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ADVANCED PATHOPHYSIOLOGY EXAM QUESTION AND ANSWERS UPDATED 2024
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In the physical examination of an individual, factors that would evidence atherosclerotic plaque - Arterial bruit and evidence of decreased blood flow to tissues What electrocardiogram (ECG) change would the healthcare professional assess for when a patient's myocardial infarction extends through the myocardium from the endocardium to the epicardium? - Pathophysiology of Angina - Angina pectoris is chest pain caused by myocardial ischemia. Stable angina is caused by gradual luminal narrowing and hardening of the arterial walls, so that affected vessels cannot dilate in response to increased myocardial demand associated with physical exertion or emotional stress. With rest, blood flow is restored and no necrosis of myocardial cells results. What medical term is used for a condition that results from pulmonary hypertension, creating chronic pressure overload in the right ventricle? - Cor pulmonale Positive risk factors for coronary heart disease - Age, Genetics, Smoking, Excess cholesterol, Diabetes, Sedentary lifestyle What is the initiating event that leads to the development of atherosclerosis? - Injury to the endothelial cells that line the artery walls Amyloidosis, hemochromatosis, or glycogen storage disease usually causes which form of cardiomyopathy? - Restrictive A patient is diagnosed with pulmonary disease and elevated pulmonary vascular resistance. Which form of heart failure may result from pulmonary disease and elevated pulmonary vascular resistance? - Right heart failure In systolic heart failure, what effect does the renin-angiotensin-aldosterone system (RAAS) have on stroke volume? - Increases preload and increases afterload Causes of CHF - Coronary artery disease. High blood pressure (hypertension) Longstanding alcohol abuse. Disorders of the disorders of the heart valves. Unknown (idiopathic) causes, such as after recovery from myocarditis Which event triggers congenital heart defects that cause acyanotic congestive heart failure? - Left-to-right shunts
American College of Cardiology (ACC)/ American Heart Association (AHA) guidelines classification of heart failure - Stage A: A person has a high risk of heart failure but currently has no identifiable disorders. Stage B: A person has a structural heart disorder but is not presenting symptoms. Stage C: A person has current or prior symptoms of heart failure associated with an underlying condition. Stage D: A person currently has advanced structural heart disease, shows clear symptoms, and requires specialized medical intervention. Causes of Acute congestive heart failure - Infections, allergic reactions, a blood clot in your lungs, viruses that damage the heart cardiopulmonary bypass surgery, severely irregular heartbeats, heart attack Causes of chronic failure - Coronary artery disease and heart attack High blood pressure (hypertension). Faulty heart valves. Damage to the heart muscle (cardiomyopathy) Myocarditis congenital heart defects heart arrhythmias Chronic diseases Within a physiologic range, what does an increase in left ventricular end-diastolic volume (preload) result in? - Increase in force of contraction Neurofibrillary tangles characterize which neurologic disorder? - Alzheimer disease
. types of dementia is caused by an infectious agent - Creutzfeldt-Jaksob disease (CJD), Postencephalitic dementia & Dementia associated with HIV A patient suffers transient ischemic attacks (TIAs). TIAs are characterized by - Blood supply to the brain is blocked for a brief period of time, called a "ministroke". Symptoms of a TIA are like other stroke symptoms, but do not last long. For example, numbness/weakness, confusion, trouble speaking, difficulty walking, dizziness, loss of balance or coordination A cerebrovascular accident causing damage to which area of the brain would result in cognitive impairment? - Frontal lobe is responsible for cognitive functions. Pathophysiology of The use of the term "brain attack" to indicate a stroke - A stroke happens when a blood clot blocks blood flow to the brain. This causes brain tissue to become damaged or die. A stroke, sometimes called a brain attack, occurs when something blocks blood supply to part of the brain or when a blood vessel in the brain bursts.
