopsy Failure of the immune system - what happens? Autoimmune disorders Immunosuppression/Immunocompromised More susceptible to diseases and infections Inability to fight off pathogens, bacteria, and viruses Severe infections  Weakened immune system Electrolyte: main function (Potassium, sodium) Sodium = fluid retention Potassium = smooth electrical conduction to the muscles Sodium, potassium, calcium Hyper/Hyponatremia Hyponatremia = sodium in blood is low Occurs in low blood volume → hypovolemic hyponatremia Occurs in high blood volume → dilutional hyponatremia Caused by severe diarrhea, vomiting, excess sweating, burns, wounds, gastric lavage, increased ADH levels (stress, pain, trauma, SIADH, medications) Symptoms = headache, lethargy, confusion, nausea, muscle cramps and spasms, apathy, severe hyponatremia has a high mortality rate Hypernatremia = sodium in blood is high Elderly and infants at highest risk Caused by excessive sodium intake, decreased extracellular losses, decreased water intake(inability to swallow, unconsciousness, impaired thirst mechanism, NPO) Signs/symptoms = oliguria, dryness, restlessness, decreased reflexes, tachycardia, hypotension Candelaria Review December 16th @8 70 questions Matching column - about electrolytes 4 select all that apply https://quizlet.com/979587924/patho-final-exam-flash-cards/ TOPICS: Electrolyte: main function (Potassium, sodium) Sodium = fluid retention Potassium = smooth electrical conduction to the muscles What is autoimmune disease Benign vs Malignant Benign = well-differentiated, remain localized, cohesive, and well-demarcated from surrounding tissue, and do not break away or travel from tumor cell mass, encapsulated in one area Malignant = poorly differentiated, invasive and destructive to surrounding tissue, lack adhesion to tumor mass so they easily break free to travel to distant sites in a process called metastasis, travel via lymphatic system or bloodstream Ketosis Forming ketones Ketosis (ketoacidosis): often the first symptom in T1DM, occurs when there is no insulin secreted by the pancreas, requires immediate treatment, *not in T2DM* When the body is producing too many ketones, causing a dangerous imbalance of the body’s pH Causes of Type 1 Diabetes When the insulin-making (beta) cells in the pancreas are destroyed Causes of Type 2 Diabetes Insulin resistance, obesity, age, lack of physical activity Link between Diabetes and Heart Disease Uncontrolled diabetes causes endothelial injury, smallest blood vessels that supply feet are first affected, neurons also affected Damages blood vessels and neurons of the heart High blood sugar can cause plaque buildup in arteries Link between High Bad Cholesterol and Heart Disease Bad cholesterol = LDL ★ LDL contributes to atherosclerosis (buildup of plaque in the arteries) → buildup of plaque narrows the arteries → this can block blood flow to the heart - The plaque tearing away from artery walls can cause clots also - Inflammation can occur which causes constriction of arteries What is Hypoglycemia? Hypoglycemia = too little glucose in blood Sweating, clammy Hunger Dizziness Nervousness, tremulousness Irritability Headache Heart palpitations Confusion, disorientation, inability to concentrate Seizures Loss of consciousness What lab tests monitor Renal Function? Glomerular filtration rate (GFR) = the amount of fluid filtered by both kidneys = the speed at which the kidneys are filtering Creatinine = a breakdown product of muscle that is completely excreted and can act as a measure of kidney filtration Creatinine Clearance = test used to assess the glomerular filtration rate, measuring both blood and urine creatinine, measures 24 hr urine volume, decreased creatinine clearance means impaired renal function Serum creatinine = better measurement of kidney function  - High serum creatinine = kidney dysfunction What are the Roles of the Kidneys? Filter blood of waste Develop concentrated urine Secrete renin to control BP Secrete erythropoietin to manufacture RBCs at bone marrow Maintain acid-base balance Excretes excess K+ Synthesizes a component of vit D → patients with renal disease will have decreased vit D and deficiency in vit D is related to cancers What would be normal hourly urinary output? 20-30 mL/hr ABGs- lab values for blood gases ABGs measure blood pH and the concentration of oxygen, carbon dioxide, and bicarb in the arterial circulation. PaO2 = 80 to 100 mmHg PaCO2 = 35 to 45 mmHg HCO3- = 22 to 26 mEq/L SaO2 = 95% to 100% Hyponatremia Hyponatremia = sodium in blood is low Occurs in low blood volume → hypovolemic hyponatremia Occurs in high blood volume → dilutional hyponatremia Fewer than 135 mEq/L Caused by severe diarrhea, vomiting, excess sweating, burns, wounds, gastric lavage, increased ADH levels (stress, pain, trauma, SIADH, medications) Symptoms = headache, lethargy, confusion, nausea, muscle cramps and spasms, apathy, severe hyponatremia has a high mortality rate Diabetes insipidus Diabetes Insipidus = Lack of antidiuretic hormone (ADH) Causes hypernatremia, dehydration, polyuria, and highly dilute urine Monitor sodium levels, monitor fluid intake What would a patient be at risk for with diabetes insipidus? Dehydration Hypernatremia Electrolyte imbalances What are the Cardinal Signs of Inflammation? Cardinal Signs of Inflammation: ❖ Redness (Rubor) ❖ Edema (Tumor) ❖ Heat (Color) ❖ Pain (Dolor) ❖ Loss of function (Functio laesa) What is Apoptosis? Apoptosis = genetically programmed degenerative change that results in cell death - Ex: ovaries undergo apoptosis at age 55 for females What are the Roles of the Nurse? Prevention and eradication of disease Educator Minimizing impact of illness Promoting healing Maximizing patient outcome Early case findings Motivate patients Vocabulary from the first 10 slides or so from the first week Pathophysiology: study of the disease process  Pathogenesis: sequence of cellular and tissue events that take place from the time of initial contact with an etiologic agent until the ultimate expression of a disease, describes how the disease process evolved Etiology: what sets the disease process in motion, cause & effect, cause of disease Idiopathic: if the cause & effect of the disease process is unknown Disease: an interruption, cessation, or disorder of a body system or organ structure, abnormal functioning occurs Illness: the feelings that might come with having a disease (the subjective experience) Sign: an objective, measurable finding Symptom: subjective, what the patient is feeling Prognosis: the prediction about the outcome of a disease, all contingent upon disease, patient factors, environment, resources, etc. Sequelae: expected, subsequent injuries related to the disease process, Ex: if you have diabetes you will have poor effusion Complications: unexpected, new problems in addition to the original disease process, Ex: Since you have diabetes and then the poor perfusion, the complication you will have is an amputation because of poor circulation Morbidity: the # of ill per 100,000 Mortality: the # who died per 100,000 Incidence: number of new cases Epidemic: the rapid increase in incidence noted Filtration: water and dissolved particles are forced across a membrane from an area of higher to lower pressure Diffusion: a passive process in which the movement of particles from an area of higher to lower concentration which can occur in air or water, it doesn’t require energy Osmosis: diffusion of water down the concentration What are the most common signs and symptoms of Heart Attack (myocardial infarction)? Diaphoresis Dyspnea Extreme anxiety Levine’s sign (fist to chest) Pallor - pale Retrosternal crushing chest pain that radiates to shoulder arm, jaw, or back Weak pulses Role of Cortisol Cortisol = steroid hormone produced by adrenal cortex that has anti-inflammatory properties = “stress hormone” = regulates body’s response to stress and danger Process of wound healing Stages of Wound Healing Hemostasis = initial response Inflammation = usually lasts up to 5 days Proliferation = weeks until max strength achieved, may involve regeneration or repair with scar tissue but loss of function Wound Contraction and Remolding = up to 2 years What is a shift to the left? Related to wound healing Immature neutrophils = bands → high number of bands = “shift to the left” → indicates an increase in newly formed neutrophils → indicates acute inflammatory process ★ Increase in newly formed neutrophil ★ Indicates an increase in the number of immature white blood cells (WBCs), particularly neutrophils, in a blood test, often signifying an active infection or inflammatory process in the body; essentially, the bone marrow is producing more immature white blood cells to combat the infection rapidly ★ When theres infection or inflammation in the body Specific vs Nonspecific Immunity Nonspecific defenses → general defense → effective against any harmful agent → first line of defense Non specific immunity is composed of successive lines of defense - First line of defense = barriers = skin, mucus membranes, body secretions, body reflexes - Second line of defense = internal nonspecific responses = inflammation, phagocytosis, natural killer cells (NK) Specific defenses → effective against a certain agent only → last line of defense Functions of the spleen Sequesters abnormally shaped and hemolyzed RBCs and destroys them “Graveyard of RBCs” Organ of immunity Alarm Stage of Stress 1. Alarm  State of arousal characterized by the central nervous system, sympathetic nervous system, and adrenal gland stimulation Fight or flight reaction Sympathetic nervous system discharges norepinephrine Brain releases corticotropin-releasing hormone (CRH) → pituitary releases adrenocorticotropic hormone (ACTH) → adrenal gland then releases epinephrine, cortisol, aldosterone Posterior pituitary releases antidiuretic hormone (ADH) What is Polycythemia? “The opposite of anemia” Overabundance of RBCs Can cause blood clots, have to hydrate patient Primary polycythemia = hyperproliferation of all blood cells, blood becomes viscous and requires periodic phlebotomy Secondary polycythemia = more common, it is a hyperproliferation of the RBCs in response to chronic blood hypoxia (as in COPD) Fetal Alcohol Syndrome Fetal Alcohol Syndrome (FAS) Occurs from exposure to excess maternal alcohol consumption while in utero throughout the entire pregnancy FAS infants born with retarded physical growth, intellectual disabilities, cardiac defects, and musculoskeletal abnormalities Born smaller than normal in length, weight, and head circumference Thin upper lips, flat midface, low nasal bridge, short upturned nose, elongated space between nose and lips Poor coordination, failure to thrive and low cognitive skills What would you see in Alkalosis? Metabolic Alkalosis Results from a loss of H+ or an addition of base to body fluid Values: - Plasma bicarb is