Docsity
Docsity

Prepare for your exams
Prepare for your exams

Study with the several resources on Docsity


Earn points to download
Earn points to download

Earn points by helping other students or get them with a premium plan


Guidelines and tips
Guidelines and tips

ADVANCED PATHOPHYSIOLOGY FINAL 2025 UPDATED EXAM (600 QUESTIONS AND SOLUTION)100% PASS., Exams of Nursing

ADVANCED PATHOPHYSIOLOGY FINAL 2025 UPDATED EXAM (600 QUESTIONS AND SOLUTION)100% PASS. ADVANCED PATHOPHYSIOLOGY FINAL 2025 UPDATED EXAM (600 QUESTIONS AND SOLUTION)100% PASS.

Typology: Exams

2024/2025

Available from 05/26/2025

vincent-prince
vincent-prince 🇺🇸

3

(1)

1.1K documents

1 / 49

Toggle sidebar

This page cannot be seen from the preview

Don't miss anything!

bg1
ADVANCED PATHOPHYSIOLOGY FINAL 2025
UPDATED EXAM (600 QUESTIONS AND
SOLUTION)100% PASS.
Do women or men more often have multiple sclerosis? - Solution Women (2-3:1)
Which disease has the following risk factors:
-Epstein-barr virus (EBV)
-Live above the 37th parallel
-Caucasian
-Female
-Vitamin D deficiency: Decreased time between clinical isolated syndrome (CIS) and 2nd
exacerbation
-Smoking - Solution Multiple Sclerosis
What is the main pathophysiological theory for multiple sclerosis? - Solution It's an
autoimmune/neurodegenerative disease:
-inflammation
-demyelination/remyelination
-permanent axonal damage
What are the Myelin forming cells of the CNS? - Solution Oligodendrocytes
What do T-Helper cell types 1 & 17 do? - Solution Pro-inflammatory
What does T-Helper cell type 2 do? - Solution Anti-inflammatory
What is the pathophysiology of Multple Sclerosis? - Solution 1. Autoreactive T cells express
Very Late Antegen-4 (VLA-4, aka α4-integrin) on their cell surface and secrete Matrix
Metalloproteinases (MMP).
2. VLA-4 binds to Vascular Cell Adhesion Molecule (VCAM) receptors on the blood brain
barrier (BBB) and MMP results in dysregulation of the BBB, allowing cell entry into the CNS.
3. Once in the CNS, pro-inflammatory cytokines (TNF-α, INF-γ, and Osteopontin [OP]) are
secreted resulting in inflammation and further T cell entry into the CNS.
4. T cells in the CNS interact with microglia, astrocytes, and macrophages to produce reactive
oxygen species and nitric oxide causing CNS damage.
5. B cells acts as ACPs, enter the CNS, and produce myelin-specific antibodies that form
membrane attack complexes with complement causing cell lysis.
Which disease presents in the following way:
**Visual changes, optic neuritis (Often the 1st sign/symptom)
-Paresthesias
-Gait issues/falls
-Foot drop
-Dysdiadochokinesia
-Fatigue
-Weakness
-Impaired coordination
pf3
pf4
pf5
pf8
pf9
pfa
pfd
pfe
pff
pf12
pf13
pf14
pf15
pf16
pf17
pf18
pf19
pf1a
pf1b
pf1c
pf1d
pf1e
pf1f
pf20
pf21
pf22
pf23
pf24
pf25
pf26
pf27
pf28
pf29
pf2a
pf2b
pf2c
pf2d
pf2e
pf2f
pf30
pf31

Partial preview of the text

Download ADVANCED PATHOPHYSIOLOGY FINAL 2025 UPDATED EXAM (600 QUESTIONS AND SOLUTION)100% PASS. and more Exams Nursing in PDF only on Docsity!

ADVANCED PATHOPHYSIOLOGY FINAL 2025

UPDATED EXAM (600 QUESTIONS AND

SOLUTION)100% PASS.

