NR507 ADVANCED PATHOPHYSIOLOGY FINAL EXAM REVIEW (2025) Actual Exam Questions and Answers, Exams of Nursing

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NR507 A DVA NC E D

PATHOPHY

C

SIOLOGY

FINAL EXAM REVIEW

Study .Te ch n ique s:

• These .classes .are .HARD, .use .your .time .wisely
• Use.a.white.board.to.test.your.knowledge
• Get .a .study .partner
• Don’t .fall .behind .on .your .reading
• Use .your .study .guide
• Use .your .resources -

Youtube

• A .systematic .inflammatory .condition .that .primarily .affects

.the .skin .and .joints. .The .clinical .presentation .includes .the

.presentation .of .erythematous .plaques .with .silvery-white

.scales .that .can .affect .any .site .of .the .body, .but .is .often

.found .on .the .extensor .surfaces .of .the .limbs, .trunk, .scalp,

.and .buttocks. .The .nails .may .also .be .affected .by .plaques,

.pitting, .and .distal .onycholysis. .Associated .symptoms

.include .itching. or .local .pain. .The .disease .can .be .classified

.as .mild, .moderate, .or .severe, .depending .on .the .affected

.body .surface .area, .presence .of .erythema, .induration, .and

.scaling.

• Management .includes .a .topical .steroid .or .vitamin .D

3

.analog .treatment .for .mild .to .moderate .disease. .If .topical

.agents .do .not .provide .adequate .treatment .response, .then

.referral .to .dermatology .to .manage .patients .with

.phototherapy .and/or .nonbiologic .(e.g., .Acitretin,

.Methotrexate, .and .Cyclosporine) .or .biologic .(e.g., .Humira,

.Enbrel, .and .Cosentyx) .agents .may .be .warranted.

Psoriasis

Rosacea

There .is .a .familial .tendency, .and .several .genes .have .been

.identified. .Neurovascular .dysregulation, .infection, .and

.factors .that .trigger .altered .innate .and .adaptive .immune

.response .are .involved .(i.e., .chronic .sun .exposure .and

.damage, .heat, .drinking .alcohol .or .hot .beverages, .hormonal

.fluctuations, .Demodex .folliculorum .[mites] .colonization,

.and .mental .stress .and .anxiety).

• An .adult .patient .presents .to .the .clinic

.with .a .rash .and .mild .itching. .The

.physical .exam .reveals .erythematous

.raised .patches .and .silver .scales; .the

.patches .vary .in .size .and .are .located .on

.bilateral .elbows .and .on .the .lower .back.

.Nail .pitting .and .onycholysis .are .also

.observed. .The .patient .has .a .long .history

.of .smoking. .Which .is .the. most. likely

.diagnosis?

• Lichen .planus
• Atopic .dermatitis
• Plaque .psoriasis
• Pityriasis .rosea

In .lower .UTI, .person .experiences

.urgency .associated .with .burning

.on .urination. .Frequency, .dysuria,

.& .suprapubic .pain. .A .lower .UTI

.can .progress .upward.

Uncomplicated .indicates .the .urinary

.tract .& .renal .function .is .normal.

• In .complicated, .there .is .decreased

.renal .function .and .an .abnormal

.urinary .tract.

Most. common. bacteria:

E. .coli

Staphylococcus. saprophyticus

Proteus .Mirabillis

Klebsiella

Week. 4 .review

Pre/Intra/Post. Renal

Prerenal- .Damage .occurs .before .the .kidney

• A .sudden .reduction .in .blood .flow .to. kidney .(renal .hypoperfusion)
• Causes .a .loss .of .kidney .function.
• Nothing .is .wrong .with .the .kidney .itself

Intrinsic

• the. damage. occurs. in. the. kidney. due. to. some. type. of. damage. to . the .glomerulus, .renal .tubules, .renal .interstitial, .or .the .renal

.vasculature.

Post-renal

• the. damage. occurs. in. the. collecting. ducts. or. even. further. down. into. the

.ureter, .bladder .or .urethra .due .to .some .type .of .obstruction, .that .include .stones

.and. strictures.. An. obstruction. can. occur. anywhere. along. this. pathway.

