Patho Final Exam Complete PDF - Rasmussen University

lOMoARcPSD|22171855 Patho Final EXAM Complete Essentials of Pathophysiology (Rasmussen University) Scan to open on Studocu Studocu is not sponsored or endorsed by any college or university Downloaded by all about sis ([email protected]) ...

lOMoARcPSD|22171855 Patho Final EXAM Complete Essentials of Pathophysiology (Rasmussen University) Scan to open on Studocu Studocu is not sponsored or endorsed by any college or university Downloaded by all about sis ([email protected])  lOMoARcPSD|22171855 Final Exam Key Concepts: Essentials of Pathophysiology Module 1  Low potassium (Hypokalemia) – Monitor heart. o Cardiac arrhythmias o Hypokalemia: muscle weakness, parasthesia, hyporeflexia, leg cramps, weak and irregular pulse, hypotension, dysrhythmias, electrocardiogram changes, decreased bowel sounds, abdominal distension, constipation, ileus, and cardiac arrest.  Catecholamines – Flight or fight response o Epinephrine o norepinephrine o Adrenaline o Increases HR, increases BP o tachycardia, increased BP, increases HR, catacholimines, cortisol, epinipherine, adrenaline, pupil dilation  Function of Albumin – decrease albumin – ascites o Albumin- plasma protein, likes water. Takes water with it o Swelling, no albumin in the blood. proteinuria o Will have ascites (abdominal swelling)- generalized fluid accumulation in the wrong places. Generalized swelling. Third spacing.  Function of Aldosterone o Sodium and water retention o Helps to maintain BP  Different fluid compartments o Intracellular- fluid inside cells o Extracellular- fluid outside cells o Intravascular- inside blood vessels o Interstitial- between cells o Transcellular- third spacing  Causes of edema – increased capillary hydrostatic pressure o Excess fluid in the interstitial space. Increased capillary hydrostatic pressure, decrease in plasma protein.  Sign and symptom o Symptom- something the patient experiences o Sign- something you see  Type 3 hypersensitivity reaction examples o Immune complex reaction o Excessive immune body produces auto antibody immune response of the body o Ex: rheumatoid arthritis, systemic lupus, erythematosus, rheumatic fever  Cause of contact dermatitis o Contact with allergens Downloaded by all about sis ([email protected])  lOMoARcPSD|22171855  Irritant contact dermatitis- chemicals, acids, rubber gloves, soaps. Does not involve immune, just triggers inflammatory response  Allergic contact dermatitis- contact with metals, chemicals, adhesive, poison ivy. Sensitization occurs, and then subsequent exposure produces manifestations  Levels of prevention o Primary- take vaccines o Secondary- screening to diagnosis o Tertiary- restores function. Focuses on people already affected by disease  Hyponatremia – Fatal to brain o Decreased sodium.  Metastatic cancer cells o Spread to the proximal and then distal sites. Ignore signals for apoptosis.  *Function of mitochondria and ribosomes o Energy Powerhouse of the cell o Contains own dna and ribosomes o Ribosomes- production of proteins  Electrylytes- calcium stored in the bones  Intracellular and extracellular ions- o Intracellular- o Extracellular- Module 2  *Colonoscopy screening after 50 years o takes 10 years to turn into cancer o colonoscopy every 10 years o sigmoidoscopy every 5 years o fetal occult blood- every year  *Primary function of bone marrow. o Produces RBCs, WBCs and platelets  *Assessment findings with localized inflammation o redness, warmth, heat, swelling  *Leukocytosis means -------- o increase WBCs  *What is Leukemia? o Blood cancer o Affects productions of RBC and platelets o Decreased WBCs  Active & passive immunity o active received through immunization. Or from already having the disease. o Passive you receive from the mother. Mother to baby Module 3 Downloaded by all about sis ([email protected])  lOMoARcPSD|22171855  What happends with Gout? o abnormal uric acid metabolism. Product of uric acid. Increased uric acid in the blood. Can cause damage to kidneys o inflammatory disease resulting from deposits of uric acid crystals in tissues and fluids. Found in organ meats, shellfish, anchovies, herring, asparagus, mushrooms o s/s: intense pain at the affected joint. Starts during the night and is described s throbbing, crushing, burning. Joint warmth, redness, swelling, tenderness, fever, joint deformities, limited joint mobility  What process results in osteoporosis? – bone loss