Do women or men more often have multiple sclerosis? - Solution Women (2-3:1) Which disease has the following risk factors: -Epstein-barr virus (EBV) -Live above the 37th parallel -Caucasian -Female -Vitamin D deficiency: Decreased time between clinical isolated syndrome (CIS) and 2nd exacerbation -Smoking - Solution Multiple Sclerosis What is the main pathophysiological theory for multiple sclerosis? - Solution It's an autoimmune/neurodegenerative disease: -inflammation -demyelination/remyelination -permanent axonal damage What are the Myelin forming cells of the CNS? - Solution Oligodendrocytes What do T-Helper cell types 1 & 17 do? - Solution Pro-inflammatory What does T-Helper cell type 2 do? - Solution Anti-inflammatory What is the pathophysiology of Multple Sclerosis? - Solution 1. Autoreactive T cells express Very Late Antegen-4 (VLA-4, aka α4-integrin) on their cell surface and secrete Matrix Metalloproteinases (MMP).

  1. VLA-4 binds to Vascular Cell Adhesion Molecule (VCAM) receptors on the blood brain barrier (BBB) and MMP results in dysregulation of the BBB, allowing cell entry into the CNS.
  2. Once in the CNS, pro-inflammatory cytokines (TNF-α, INF-γ, and Osteopontin [OP]) are secreted resulting in inflammation and further T cell entry into the CNS.
  3. T cells in the CNS interact with microglia, astrocytes, and macrophages to produce reactive oxygen species and nitric oxide causing CNS damage.
  4. B cells acts as ACPs, enter the CNS, and produce myelin-specific antibodies that form membrane attack complexes with complement causing cell lysis. Which disease presents in the following way: **Visual changes, optic neuritis (Often the 1st sign/symptom) -Paresthesias -Gait issues/falls -Foot drop -Dysdiadochokinesia -Fatigue -Weakness -Impaired coordination

-Cognitive changes MRI: ***Gadolinium enhanced lesions LUMBAR PUNCTURE TEST: -Increased IgG -Increased Myelin basic protein (MBP) -Increased CSF protein - Solution Multiple Sclerosis Which cognitive test is most commonly used to diagnose MS? - Solution Symbol Digit Modalities Test (SDMT) What is the primary diagnostic test for MS? - Solution MRI with or without contrast What is the most common type of MS, which is involves episodes of acute worsening with some recovery and no progression in between exacerbations? - Solution Relapsing Remitting MS (RRMS) What type of MS can develop from RRMS, have a steady progression of the disease in between exacerbations, and present with more black holes and brain atrophy? - Solution Secondary Progressive MS (SPMS) What type of MS is the least common, it doesn't develop from RRMS and is the progressive worsening of the disease from the start, lacking recovery times? - Solution Primary Progressive MS (PPMS) What is the prognosis (good or bad) for someone with MS who is:

  • under 40 years old -Female -First sign/symptom is optic neuritis/sensory issues -Low exacerbation frequency -RRMS -Single lesion - Solution Good prognosis What is the prognosis (good or bad) for someone with MS who is:
  • over 40 years old -Male -First sign/symptom is motor or cerebellar -Multiple lesion locations -PPMS - Solution Bad prognosis What are the treatment goals for treating MS? - Solution -Decrease attack/exacerbation rate -Decrease annualized relapse rate (ARR) -Slow progression of disease -Prevent/limit ADRs -Symptom management (fatigue, bladder dysfunction, cognitive dysfunction, constipation, depression) When monitoring MS patients should follow-up with their neurologists every _________. Get an MRI every ___________. - Solution When monitoring MS patients should follow-up with their neurologists every 6 months-1 year. Get an MRI every 1 year (based on need). What is the difference between seizure and epilepsy? - Solution Seizure: a discrete clinical event
  1. Transitory imbalance in neurotransmitters -Enhanced excitatory neurotransmission (Glutamate/Aspartate, and NMDA/AMPA receptors) What are some seizure recurrence risk factors? - Solution -Abnormal EEG -Seizure occurs during sleep -Family history -Prior acute seizure -Mental retardation or cerebral palsy *NOT seizure type *NOT seizure length *NOT age of onset What type of seizure involves one hemisphere of the brain and may be with or without dyscognitive features. - Solution Focal Seizures What type of seizure involves the loss of consciousness for 5-20 seconds but the patient does not lose postural control? - Solution Absence Seizure What type of seizure involves bilateral muscle jerks and twitching? - Solution Myoclonic Seizure What type of seizure involves continuous shaking? - Solution Clonic Seizure What type of seizure involves stiffness (with gasp, wheeze, yelp)? - Solution Tonic Seizure What type of seizure involves going from stiff to shaking, stiff to shaking? - Solution Tonic- Clonic Seizure What type of seizure involves no movement, and the patient just falls? - Solution Atonic Seizure If the seizure patient has dejavu what part of the brain is involved? - Solution Parietal or Temporal lobe If the seizure patient has sweating, salivating, pale skin, lip smack what part of the brain is involved? - Solution Autonomic area What type of seizure is caused by fever? - Solution Febrile Seizure What time frame is the best to get an EEG for a seizure patient? - Solution Within 4 hours of seizure When does Parkinson's onset usually occur? - Solution Over the age of 60 Do more men or women get Parkinson's? - Solution Men What are some of the etiology/Risk factors of Parkinson's Disease? - Solution -Idiopathic -Genetic predisposition -Environmental -Family History -Drug Induced Parkinsonism (DIP) What disease presents in the following way? -Tremor (slow, rhythmic, methodical, occurs at rest, initially unilateral, disappears with

