Patho Final Exam Study Guide Fall 2024 PDF

1. ABG interpretation a. Pneumonia -- respiratory acidosis b. Renal failure -- metabolic acidosis (KUSSMAUL) 2. Acid/base imbalances and compensation c. Metabolic acidosis (renal failure or DKA) -- Kussmaul d. Metabolic alkalosis (excessive antacid upe) -- shallow slower...

1. ABG interpretation a. Pneumonia -- respiratory acidosis b. Renal failure -- metabolic acidosis (KUSSMAUL) 2. Acid/base imbalances and compensation c. Metabolic acidosis (renal failure or DKA) -- Kussmaul d. Metabolic alkalosis (excessive antacid upe) -- shallow slower than normal breathing e. Respiratory acidosis (hypoventilation because of head trauma or medications) -- kidneys excrete H+ and retain bicarbonate f. Respiratory alkalosis (hyperventilation) -- use a paper bag, renal compensation to decrease H+ excretion and decrease bicarbonate reabsorption 3. Acute bacterial infections -- changes in lab values g. Elevated WBC count, neutrophils, lymphocytes, basophils 4. Acute cystitis -- cause h. Most common cause E.coli i. Movement of GI gram-negative bacilli back into urethra and bladder from opening in urethra 5. Acute kidney injury -- types j. Prerenal -- affects blood volume or oxygen in blood as it travels to renal arteries to kidneys i. Hypotension or hypovolemia from fluid loss, sepsis, inadequate CO, renal vasoconstriction (NSAIDS), renal artery stenosis k. Intrarenal -- happens in kidneys itself ii. Ischemic acute tubular necrosis, acute glomerulonephritis, NSAIDS/antibiotic l. Postrenal -- anything from renal pelvis to urethra iii. Kidney stone, stricture, prostatic hypertrophy, tumor, neurogenic bladder, bladder outlet obstruction 6. Acute respiratory distress syndrome -- clinical manifestations m. Dyspnea and hypoxemia (EVEN WITH OXYGEN) n. hyperventilation and respiratory alkalosis o. decreased tissue perfusion, metabolic acidosis, organ dysfunction p. increased work of breathing, decreased tidal volume, and hypoventilation q. hypercapnia, respiratory acidosis r. respiratory failure, decreased CO, hypotension and death 7. Aplastic anemia -- clinical manifestations s. Hematopoietic failure or bone marrow aplasia with a reduction in effective production of mature cells by the bone marrow, causing peripheral pancytopenia, REDUCTION OR ABSENCE OF ALL THREE BLOOD CELLS (RBC, WBC, platelets) 8. Aspiration -- risk for t. Lying flat in bed, can't swallow, no gag reflex, pts in surgery with food in stomach, GERD u. Goes into lower lobe of lung and causes pneumonia 9. Atherosclerosis risk factors v. Smoking, hypertension, diabetes, age, previous heart problems, family history, high cholesterol, lack of exercise, hyperlipidemia, autoimmunity 10. Alveolar cells -- types and their functions w. Type 1 -- structure x. Type 2 - surfactant 11. Alterations in fluid/electrolytes in the elderly -- risk for dehydration y. Decline in percentage of TBW (higher percentage of fat, decreased percentage of muscle, loss of bone structure), forgetting to drink fluids, reduced ability to regulate sodium and water balance, and less efficient kidneys at producing either concentrated or diluted urine 12. Acute pancreatitis -- causes z. Gallstones and alcoholism 13. Acid/base imbalances and compensation a. Metabolic acidosis (renal failure or DKA) -- Kussmaul b. Metabolic alkalosis (excessive antacid upe) -- shallow slower than normal breathing c. Respiratory acidosis (hypoventilation because of head trauma or medications) -- kidneys excrete H+ and retain bicarbonate d. Respiratory alkalosis (hyperventilation) -- use a paper bag, renal compensation to decrease H+ excretion and decrease bicarbonate reabsorption 14. Aspergillosis -- clinical manifestations e. Fever, coughing up blood, chest pain, SOB, headache, fatigue, nasal congestion 15. Atrophic glossitis -- potential cause f. Nutritional deficiency, could be vitamin B12, iron, folic acid, riboflavin, or niacin 16. Autism spectrum disorders -- clinical manifestations g. Social communication, repetitive