due to aging. o loss of calcium from the bones. Bone becomes brittle. Increase in bone absorption, bad for bone formation  Priority assessment with myasthenia crisis o Disease affecting the muscles of the body o Affects respirations. o Airway will be priority  Complication with compartment syndrome o Complication of bone fracture & cause pain and tissue damage. o Serious condition that results from increased pressure in a compartment, usually the muscle fascia in the case of fractures. o 5 P’s of compartment syndrome – pulselessness, paralysis, palor, pain, parathesia Module 4  *Stress and peptic ulcer relation (H.Pylori infection) o stress reduces blood flow gi tract o stress causes ulcers o h. pylori causes peptic ulcer  Cause of Hirschsprung’s disease o End of colon is not fully developed in newborn o Stools accumulate, child will not be able to pass stools. o Colostomy to empty stools  *Function of parietal cells of gastric mucosa o helps with secretion of intrinsic factor. o Absorption of vitamin b12  *Frequent location of peptic ulcer o proximal duodenum o acid mixed with food comes into contact with the proximal duodenum  *What is occult blood? o Blood in the stool  *What is esophageal varices – occurs as a complication to portal hypertension o complications with the liver Module 5  What is anabolic process? Downloaded by all about sis ([email protected])  lOMoARcPSD|22171855 o Forming complex molecules from simple molecules  Genetic defect with cystitis and what is cystitis o Vesicoureteral reflux- Back flow of the urine into the bladder o Cycstits is inflammation of the bladder and the bladder lining  Hormone associated with dysfunctional uterine bleeding o progesterone  Kidney disease- location of pain. o Costovertebral angle  Symptoms with BPH o Inability to pass urine effectively o Cannot initiate a stream of urine o Decreased urine output o Sense of urgency  When is Renin-angiotensin system activated. o Hypovolumia o Hypotensive state  Human Papilloma virus – Cervical cancer o Linked with cervical cancer  Stress Incontinence o Accidental leak of urine o Jumping, coughin, sneezing causes leak of urine Module 6  *Cause for Diabetes type 2 and type 1 o type 1- deficiency or absence of insulin o type 2- increased resistance or decreased sensitivity to insulin  *What is Graves disease? Symptoms with hyperthyroidism & hypothyroidism o hyper: increased metabolic rate, tachycardia, restlessness, insominia, palpitations, diarrhea o hypo- bradycardia, decreased HR, decreased BP, fatigue, constipation, cold intolerance  *What is myxedema o hypothyroidism in adults o life threatening, advanced hypotension o coma-extreme  *Diabetes insipidus and SIADH o Deficiency in antidiuretic hormone o SIADH- increased production of antidiuretic hormone  Fluid retention  Too much fluid in the body  *DKA (Diabetic ketoacidosis) o complication of type 1 diabetes o build up of ketones body and produces end products o tachycardia Downloaded by all about sis ([email protected])  lOMoARcPSD|22171855 o hypotension o abdominal pain o kussmaul respirations o orthostatic hypotension  *What is cushing syndrome? o Hypercortosolism- increase cortisol secretions o Excessive amounts of glucocorticoids o Excessive cortisol levels that result from increased ACTH levels (adrenocorticotropic)  Assessment finding:  Hypercortilosim  Trunkal obesity  hyperglycemia  Moon face  Buffalo hump  Weight gain  Edema  Hypokalemia  hypertension  *Insulin and Glucagon function o insulin- reduces blood sugar o glucagon- increases blood sugar levels  *Acromegaly and gigantism difference o acromegaly- increased bone growth after growth plates fuse. Body continues to produce growth hormone. o gigantism- increased growth hormone before the epiphyseal plates fuse.  *Parathyoid gland problems – calcium imbalance o helps to maintain calcium level Module 7  *Priority assessment with spinal cord injury o ABC’s o Airway, breathing, circulation and maintain stabilization of spinal cord  *Mechanism of spinal cord injury – hyperextension, hyperflexion and compression injury. o  *Glasscow coma scale – o checks patients level of consciousness o meausres eye response- spontaneous (4), to voice (3), to pain (2), no response (1) o verbal response-oriented, converse (5), disoriented, converses (4), inappropriate words (3), incomprehensive sounds (2), no response, intubated (1) o motor response- follows commands (6),vocalizes response (5), withdraws (4), decorticate (3), decerebrate (2), no response (1)  *Examples for compression injury – Diving accident.  *cause for cerebral palsy Downloaded by all about sis ([email protected])  lOMoARcPSD|22171855 o occurs during birth, prior to birth, prior to labor, during labor, post labor, post deliviery  Difference between epidural and subarachnoid bleed o Epidural bleed- breaking of the arteries, sudden, fast o Subarcahonoid- breaking of the vein, gradual, slow bleeding  *Differentiate hemorrhagic and thromboembolic stroke o hemorraghic- bleeding in the brain o thrombo- thrombus, clot in the brain  *What happends with increases intracranial pressure? o causes compression of the brain o inflammation of the brain tissue o inability of the brain tissue to expand  *Signs of increased ICP o Patient loss of consciousness o Pupil dilation o Restlessness o agitation o disorentation  *What cause secondary brain injury after head trauma? o Brain injury resulting from Bodys response to tissue damage  *Meningitis and encephalitis – encephalitis can lead to inc ammonia level in the blood. o Meningitis-inflammation of the meninges o Encephalitis- inflammation of the brain  Can lead to increased ammonia level in the blood  Patient will be confused  Seizures definition – and How to classify seizures o Increased electrical discharges in the brain  How to classify- based on clinical symptoms from the EEG (electroencephalogram) and based on the patients signs and symptoms  Parkinson disease symptoms o Problem with mobility and functioning o Deficiency of neurotransmitter dopamine, which controls mobility.  Cause of CVA and diagnosis o Bleeding, hemorrhaging, or moving clot o Diagnosed by CT scan o Will have decreased circulation to the brain o Decreased perfusion or ischemia to the brain  *Reperfusion Injury o injury that occurs after the perfusion has restored Module 8  Ventilator dependent patients – priority is airway o Suction frequently Downloaded by all about sis ([email protected])  lOMoARcPSD|22171855  Polycythemia(inc RBC) and pulmonary hypertension o Polycythemia- increased RBCs o pulmonary hypertension- too much fluid in the lungs  What is ventilation o Moving of air in and out of the lungs  What is corpulomonale – o Pulmonary Hypertension leading to Rt side heart failure  Causes of respiratory distress syndrome o leads to hypoxemia o hypercapnia- Increased CO2 retention o emphysema(barrel chest), bronchial asthma, COPD  Respiratory failure – hypoxemia and hypercapnia o Hypoxemia- decreased oxygen in the blood o Hypercapnia- increased CO2 retention  Tuberculosis o airborne precaution  What is pneumothorax and treatment. o Air trapped in pleural space affecting the lungs and heart o Air in thoracic cavity o Treatment- chest tube insertion to take air out  Define pleural effusion o Fluid in pleural cavity  Asthma (wheezing, dyspnea, and coughing) – treatment with rescue inhaler  Brain’s respiratory center o Medulla oblongata o Pons o (if you see medulla & pons as an answer pick that one. If you only see medulla, pick medulla)  Examples of obstructive pulmonary disorders o (barrel chest seen with air trapping in alveoli)  Extrinsic asthma & exercise induced asthma o Extrinsic-igE synthesis & airway inflammation which leads to mast cell destruction and inflammatory mediator release  Triggers: allergens (pollen, dust, food) o Exercise induced- results from physical activity or vigorous exercise  Causes of pulmonary embolism o DVTs o Moving clot form the legs  Pneumonia – high risk group include sick and immunocompromised o Old age, sick and immunocompromised  ABG – Especially normal Values. o pH: 7.35-7.45 o PaCO2: 35-45mmHg Downloaded by all about sis ([email protected])  lOMoARcPSD|22171855 o HCO3:22-26 mEq/L  Example for ABG questions: o Example: pH 7.31 o PaCO2 60 (respiratotry) o HCO3(bicarb) 24 (kidneys) o Decreased pH- acidotic ,PaCO2 abnormal HCO3 normal o Diagnosis is respiratory acidosis because ph is low and paCO2 is high o Low ph is acidosis, high ph is alkaline o If bicarb goes with ph- metabolic o If paCO2 goes with pH-respiratory Module 9  *Normal INR – High INR symptoms o normal: 0.8-1.1 seconds  patients on blood thinners - INR 2-3  *Difference between hemostasis (first step is vasospasm) and homeostasis o hemostasis- stoppage of blood flow, normal to seal a blood vessel, abnormal when it causes inappropriate clotting  first step is vasospasm o homeostasis- maintaining stage of