intention/sleep) -Rigidity (cogwheeling) -Bradykinesia -Postural Instability -Shuffling gait -Small hand-writing -Smelling loss - Solution Parkinson's Disease What is the pathophysiology of Parkinson's Disease? - Solution -Injury to the dopaminergic pathway (Nirostriatial pathway: Substantia nigra to striatum) -Dopamine activity decreases (Dopamine inhibits the activity of acetylcholine) -Aceytlcholine activity increases -Nigral neurons cell death Which disease will most likely present with intraneuronal lewy bodies in the autopsy? - Solution Parkinson's Disease What effect does Dopamine have on the basal ganglia? - Solution Dopamine stimulates an inhibitory process, which has a dampening effect producing controlled muscle contraction. What is the differences in diagnoses (possible, probable, definite) for Parkinson's Disease? - Solution Possible: any one of the major symptoms (Asymmetric resting tremor, rigidity, bradykinesia) Probable: any two of the symptoms Definite: any two symptoms and responds to anti-parkinson's drugs For what disease might a DaTscan be done to diagnose the disease? - Solution Parkinson's disease What test is used to determine the severity of Parkinson's Disease symptoms? - Solution Hohen and Yahr Staging Which disease presents in the following way? -Bilateral tremor (involves the head) -Postural/kinetic tremor -Strong family history - Solution Essential Tremor Which disease presents in the following way? -Parkinson's symptoms -Results from head injury/Traumatic Brain Injury -Stroke -Medications -Toxins - Solution Secondary Parkinsonism What disease presents in the following way? -Early autonomic symptoms (blood pressure changes, etc) -Falls -Symmetrical onset -Lack of tremor -No response to Dopaminergic agents - Solution Multi-Symptom Atrophy (MSA) What disease presents in the following way?

A patient with Major Neurocognitive Disorder is fully dependent, what modifier of severity would be appropriate (Mild, Moderate, or Severe)? - Solution Severe, Major Neurocognitive Disorder Which disease presents in the following way? -Cognitive dysfunction -Not age-dependent -Sudden onset -Typically reversible - Solution Delirium Which disease presents in the following way? -Cognitive dysfunction -Age-dependent -Slow and gradual cognitive decline - Solution Dementia What disease presents in the following way? -Aphasia (language impairment) -Apraxia (motor function imppairment) -Agnosia (failure to recognize) -Disturbed executive function -Delusions -Hallucinations -Depression -Sundowning -Agitated behaviors - Solution Alzheimer's Disease What are some risk factors of Alzheimer's Disease? - Solution -Age -Family History -Genetics (APP gene - 21; PS1 gene - 14; PS2 gene 1; epsilon4 on ApoE gene - 19) -Down Syndrome (Trisomy 21) -Head trauma Which disease has the following cellular changes? -Cotrical atrophy -Ventricular enlargement -Plaques and tangles -Decreased Acetylcholine - Solution Alzheimer's Disease What causes amyloid fibrils to develop around neurons in the brain? - Solution Amyloid beta aggregates What is dyspnea? - Solution Subjective feeling of difficulty breathing Which pulmonary function test measures the maximum amount of air that can be rapidly and forcefully exhaled from the lungs after full inspiration? - Solution Forced Vital Capacity (FVC) Which pulmonary function test measures volume of air expired in the first second of FVC? - Solution Forced Expiratory Volume (FEV1) Which lab value measures the volume of air expired in the first second expressed as a percentage of FVC? - Solution FEV1/FVC ratio According the the National Heart, Lung and Blood Institute, how is Asthma defined? - Solution - Airflow obstruction