behaviors, restricted interests 17. Aplastic anemia -- clinical manifestations h. Hematopoietic failure or bone marrow aplasia with a reduction in effective production of mature cells by the bone marrow, causing peripheral pancytopenia, REDUCTION OR ABSENCE OF ALL THREE BLOOD CELLS (RBC, WBC, platelets) 18. Cardiac output equation i. Stroke volume multiplied by heart rate 19. Cancer staging j. Stage 1 -- no metastasis k. Stage 2 -- locally invasive l. Stage 3 -- spread to regional structures (lymph nodes) m. Stage 4 -- distant metastasis 20. Cause of chest pain with angina n. Heart is not getting enough oxygen rich blood o. Stable -- chest pain during exercising p. Unstable -- chest pain at rest 21. Causes of acute pancreatitis q. Gallstones and alcoholism 22. Cellular adaptations -- metaplasia, dysplasia, hyperplasia, hypertrophy, and atrophy r. Atrophy -- cells shrink in size s. Hypertrophy -- cells grow in size t. Hyperplasia -- cells increase in number (ENDOMETRIOSIS) u. Metaplasia -- mature cell replaced by different type of cell (SMOKER RESPIRATORY TRACT CELLS) v. Dysplasia -- abnormal cellular increase or change in size, shape or organization (DERANGED CELLS) 23. Chemoreceptors and baroreceptors w. Chemoreceptors -- sensitive to CO2 levels to help control breathing (potential dilator) and located in brain x. Baroreceptors -- help when changing position to keep BP steady, located on aortic arch and carotid arteries 24. Cholecystitis -- cause y. Inflammation of gallbladder caused by GALLSTONES or CHOLELITHIASIS that backs up bile, causing damage, inflammatory response, and infection 25. Clinical manifestations of left-sided vs. right-sided heart failure z. Left-sided -- dyspnea, orthopnea, cough of pink frothy sputum, fatigue, decreased urine output, pulmonary edema a. Right-sided -- increase in pressure in systemic venous circulation resulting in peripheral edema and hepatomegaly and splenomegaly, jugular vein distention 26. Clinical manifestation of severe pulmonary edema b. PINK FROTHY SPUTUM, respiratory acidosis, SOB, respiratory distress/arrest, raised levels of natriuretic peptides 27. Compensation for hypercapnia c. Elevated levels of CO2 in blood d. Exhale it, kidneys will dump H+ or hold onto bicarbonate 28. Compartment syndrome -- clinical manifestations e. Pain, paresthesia, paresis, pallor, lack of pulse 29. Compensatory hypertrophy of the kidney -- causes f. Anything to damage one kidney (OBSTRUCTION, REMOVAL, DONATION) will cause other kidney to hypertrophy and do the work 30. Cor pulmonale -- definition g. RIGHT-SIDED HEART FAILURE from some respiratory disease or problems resulting in pulmonary hypertension. The blood vessels that supply blood to the lungs and make a gas exchange with alveoli become very CONSTRICTED, causing PRESSURE TO INCREASE. Pulmonary hypertension causes right side of heart to push harder to get blood to move forward into blood vessels. Becomes HYPERTROPHIED 31. Clinical manifestations of left-sided vs. right-sided heart failure h. Left-sided -- dyspnea, orthopnea, cough of pink frothy sputum, fatigue, decreased urine output, pulmonary edema i. Right-sided -- increase in pressure in systemic venous circulation resulting in peripheral edema and hepatomegaly and splenomegaly, jugular vein distention 32. Dangerous skin lesions j. Kaposi sarcoma -- common in HIV, lesions are red, purple, or brown macules and develop into plaques and nodules k. Malignant melanoma -- melanocytes, cells that synthesize the pigment melanin and located on basal layer of skin iv. Prevention : stay out of sun, sunscreen, no tanning beds l. Squamous cell carcinoma -- tumor of epidermis and second most common human cancer 33. DIC definition m. Disseminated intravascular coagulation -- extreme clotting issue that the body has in response to significant trauma or sepsis. The body's clotting factors and clotting cascade go haywire. Clots appear everywhere, and then bleeding starts everywhere 34. Emphysema -- clinical manifestations