equilibrium  *Sickle cell crisis o pain is the problem o a painful episode that occurs in someone with sickle cell anemia o crisis can last for hours to days o treatment is :hydration, pain management, rest are priorities  *What is disseminated intravascular coagulation – bleeding and clotting occurs simultaneously (intravascular coagulation), treatment is by identifying the cause. – seen as complication with sepsis. o DIC- life threatening o Results from inappropriate immune response o Widespread coagulation followed by massive bleeding because of depletion of clotting factors. o Seen as complication with sepsis, shock, multisystem organ failure  *Anemia complication is tissue hypoxia  *Hormone help in the RBC synthesis - Erythropoietin  *Thrombocytopenia o decreased platelets  *Hemophilia treatment o give antihemophillic factor, or factor A  *Components of complete blood count o WBC, RBCs, platelets, hemoglobin  *What is Prothrombin Time? o Time it takes to form a clot  *What happened with hemostasis? Downloaded by all about sis ([email protected])  lOMoARcPSD|22171855 o Clot formation- vasospasm  *List the plasma proteins o – Albumin, Globulin, and Fibrinogen  *Hematemesis o blood present in vomitus  *What hormone helps in red blood synthesis? o - Erythropoetin  *Anemia complication and treatment goal o tissue hpoxia  *Hodgkins and non-hodgkins lymphoma difference o hodgkins- affects upper part of body. Does biopsy, presence of reed-sternberg cells o non-hodgkins- affects any part of the body Module 10  Cardiogenic shock – o ventricular dysfunction o ventricles do not work normally  What is hypovolemic shock and septic shock? o Decreased blood volume, or hemorrhage, hypotension, dehydration o Septic shock- follows sepsis or infection throughout the body o What causes obstructive shock?? Mechanical obstruction in blood flow  Pulmonary embolism, cardiac tamponade and tension pneumothorax  Complications of shock o – loss of consciousness, tachycardia, hypotension  Phlebitis o Inflammation of vein  CHF priority assessment – o fluid overload in the lungs.  Chest pain – o First assessment o check EKG- elctrocardiogram  Right side and left side heart failure priority assessment and denominator o Left side- lungs o Right side- painful edema o Denominator- blood pressure, check cardiac output (decreased cardiac output)  Atherosclerotic plaques o Injury to endothelium coronary arteries o Complete block- MI o Partial block- angina o Damages inner most layers  What is angina pectoris (stable angina)? What happened with MI and coronary artery disease. o MI- permanent o Angina- temporary, partial block, ischemia Downloaded by all about sis ([email protected])  lOMoARcPSD|22171855 o Pain can radiate to neck, shoulders, and back o EKG changes o Permanent death of tissues o Emergency situation  Complication of uncontrolled hypertension – o Damage to heart and kidneys  Hypertension Risk factors o Advanced aging o Ethnicity o Family history o Being overweight/obese o Physical inactivity o Tobacco use o High-sodium diet o Low-potassium diet o High vitamin D intake o Excessive alcohol intake o stress  Difference between unstable angina and stable angina o Stable- chest pain due to activity, when you stop doing activity- pain stops  Initiated by increased demand(Activity) and relieved with reduction of that demand (Rest) o Unstable- increased intensity/frequency, does not go away with demand reduction, or occurs at rest (emergency)  Anaphylactic – symptoms o Narrowing of the bronchioles, dilation of the peripheral blood vessels, increased capillary permeability  Signs of hypotension. o Decreased urine output o Low blood pressure  What is coronary artery disease? o Causes damage to endothelium of coronary arteries  Cystic fibrosis- o increased mucus production that blocks the respiratory tract and GI tract o Genetic disorder, autoimmune, recessive  Pain at macburneys point o LRQ o Diarrhea o Rebound tenderness o Appendicitis  Goal for Treating sepsis? Downloaded by all about sis ([email protected])  lOMoARcPSD|22171855 o Identify the cause  Hypoventilate o Not breathing normally o CO2 trapped in lungs  Dialysis- o Helps remove waste from the body  Prerenal, Postrenal and Intrarenal kidney injury – Causes: o Prerenal: probem is with the heart. Hypertension, hypervolumia o Postrenal: obstructions in the ureters o Intrarenal: use of contrast dye, hypovolumis Downloaded by all about sis ([email protected])