Tremors at rest, rigidity, akinesia, and postural abnormalities are a result of the atrophy of neurons in the brain's: - Substantia nigra that produces dopamine Pathophysiology of Bell's palsy - Bell's palsy is an unexplained episode of facial muscle weakness or paralysis. It begins suddenly and worsens over 48 hours. This condition results from damage to the facial nerve (the 7th cranial nerve). Pain and discomfort usually occur on one side of the face or head. S/S of Amytrophic Lateral Sclerosis (ALS) - Difficulty walking or doing normal activity, tripping/falling, hand weakness, clumsiness, slurred speech or trouble swallowing, inappropriate crying, laughing or yawning; muscle cramps and twitching in your arms, shoulders and tongue What is the central component of the pathogenic model of multiple sclerosis? - Demyelination of nerve fibers in the CNS Multiple sclerosis is best described as a(an): - Central nervous system demyelination, possibly from an immunogenetic virus Ventricular dilation and grossly impaired systolic function, leading to dilated heart failure, characterize which form of cardiomyopathy? - Congestive A disproportionate thickening of the interventricular septum is the hallmark of which form of cardiomyopathy? - Hypertrophic Which immunoglobulin (Ig) is present in childhood asthma? - IgE Which statement by the professor best describes acute respiratory distress syndrome (ARDS)? - A pulmonary disease characterized by severe hypoxemia, decreased pulmonary compliance, and the presence of bilateral infiltrates on chest x-ray imaging Which statement about the late asthmatic response is true? - The release of toxic neuropeptides contributes to increased bronchial hyperresponsiveness. The most successful treatment for chronic asthma begins with which action? - Avoidance of the causative agent Which factor contributes to the production of mucus associated with chronic bronchitis? - Increased Goblet cell size Which condition involves an abnormally enlarged gas-exchange system and the destruction of the lung's alveolar walls?. - Emphysema
Clinical manifestations of decreased exercise tolerance, wheezing, shortness of breath, and productive cough are indicative of which respiratory disorder? - Chronic bronchitis Clinical manifestations that include unexplained weight loss, dyspnea on exertion, use of accessory muscles, and tachypnea with prolonged expiration are indicative of which respiratory disorder? - Emphysema What is the cause of polycythemia in the fetus? - Increased erythropoiesis occurs in response to the hypoxic intrauterine environment. A nurse practitioner is discussing immunizations with a 67-year-old male with chronic obstructive pulmonary disease (COPD), you advise - that receive inactivated flu virus vaccine How the forced expired volume in the first second (FEV1) for a patient with moderate to severe emphysema would be..? - Individuals have an increased work of breathing, a mismatching of the ventilation-perfusion ratio, and a decreased forced expiratory volume in 1 second (FEV1). Emphysema Pathophysiology - Emphysema is a pathologic diagnosis defined by permanent enlargement of airspaces distal to the terminal bronchioles. This leads to a dramatic decline in the alveolar surface area available for gas exchange. Furthermore, loss of alveoli leads to airflow limitation by 2 mechanisms. First, loss of the alveolar walls results in a decrease in elastic recoil, which leads to airflow limitation. Second, loss of the alveolar supporting structure leads to airway narrowing, which further limits airflow. What is the most common pathogen of acute otitis media in adults? - Streptococcus pneumoniae Group A beta hemolytic strep (GAS) is a common pathogen in bacterial pharyngitis. It is also an infectious agent in which of the following medical conditions? - Rheumatic fever A nurse practitioner has diagnosed a patient with acute bacterial rhinosinusitis (ABRS). What findings would the nurse practitioner identify: - Four signs and symptoms are the most helpful in predicting acute bacterial rhinosinusitis: purulent nasal discharge, maxillary tooth or facial pain (especially unilateral), unilateral maxillary sinus tenderness, and worsening symptoms after initial improvement. Most common cause of community acquired pneumonia - staphylococcus aureus Miss Z (38 y/o) presents to the ED with complaints of a cough fever and sputum. She states she had a sudden onset of shaking chills last night, it hurts when she takes a deep breath, she coughs up rusty colored sputum. Her temperature is 102.50F, HR 110, B/P 110/70, RR 28 and labored. On auscultation of her lungs she has fine inspiratory crackles and bronchial breath sounds. Based on this presentation Miss Z most likely has -