n. An obstructive respiratory disorder, more difficult to exhale ; the air they inhale gets trapped inside the alveoli and begins to stay expanded o. BARREL CHEST, redness in appearance, clubbine, pursed lip breathing, productive cough, dyspnea, and wheezing 35. Effects of chronic cortisol p. obesity, elevated blood glucose levels, decreased inflammatory response, sleep deprivation, lipid abnormalities, hypertension, DM, atherosclerosis, loss of bone density, cognitive impairment, emotional disorders, gastric ulcers 36. Effects of glucose on arteries q. Diabetes and insulin resistance can lead to higher levels of glucose in the blood. Elevated glucose levels can cause plaque to build up in the blood vessels, causing stiffening and blockages. Contributing to atherosclerosis. 37. Fever -- control center r. HYPOTHALAMUS, rest thermostat to higher levels from exogenous or endogenous pyrogens, causing temp to rise and cause fever 38. Fracture healing s. Direct -- surgical fixation allows the pieces to be in contact as they heal t. Indirect -- bleeding -\> hematoma -\> osteoblasts -\> callus -\> remodeling u. CAN USE BONE WHEN HARD CALLUS FORMS 39. General Adaptation Syndrome stages v. Alarm stage -- stressor triggers the HPA axis (activates sympathetic nervous system) and AROUSAL of body defense w. Resistance stage -- begins with the action of adrenal hormones, and mobilization contributes to FIGHT OR FLIGHT x. Exhaustion stage -- occurs only if the stress continues and adaptation is not successful and leads to a stress-related disorder 40. GERD -- pathophysiology y. Sphincter in the esophagus gets loose (DOESN'T CLOSE), resulting in stomach acid backing up and damaging the lining. Can have acid reflux and aspiration 41. Graves disease clinical manifestations z. Hyperthyroidism -- elevated HR, BP, extreme weight loss, can't sleep, heat intolerance, pretibial myxedema, PROTRUDING EYEBALLS 42. Gout -cause a. Build-up of URIC ACID crystals in the joints from too many purines 43. Heart failure -- what happens to cardiac output b. Cardiac output drops with heart failure 44. Hearing loss types and causes c. Conductive hearing loss -- impacted cerumen, carcinoma, effusion d. Sensorineural hearing loss -- noise exposure, Meniere, ototoxic drugs, syphilis, Paget disease, collagen disease, DM 45. Hepatic encephalopathy -- cause and clinical manifestations e. Brain disease caused by liver failure with direct relationship to high levels of ammonia building up in the bloodstream f. Confused, disoriented, flapping of the hands when hold them straight out 46. Histamine vs. Leukotrienes g. Both -- dilate blood vessels and increase permeability h. Leukotrienes -- come on scene later i. Histamines -- quick response 47. HIV -- etiology j. Severe decline in CD4 T-helper cells, so the body attach those helper cells and destroys them 48. Hydrostatic and oncotic pressures -- forces that favor the movement of fluid into cells k. Hydrostatic -- high is pushing stuff out of bloodstream, low is allowing more water to come in l. Oncotic -- high is pulling water in, low in holding water in 49. Hypernatremia -- type of IV fluids for treatment m. Hypotonic solution for hypernatremia n. Hypertonic for hyponatremia 50. Hypersensitivity types o. Type 1 (IgE mediated) -- environmental allergens (pollen, trees, bees) p. Type 2 (tissue-specific) -- specific cells or tissue is target of immune response (GRAVES, DM TYPE 2, DRUG INDUCED HEMOLYSIS, AUTOIMMUNE THROMBOCYTOPENIA) q. Type 3 (immune complex) -- antigen-antibody complexes are in circulation and are later deposited in vessel walls (LUPUS, CELIAC) r. Type 4 (cell-mediated) -- delayed type of hypersensitivity reactions (GRAFT REJECTION, TB SKIN TEST, ALLERGY TO POISON IVY OR METAL) 51. Hypocalcemia -- Chvostek's and Trousseau's s. Chvostek's is facial nerve on cheek t. Trousseau's is when you pump BP cuff, see carpal pedal spasm of hand 52. Hypoxia vs. hypoxemia u. Hypoxia -- deficiency in amount of oxygen reaching the tissues