-Bronchial hyper-responsiveness -Underlying inflammation -Reversible Which antibody is the principal mediator of Type 1 Hypersensitivity reactions? - Solution IgE In Type 1 Hypersensitivity reactions, what must a patient be exposed to? - Solution An allergen In Type 1 Hypersensitivity reactions, what is the most important mediator? - Solution Histamine In Type 1 Hypersensitivity reactions, what is the principle effector cells, which release proinflammatory mediators? - Solution Mast cells In Type 1 Hypersensitivity reactions, what cell recruits eosinophils? - Solution T helper cells What cell is the primary cell responsible for inflammation? - Solution Eosinophil What cell is known as a "scavengers" which initiate the inflammatory cascade? - Solution Alveolar macrophage What type of Asthma is induced by exposure to an allergen, and develops within 10-20 minutes?

  • Solution Extrinsic (Atopic) Asthma What type of Asthma is non-allergic? - Solution Intrinsic Asthma In Extrinsic Asthma, what is the pathophysiolgic early-phase process? - Solution 1. Fast onset
  1. Antigen binds to IgE on Mast Cell
  2. Release of cytokines
  3. increased mucus/edema
  4. Bronchospasm In Extrinsc Asthma, what is the pathophsyiolgic late-phase process? - Solution 1. Recruited cells (by cytokines) drive the response
  5. Airway epithelial cells also release eotaxin (which recruits eosinophils)
  6. Epithelial cell injury/bronchoconstiction
  7. increased airway responsiveness = prolonged asthma symptoms Which disease presents in the following ways? -Cough -Wheezing -Dyspnea/Chest tightness -Tachypnea & Tachycardia -Hypoxemia - Solution Asthma What disease presents in the following way? -Persistent respiratory symptoms -Airflow limitation that is due to airway and/or alveolar abnormalities -Onset later in life -Not fully reversible -Symptoms progessively worse -Neutrophils involved - Solution COPD What are some risk factors for COPD? - Solution 1. Smoking/second-hand (>90%)
  8. Occupational exposure

Severe: all 3 symptoms Cardinal Symptoms of COPD:

  1. Increased dyspnea
  2. Increased sputum purulence (change in color)
  3. Increased sputum volume What are the complications of COPD? - Solution -Pulmonary hypertension -Persistent Hypoxemia -Cor Pulmonale (right side heart failure) -Polycythemia Vera (increased RBCs) -Increase risk of blood clots -Acute Respiratory Failure Which disease must have 2 or more of the following in a 1 month period of time & continual signs persist for at least 6 months:
  4. Delusions
  5. Hallucinations
  6. Disorganized speech
  7. Grossly disorganized
  8. Negative symptoms - Solution Schizophrenia *At least 1 sign must be 1, 2, or 3 Which disease must have 2 or more of the following in a 1 month period of time & continual signs persist less than 6 months:
  9. Delusions
  10. Hallucinations
  11. Disorganized speech
  12. Grossly disorganized
  13. Negative symptoms - Solution Schizophreniform Disorder *At least 1 sign must be 1, 2, or 3 Which disease must have 2 or more of the following for at least 1 day but less than 1 month:
  14. Delusions
  15. Hallucinations
  16. Disorganized speech
  17. Grossly disorganized
  18. Negative symptoms - Solution Brief Psychotic Disorder *At least 1 sign must be 1, 2, or 3 Which disease involves the presence of 1 or more delusions for 1 month or longer, criterion A for schizophrenia has not been met, functioning is not markedly impaired, behavior is not obviously bizzare? - Solution Delusional Disorder What are the Core Symptom clusters for Schizophrenia? - Solution -Positive symptoms (Delusions, Hallucinations, Disorganized speech, etc.) -Negative symptoms (Alogia, Avolition, Anhedonia, etc.) -Cognitive symptoms (memory, attention) -Mood symptoms (Dysphoria, Suicidality) -Social and Occupational Dysfunction

What is the Dopamine Hypothesis? - Solution 1. Efficacy of antipsychotics correlates with dopamine D2 blockade.