Week. 5 .review

• Review - Anxiety. disorders - Panic .attacks -

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Target. insulin-producing. pancreatic. 𝐀. cells

Autoimmune .destruction .of .80%–90% .of .cells

Leads .to .insulin .deficiency .and .hyperglycemia.

Islet .cell .cytoplasmic .autoantibodies .(ICA)

Insulinoma-associated-2. (IA-2). autoantibodies

Insulin. autoantibodies. (IAAs)

Zinc .transporter-8 .autoantibodies .(ZnT8A)

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Require .insulin .replacement .at .all .times .to .treat .hyperglycemia

Failure .to .supplement .insulin .leads .to:

Diabetic .ketoacidosis .(DKA) .(can .be .life-threatening)

Chronic .complications .of .diabetes

Pathophysiology.of.type. 2 .DM

• A .combination .of .defective .insulin .secretion .and .decreased .insulin .sensitivity.
• Defective .insulin .secretion: - Insulin. secretion. by. 𝐀. cells. requires. glucose. transport. into. the. cell - Mediated .by .glucose .transporter. 2 .(GLUT-2) - Obesity .and .high-fat .diet .may .affect .this .transport, .causing .decreased .insulin .secretion
• Peripheral .insulin .resistance: - With .constant .high .intake .of .glucose, .there .is .a .constant .high .demand .for .insulin. - Hyperinsulinemia .leads .to .decrease .in .sensitivity .of .the .insulin .receptors .in .liver,

.muscle, .and .adipose .cells.

• Down-regulation .of .receptors .leads .to .vicious .cycle .of .high .insulin .levels.
• Additional .mechanisms:

Impaired .hepatic .sensitivity .to .insulin .leads .to .lack .of .inhibition .of .glycogenolysis

.and .gluconeogenesis

• Hyperglycemia. can. impair. pancreatic. 𝐀-cell. function. and. exacerbate. insulin. resistance.
• High .demand .for .insulin .and .excessive .production .of .pancreatic .enzymes .causes .pro- . amylin .accumulation .and .pancreatic .apoptosis.
• Progressive. pancreatic. 𝐀-cell. failure

DM .testing

.Guidelines

Testing .for .prediabetes .and .type. 2 .diabetes .should

.be .considered .for .all .asymptomatic .adult .patients

.who .are .overweight .(BMI .>25 .or .>23 .in .Asian

.Americans) .and .have. 1 .or .more .risk .factors.

Testing .for .all .patients .should .begin .at. 45 .years .of

.age. .If .testing .results .are .normal, .repeat .testing

.every. 3 .years .is .recommended. .Diabetes .and

.prediabetes .may .be .screened .for .with .the .use .of .a

.fasting. plasma. glucose. (FBG),. hemoglobin. A1C,. or

.2-h .plasma .glucose .(2-h .PG) .level .during .a. 75 .g .oral

.glucose .tolerance .test .(OGTT).

Urine .glucose .levels, .fasting .insulin .levels, .and .c-

.peptide .levels .are .often .used .during .the .evaluation

.and .treatment .of .type. 1 .and .type. 2 .diabetes.

Thyroid .Dysfunctions

Hypothyroid

Signs .include .cold .intolerance, .weight

.gain, .muscle .fatigue, .constipation,

.swelling .of .the .hands, .and .dry .skin.

Laboratory .tests, .including .for

thyroid-stimulating .hormone .and .total

.thyroxine .and .triiodothyronine .levels,

.are .required .to .confirm .the .disease

.and .determine .medication .dosages.

Levothyroxine .(Synthroid) .is .the .most

.common .medication .treatment .for

.hypothyroidism.

Hyperthyroid

• Caused .by .overproduction .of .thyroid

.hormones, .creating .an .increase .in

.the .body’s .metabolism.

• More .common .in .women .and .may .result

.from .autoimmune .conditions .(such .as

.Graves .disease), .goiter, .or .iodine

.administration. .This .results .in .weight .loss,

.increased .heart .rate, .heat .intolerance,

.and .often .anxiety.

• Patients .may .also .experience .lid .lag,

.emotional .lability, .amenorrhea, .and

.palpitations. .Many .of .these .symptoms .are

.caused .by .an .increased .sympathetic

.response.