v. Hypoxemia -- low levels of oxygen in BLOOD 53. Hypertension -- risk factors for cardiovascular disease w. Hypertension, smoking, obesity, high LDL, cholesterol 54. Hypothyroidism -- primary vs. secondary x. Primary -- destruction of thyroid tissue or defective hormone synthesis y. Secondary -- conditions that cause either pituitary or hypothalamic failure with deficiency of TRH and TSH 55. Infectious mononucleosis -- microorganism of transmission z. Epstein-Barr virus 56. Interferons use a. Protein molecules released by host cells to nonspecifically inhibit the spread of viral infections 57. Intermittent claudication -- clinical manifestations b. Leg pain with ambulation that goes away when resting 58. Intentional and unintentional wounds -- stab wounds, incised wounds, puncture wounds, and chopping wounds c. Stab wounds -- deeper than it is long d. Incised wounds -- longer than it is deep e. Puncture wounds -- like stepping on a nail, has abrasion of edges f. Chopping wounds -- sharp and blunt force characteristics, like from an ax or hatchet 59. Ischemic stroke -- cause g. Blockage of arterial blood flow to the brain 60. Importance of albumin to keeping fluid in blood vessels h. Increases oncotic pressure 61. Leukemia -- common types in children vs adults i. Children -- Acute Lymphoblastic Leukemia j. Adults -- Chronic Lymphocytic and Acute Myelogenous Leukemia 62. Lines of Defense k. First -- skin, hair and sebaceous glands l. Second -- body's inflammatory response m. Third - antibodies 63. Lung receptors -- functions n. Irritant receptors -- detects noxious vapors, dust, and irritants, initiating cough reflex o. Stretch receptors -- when lungs become more stretched they prevent the over inflation of the lungs by sending impulses to the expiratory center and down the intercostal nerve to expiratory muscles so expiration can occur p. J-receptors -- sensitive to increased capillary pressure and initiate rapid shallow breathing, hypotension and bradycardia 64. Medications to decrease prostaglandin effects q. NSAIDS 65. Multiple myeloma -- unique diagnostic feature r. Presence of M protein 66. Multiple sclerosis -- pathophysiology s. Autoimmune disorder when patches of neurons become inflamed and demyelinated 67. Myasthenia gravis -- pathophysiology t. Injury at neuromuscular junctions and acetylcholine can't get across 68. Myelodysplastic syndrome -- clinical manifestations u. Fatigue, SOB, pallor (because of anemia), easy or unusual bruising or bleeding (because of low platelet count -- thrombocytopenia) 69. Natriuretic peptides -- effects v. Decrease blood pressure and increase sodium and water excretion 70. Orthostatic hypotension -- clinical manifestations w. Dizziness, blurring or loss of vision, and syncope or fainting 71. Paroxysmal nocturnal dyspnea -- cause x. Increased venous return when lying flat 72. Patients at risk for pernicious anemia y. Northern European ancestry, autoimmune patients, digestive issues and post surgery 73. Parkinson Disease -- missing neurotransmitter z. Depletion of dopamine from basal ganglia 74. PCOS clinical manifestations a. Irregular menstrual periods, amenorrhea, hirsutism, obesity b. Untreated can leave to CVD and abnormal insulin resistance with DM type 2 75. Postmortem changes c. Pallor, muscles stiffen, body temperature decreases 76. Pneumothorax -- clinical manifestations d. Sudden pleural pain, tachypnea, possible mild dyspnea e. Tension: severe hypoxemia, tracheal deviation away from affected lung, hypotension 77. Primary and secondary immune responses f. Primary -- triggered by first exposure of B and T lymphocytes to a particular antigen g. Secondary -- re-exposure to same antigen gives faster, more prolonged, more effective response 78. Prevention of pulmonary embolism h. Sequential compression devices, early ambulation, anticoagulant medications 79. Pulmonary edema -- etiology i. Left-sided heart failure, mitral valve disease, pulmonary embolus, systemic hypertension, arrhythmias, renal failure, head