  1. Psychotic symptoms can be induced by dopamine agonists. What are the 4 Major Dopamine Pathways? - Solution 1. Nigrostriatal tract: Basal ganglia
  2. Mesolimbic tract: Nucleus accumbens
  3. Mesocortical tract: anterior cortical areas
  4. Tuberoinfundibular tract: hypothalamus In Schizophrenia, which dopaminergic pathway has hyperactivity? - Solution Mesolimbic (nucleus accumbens) -decrease in serotonin/increase in dopamine In Schizophrenia, which dopaminergic pathway has hypoactivity? - Solution Mesocortical (anterior cortical areas) -increase of serotonin/decrease in dopamine Which major monoamine neurotransmitter is more ubiquitous than Dopamine? - Solution Serotonin What secretes Serotonin? - Solution Raphe nuclei What is the major excitatory neurotransmitter? - Solution Glutamate Which receptors' decrease function is implicated in Schizophrenia? - Solution NMDA receptor increased PCP->increased schizo increase ketamine->increased schizo Are Glutamate pathways descending or ascending? - Solution Descending pathways Decrease functioning of what pathway can lead to hyperactivity in the mesolimbic area? - Solution Cortico-brainstem pathway Does and NMDA antagonists increase or decrease serotonin levels in the prefrontal cortex? - Solution increases serotonin What are the 5 Neuropathological changes observed in Schizophrenia? - Solution 1. Neurotransmitters -Glutamate excitotoxicity (decreased GABA inhibition)
  5. Oxidative Stress
  6. Neurotrophins -decreased BDNF and NGF -decreased glial cells
  7. Molecular Cascades in Apoptosis
  8. Energy Metabolism -decreased mitochondria What is the difference between Bipolar I and II? - Solution Bipolar I involves manic episodes. Bipolar II does not.

-Somatization -Cognitive impairment -2 months of symptoms -functioning severely impaired - Solution Major Depression Disorder What percentage of patients with Major Depressive Disorder only experience one episode, exhibit recurrent episodes, and become chronically depressed? - Solution One episode: 50% Recurrent episodes: 20% Chronically depressed: 30% The risk of depressed patients will have at least one subsequent episode of depression during their lifetime is? - Solution 50% What are the factors involved in the etiology and pathogenesis of depressive disorders? - Solution 1. Neurobiologic factors -Serotonin -Norepinephrine -Cytokines (inflammation;interferon-α)

  1. Psychosocial factors
  2. Development factors Serotonin and Norepinephrine are both involved in depressed mood, but what other domains are they involved in? - Solution Serotonin: sex, appetite, aggression. Norepinephrine: concentration, interest, motivation. What is a physical symptom of significance for depression? - Solution Aches/pain What is D SIG E CAPS assessment for depression? - Solution D epressed mood S leep I nterest G uilt E nergy C oncentration A ppetite P sychomotor S uicide What is PHQ2? - Solution Patient Health Questionnaire:
  3. During the past 2 weeks, have you been bothered by little interest/pleasure in doing things? 2.During the past 2 weeks, have you been bothered by feeling down, depressed, or hopeless? How is Generalized Anxiety Disorder (GAD) diagnosed? - Solution -Excessive anxiety/worry for at least 6 months. -Other symptoms (restlessness, fatigue, muscle tension, etc.) What are risk factors for Generalized Anxiety Disorder? - Solution -Female -Midlife -Genetics What disorder involves the abrupt surge of intense fear or discomfort that reaches a peak within minutes? - Solution Panic Disorder

How is Panic Disorder diagnosed? - Solution -At least 1 attack followed by 1 month of one or both of the following:

  1. Persistent concern/worry about having another attack
  2. A significant maladaptive change in behavior to prevent another attack What is the role of benzodiazepines (and receptors) to treat Generalize Anxiety Disorder? - Solution -Benzodiazepines relieve anxiety
  3. Benzodiazepine receptors receives GABA
  4. GABA causes neuron to stop firing (calming) *GAD is a problem in this feedback system. What part of the brain is the "alarm button", the hub of fear circuit? - Solution Amygdala How is Obsessive Compulsive Disorder (OCD) diagnosed? - Solution 1. Presence of obsessions, compulsions or both. Obsessions: recurrent/persistent thoughts. Compulsions: repetitive behaviors
  5. time consuming (more than 1 hour per day) What is normal sleep latency? - Solution 10 minutes In normal sleep what are the percentages for each stage? - Solution Stage 1: 5% Stage 2: 50% Stage 3/4 (slow wave sleep): 15-25% REM: 25% What is the Hypothalamus-mediated pathway for wakefulness? - Solution Decreased activity in the Ventrolateral Proptic Area (VLPO) leads to sleep. Increased activity in the Tuberomammillary nucleus leads to wake. What are the sleep promoting neurotransmiters? - Solution -GABA -Galanin What are the wakefulness promoting neurotransmitters? - Solution -Orexin -Histamine -Norepinephrine -Serotonin What is the pathophysiology of Insomnia? - Solution -Insomnia is a state of hyperarousal -Increased secretion of corticotropin and cortisol throughout the sleep-wake cycle -Greater whole-brain metabolism -Failure of wakefulness-promoting structures to deactivate Which disease is characterized by repetitive episodes of decreased airflow that occur during sleep? - Solution Sleep Apnea Syndrome Which disease is characterized by excessive daytime sleepiness, snoring, and obesity is a risk? - Solution Sleep Apnea-Hypopnea Syndrome What type of Diabetes is also called 'Juvenile diabetes,' and is an autoimmune disorder resulting from genetics, environmental trigger, hypersensitivity reaction? - Solution Type 1 Diabetes