greater than 26 - Arterial pH is greater than 7.45 Clinical manifestations: Dysrhythmias, paresthesias, lightheaded, kidney will reabsorb H+ instead of its usual K+ so hypokalemia occurs  Nursing action: IV normal saline, administration of IV DIAMOX (enhances kidney excretion of bicarb and reduces excretion of K+), administration of KCL, or sometimes a mildly acidic solution is needed IV Patients at risk: Excess bicarb ingestion, postcode excess bicarb IV, or vomiting of excess gastric acid Compensation: the lungs attempt to retain CO2 by decreasing the rate of resp, breathing is slowed What is hypertrophy? Hypertrophy = increase in size usually due to an increased workload Prodromal stage of a disease Stage of vague and non-specific manifestations, start feeling not-right Specific lab tests following a heart attack ECG = Electrocardiogram Troponin levels CKB-MB (Creatine kinase) Elevated white cell count - what might that mean and why we see that Infection Role of hypothalamus during inflammation Hypothalamus receives signals from the immune system from circulating cytokines then influences hormonal responses through the pituitary. Lab values go up, GFR goes down: this means the kidneys are slowing down GFR - speed at which the kidneys filter Primary vs. secondary lymphoid tissue Primary lymphoid tissue: The thymus and bone marrow are primary lymphoid tissues that produce lymphocytes. Secondary lymphoid tissue: The lymph nodes, spleen, tonsils, and Peyer's patches are secondary lymphoid tissues where lymphocytes interact with antigen-presenting cells (APCs) to fight off germs and foreign substances. Wound healing - why would a person feel pain from an injury? Release of prostaglandins and histamine Lymphatic organs (what do they do)- especially thymus  Thymus = produces and matures immune cells (T-cells specifically) Lymph system: made up of tissues and organs that help protect the body from infection and disease: tonsils, adenoids, thymus, spleen, bone marrow, lymph vessels, and lymph nodes What is compensation? Imbalance of pH caused by one system will be made up for by another system after a period of time. Ex: respiratory will assist to regulate metabolic imbalance, and metabolic will assist to regulate resp imbalance Hyperplasia Hyperplasia = increase in the number of cells May be compensatory, hormonal, or pathologic Ex: gingival hyperplasia Why would a person develop a fever after injury? 1. Neutrophils and macrophages secrete a pyrogen. 2. Hypothalamus secretes prostaglandin E (PGE). 3. PGE resets the body's temperature set point. 4. The temperature rises. 5. After the pathogen is gone, phagocytes stop producing the pyrogen. 6. Temperature set point returns to normal. The body's inflammatory response to trauma triggers the immune system to raise body temperature as a natural defense mechanism to fight off potential infection at the injury site. Role of the Macrophage ★ Dissolve clots, clear debris, add TGF-B, VEGF, and MMPs ★ Surround and consume foreign material during phagocytosis ★ Destroy pathogens What is Natural Immunity? Developing antibodies after fighting the infection.  Contact with the disease What is Passive Immunity? When you are given antibodies from a different source (from someone or something) Mother’s milk or placenta Immune serum = blood serum containing antibodies Signs and symptoms of infection in a wound - what would we be looking for in the process of wound healing? ★ Abscess, sinus tract, cellulitis, necrosis and gangrene Signs and symptoms of left vs. right sided heart failure (what would I see each side) LVEF: - volume of blood pumped with each ventricular contraction - Lower than 40% of blood volume in the LV is pumped out with each contraction - Dyspnea - Cough - Orthopnea - Crackles in the lungs - Paroxysmal nocturnal dyspnea (PND) RVEF: - Lower body: Swelling in the feet, ankles, and legs - Abdomen: Distended abdomen - Chest: Chest discomfort or pain Risk factors for Heart Disease (failure) Age (65 and older) Ethnicity (african americans) Family history and genetics Diabetes Ischemic heart disease Obesity HTN Lifestyle factors (smoking & sedentary lifestyle) Aortic Aneurysm First manifestation is a pulsatile mass  Hypertension weakens the walls of arteries, increasing development of bulges in arterial walls Cause turbulent blood flow and are susceptible to rupture Bruits may be heard Most common in aorta and cerebral arteries Signs and Symptoms of Pyelonephritis Pyelonephritis = infection of the kidney Signs/Symptoms: abdominal tenderness, vomiting and nausea, chills and fever, dysuria, urinary frequency, microscopic hematuria, pyuria (WBCs in urine), increase white cells, flank pain, malaise Cushing’s Disease Adrenal overactivity → hyperadrenalism or hypercortisolism Endocrine disorder caused by high levels of cortisol in the blood Caused by a hyperactive adrenal gland that secretes excessive cortisol Can occur because of: adrenal adenoma, adrenal carcinoma, or adrenal hyperplasia Can also be caused by secretion of ACTH from tumors of the lung of other cancers Administration of exogenous steroids can lead to the development of Cushing’s syndrome Symptoms can occur with the administration of oral, injected, or inhaled steroids Symptoms = osteoporosis, hypertension, immunosuppression, glucose intolerance, hyperglycemia What are patients at risk for with diabetes insipidus: electrolyte and fluid imbalance, dehydration (sodium, potassium)