trauma, drug overdose, exposure to high altitudes j. Excessive fluid accumulates in the pulmonary tissue air space of the lungs causing an overload with excessive blood volume 80. Pulmonary embolism clinical manifestations k. Sudden onset of pleuritic chest pain, dyspnea, tachypnea, tachycardia, and unexplained anxiety 81. Purpose of the inflammatory response l. Contain site damage, localize response, eliminate invader, and restore tissue function 82. Peptic Ulcer Disease -- contributing factors m. H. pylori infection, NSAID abuse, smoking and alcohol use 83. Potential causes of right-sided heart failure n. COPD, cystic fibrosis, ARDS, MI, cardiomyopathies, and pulmonic valvular disease 84. RAAS o. Liver releases angiotensinogen p. Kidneys release enzyme renin q. Angiotensinogen and renin make angiotensin I r. Lungs respond with release of ACE s. ACE and angiotensin I make angiotensin II t. Angiotensin II goes to adrenal gland and creates aldosterone which regulates BP u. Angiotensin II goes to kidneys and causes vasoconstriction v. OVERALL RAISES BLOOD PRESSURE 85. Raynaud's disease -- clinical manifestations w. Chronically cold hands and feet, pallor, coldness, numbness, cyanosis, pain and erythema during spasms, ulcerations on fingers and toes 86. Reperfusion injury x. Return. Of oxygen and inflammatory cells may lead to free radical generation, further damaging myocytes 87. Restrictive vs obstructive pulmonary disease y. Restrictive -- decreased lung compliance, more difficult to inhale (PNEUMONIA) z. Obstructive -- more difficult to exhale (ASTHMA, COPD) 88. Rheumatoid arthritis -- classification of disease a. autoimmune 89. Rhabdomyolysis -- dangers b. Acute renal failure, electrolyte imbalances, acid-base derangement, and cardia dysrhythmias 90. Seizures -- clinical manifestations c. Aura, loss of consciousness, memory loss following seizure, drowsiness or difficult to arouse for short time after seizure, incontinence (urine and/or bowel) 91. Sepsis -- risk factors d. Suppressed immune system, extreme age (infant or elderly), organ transplant, surgery, indwelling device, sickness 92. Skin lesions in HIV patients e. Kaposi sarcoma -- common in HIV, lesions are red, purple, or brown macules and develop into plaques and nodules 93. Sleep apnea -- clinical manifestations f. Excessive snoring, periods of apnea and hypersomnia g. Upper airway obstructed during sleep, tongue falls to back of the mouth, oxygen levels decline h. Waking up in night therefore tired in the day (hypersomnia) 94. Strain, sprain, subluxation, dislocation i. Strain -- tearing of muscle or tendon j. Sprain -- tearing of ligament k. Subluxation -- a partial dislocation l. Dislocation -- displacement of one or more bones in a joint 95. Stages of the infectious process m. Incubation -- period from initial exposure to onset of first symptoms n. Prodromal -- onset of initial symptoms o. Invasion or acute illness period -- pathogen is multiplying rapidly, immune and inflammatory response is triggered p. Convalescence -- immune and inflammatory responses are successful or disease may be fatal or enter latency phase 96. Tuberculosis method of transmission q. airborne 97. Triad of Virchow r. Hypercoagulability s. Venous stasis t. Endothelial lining damage 98. Tumor markers for liver cancer u. Alpha-fetoprotein (AFP) 99. UC vs Crohn's v. Crohn's disease usually has lesions more on the right side and ulcerative colitis usually has lesions more on left side 100. Vertigo -- clinical manifestations w. Sensation of spinning, loss of balance, nystagmus 101. V/Q ratios -- dead space vs. shunt x. Dead space is when there is high ventilation but no perfusion and the V/Q ratio is high y. Shunt is when there is no ventilation but there is perfusion and the V/Q ratio is approaching zero 102. Wound healing and intentions z. Primary intention -- wounds that heal under conditions of minimal tissue loss a. Secondary intention -- wounds that require a great deal more tissue replacement (OPEN WOUND)