What is the NCEP ATP III Criteria for diagnosis of Metabolic Syndrome? - Solution -Abdominal obesity: waist >35 in. in women, >40 in. in men -Triglycerides > or equal to 150 mg/dL -HDL <50 mg/dL in women, <40 mg/dl in men -Blood pressure >130/ -Fasting plasma glucose >100 mg/dL Which disease has the following signs and symptoms? -Excess glucose not reabsorbed/water loss -Intracellular dehydration -Cellular starvation -Osmotic diuresis, fat, and protein used for energy* -Lens and retina exposed to hyperosmotic fluid -Temporary dysfunction of peripheral nerves - Solution Diabetes Mellitus *Osmotic diuresis, fat, and protein used for energy (ONLY for TYPE 1 DM) When should individuals get tested for diabetes? - Solution All individuals 45 years and older. Below 45 years old if: -1st degree relative has DM -Obese -physical inactivity -High risk ethnic population -Women with PCOS -Have HTN, HLP, or CVD What are 3 diagnostic tests for Diabetes? - Solution -Fasting blood glucose test -Oral glucose tolerance test -HbA1c test How long must one fast in the fasting blood glucose test? - Solution 8 hours What is the normal and impaired ranges for the fasting blood glucose test? - Solution Normal: <100 mg/dL Impaired: 100-125 mg/dL What is the normal and impaired ranges for the Oral glucose tolerance test? - Solution Normal: <140 mg/dL Impaired: 140-199 mg/dL True or false? Glucose entry into RBC is not insulin dependent. - Solution True According to the ADA criteria, what is the diagnostic reading of HbA1c for diabetes? - Solution greater than or equal to 6.5% *Note the ADA does not have this diagnostic criteria for gestational diabetes According to the ADA criteria, what is the diagnostic reading of fasting plasma glucose for diabetes? - Solution greater than or equal to 126 mg/dL According to the ADA criteria, what is the diagnostic reading of the Oral Glucose Tolerance Test for diabetes? - Solution greater than or equal to 200 mg/dL What are the 3 acute complications of Diabetes Mellitus? - Solution 1. Diabetic Ketoacidosis (DKA)

  1. Hypoglycemia
  2. Hyperosmolar Hyperglycemia State (HHS) Which acute complication of Diabetes Mellitus presents in the following way? -Blood glucose 250-600 mg/dL -Dehydration -Acidotic -Nausia/Confusion -Insulin deficiency - Solution Diabetic Ketoacidosis (DKA) Which acute complication of Diabetes Mellitus presents in the following way? -Blood glucose >600 mg/dL -Osmotic diuresis and dehydration -Non-acidotic, no ketones -Relative insulin deficiency - Solution Hyperosmolar Hyperglycemia State (HHS) Which acute complication of Diabetes Mellitus presents in the following way? -Blood glucose <70 mg/dL - Solution Hypoglycemia What are 3 general systems affected by chronic complication of Diabetes Mellitus? - Solution 1. Impaired Immune System
  3. Microvascular
  4. Macrovascular Name 3 common Microvascular chronic complications from Diabetes Mellitus. - Solution 1. Retinopathy (Eye)
  5. Nephropathy (Kidney)
  6. Neuropathy (Nerves) Name 3 common Macrovascular chronic complications from Diabetes Mellitus. - Solution 1. Coronary artery disease (MI)
  7. Peripheral vascular disease (Atherosclerosis)
  8. Cerebrovascular disease (Stroke) What is the Somogyi effect? - Solution An episode of Insulin induced hypoglycemia that occurs overnight. What is the Dawn phenomenon? - Solution Increased fasting blood glucose episode in the morning. Without prior hypoglycemia. Interference with outflow of blood and interference with removal of waste are characteristic of venous or arterial disorders? - Solution Venous disorders What is the etiology of venous thrombi? - Solution -Stasis of blood -Activation of clotting cascade (fibrin complex) What is the etiology of arterial thrombi? - Solution -Turbulence of blood -Platelet aggregation Is endothelial dysfunction reversible or irreversible? - Solution Reversible What are apoproteins and what is their function? - Solution Made of water soluble phosopholipids and proteins. They coat cholesterol and triglycerides providing stability. They also activate the removal of lipids.

incretin effect (small intestine) -Increased lipolysis (fat cells) -Increased glucose reabsorption (kidneys) -Decreased glucose uptake (muscle) -Neurotransmitter dysfunction (brain) -Increased HGP (liver) -Increased glucogon secretion (Pancreas islet alpha cells) -Decreased insulin secretion (Pancreas beta cells) What is the term used to describe a reduction in arterial flow resulting in insufficient oxygenation to meet needs? - Solution Ischemia What is the term used to describe an area of ischemic necrosis resulting from occlusion of arterial supply or venous drainage? - Solution Infarction What can hyperlipidemia cause in the body? - Solution -Atherosclerosis -Ischemia -Infarction (Examples: Stroke, MI, CV event) At what age should men and women get cholesterol screenings? - Solution Men: 35+ Women: 45+ What is Atheroslcerosis? - Solution The hardening of the arteries True or false? Atherosclerosis is a monocyte based condition. - Solution False. Atherosclerosis is a platelet based condition. What is the pathophysiologic mechanism of Atherosclerosis? - Solution 1. Monocytes bind to LDL

  1. Monocytes become "Foam Cells"
  2. Plaque structure with a necrotic core is formed from foam cells.
  3. Platelets aggregate to form a fibrous cap. What conditions can Atherosclerosis lead to? - Solution -Atherosclerotic Cardiovascular Disease (ASCVD):
  4. Coronary heart disease (CHD) (Ex. MI, stable/unstable angina, etc.)
  5. Stroke/Transient Ischemic Attack (TIA)
  6. Peripheral artery disease -Aneurysms Which condition has the following risk factors? -Hyperlipidemia -Smoking -Hypertension -Elevated homocysteine -Elevated inflammatory markers (C-reactive protein) - Solution Atherosclerosis Which condition can be diagnosed in the following way? -Brittle toenails -Hair loss -Pallor -Palpate

-Ankle-brachial index -Ultrasound -MRI/CT - Solution Peripheral Artery Disease (PAD) What is the pathophysiogical mechanism of Peripheral Artery Disease (PAD)? - Solution 1. Endothelial injury

  1. Adhesion of monocytes & platelets
  2. Formation of foam cells
  3. Atherosclerotic lesion/fatty streaks
  4. Plaque formation/ thrombosis
  5. PAD What are risk factors of Peripheral Artery Disease (PAD)? - Solution -Male -Increasing age -Atherosclerosis -Smoking -Diabetes mellitus What disease presents in the following way? -Intermittent circulation -Vague aching -Numbness -Muscular atrophy -Skin thinning/ulcerations -Cool temperature -Weak pulses -Blanching with leg elevation -Deep red color with leg lowered -Eventually pain at rest - Solution Peripheral Artery Disease (PAD) What is the formula to calculate Mean Arterial Blood Pressure? - Solution Blood Pressure = Cardiac Output x Peripheral Vascular Resistance Cardiac Output = Stroke volume x Heart rate What are 3 mechanisms which increase cardiac output (and increase blood pressure)? - Solution -Increased blood volume -Increased heart rate -Increased myocardial contractility What mechanism increases peripheral resistance (and increase blood pressure)? - Solution - Increase vasoconstrictors (AngII, Catecholamines, Thromboxane, Endothelin) *To decrease peripheral resistance: vasodilators (Nitric Oxide, Prostacyclins, Kinins, ANP) Which is a stronger predictor of CV disease systolic or diastolic blood pressure? - Solution Systolic blood pressure What is systolic and diastolic blood pressure? - Solution Systolic: peak value during cardiac contraction Diastolic: value after contraction What is the formula to calculate Mean Arterial Pressure (MAP)? - Solution MAP = (SBP x 1/3)
  • (DBP x 2/3)