Download PATHOPHYSIOLOGY EXAM 2 STUDY GUIDE UPLOADED 2023 LATEST and more Study Guides, Projects, Research Nursing in PDF only on Docsity!
GUIDE UPLOADED 2023 LATEST
Module 4
▪ Clinical manifestations – appendicitis
o Right, lower abdominal pain, nausea, occasional diarrhea
▪ Cause of pseudomembranous colitis and nonpharmacologic treatments-
o (Often called antibiotic associated colitis) Acute inflammation and necrosis of
the large intestine caused by Clostridium difficile. Exposure to antibiotics is the major factor predisposing to the development of this disorder. Stop the affecting antibiotic. Treat ischemia, fecal transplant, colectomy
▪ Clinical manifestations – cholecystitis-
o Acute: Inflammation of the gallbladder wall.
o Chronic- inflammation of the gallbladder wall attributed to persistent low- grade
irritation from gallstones or recurrent attacks of acute cholecystitis.
▪ Cause of Helicobacter pylori (H. pylori)-
o Transmission person to person, fecal-oral route, reservoir in water sources.
H. pylori often causes peptic ulcer disease
▪ Clinical manifestations – gastric carcinoma
o Early- none.
o Advanced- anorexia, weight loss and GI bleed
▪ Causes of gastroenteritis due to Salmonella
o Consumption of raw or undercooked chicken/eggs
o Diarrhea, N/V, abdominal pain
▪ Complication of perforated gallbladder-
o Sepsis.
o Rare complication of acute cholecystitis
▪ Cause of jaundice and disease associated with jaundice-
o Elevated levels of bilirubin
o Caused by a buildup of bilirubin, which is a waste product in blood. An inflamed
liver or obstructed bile duct can cause jaundice. Diseases associated: infections of the liver from a virus (Hepatitis), overuse to Tylenol.
▪ Define the following terms: dysphagia; occult blood-
o Dysphagia: difficult or painful swallowing
o Occult blood (cause by polyps) blood you can’t see with the naked eye, FOBT (fecal
occult blood test). Means there is usually bleeding somewhere in the digestive tract.
▪ What should patients with newly diagnosed pancreatitis avoid?
o Alcohol
▪ What causes greenish-yellow emesis?
o Bile, caused by vomiting on an empty stomach, or bile reflux.
▪ Most frequent location of peptic ulcers-
o Proximal Duodenum
▪ What types of hepatitis increase the risk of hepatocellular carcinoma?
GUIDE UPLOADED 2023 LATEST
o Hep B and C
▪ Clinical manifestations of chronic gastritis
o Upper abdominal pain
o Indigestion
o Bloating
o N/V
o Weight loss/loss of appetite
o Hematemesis may occur bc of damage to the gastric epithelial mucosa
▪ What types of things put a patient at risk for developing acute gastritis?
o Ingesting irritating substances- alcohol, aspirin, NSAIDs, viral bacteria,
autoimmune
▪ Clinical manifestations of acute gastritis-
o Anorexia, nausea, vomiting, and postprandial (after meal) discomfort
▪ Causes of hiatal hernia-
o Conditions where intraabdominal pressure increases: ascites, pregnancy,
obesity, chronic straining or coughing
o Loosening of the muscular band around esophageal and diaphragmatic
function
▪ What is the cause of a rigid abdomen in peritonitis?
o Peritonitis is inflammation of the peritoneum. Inflammation and abdominal
spasms Module 5
▪ What is cryptorchidism and complications associated with the condition?
o Hidden testes, the testes did not descend all the way. Failure to treat this can
cause fibrotic tubules with deficiency in spermatogenesis, infertility.
▪ Clinical manifestations – acute prostatitis-
o Ch31, slide 32- Fever, chills, LBP, frequency, urgency, and dysuria. Tender and
swollen prostate
▪ What is a complication of removing too much fluid during dialysis, and what would you
want to monitor?
o Complication- Low BP
o Monitor- BP, Nausea and dizziness
▪ Clinical manifestations – pyelonephritis (kidney infection)-
o Chills, flank pain, nausea, vomiting, CVA tenderness
o Stretching of renal caps causes pain
▪ Individuals with HPV (human papillomavirus) are at risk for developing what
disease?
o Cervical cancer
▪ Define the following terms: enuresis, stress incontinence, micturition, overflow
incontinence:
o Stress incontinence- small amounts of urine are voided involuntarily with
intraabdominal pressure.
GUIDE UPLOADED 2023 LATEST
o Dermopathy- thick, red skin on shin & top of feet
▪ What processes occur during fasting?
o Glucose is produced by glycogenolysis, gluconeogenesis, and insulin falls to
basal level
o Glucagon is responsible for most glucose production in fasting state
o Other counterregulatory hormones (corticosteroids, growth hormones,
catecholamines) augment glucose production
▪ This type of tissue is accessed to promote energy production in type I diabetes-
o Adipose Tissues
▪ Clinical manifestations of hyperthyroidism; hypothyroidism; hypoparathyroidism;
hyperparathyroidism-
o HYPERthyroidism - fatigue, weight loss, sensitivity to cold, depression, memory
problems, goiter, hair loss, muscle pain, trembling hands, infertility. Hyper= grave’s disease.
o HYPOthyroidism - decreased BMR, weakness, fatigue, cold intolerance, decreased
appetite, weight gain, depression, menstrual irregularities, muscle weakness.
o HYPOparathyroidism - tingling/burning in fingertips, toes, lips, muscle aches
and cramps, twitching/spasms of muscles (esp in the mouth area, hands, arms, and throat, fatigue, weakness, painful periods.
o HYPERparathyroidism - osteoporosis, kidney stones, excessive urination,
abdominal pain, easily tired, depression/forgetfulness, bone/joint pain.
▪ Clinical manifestations – ketoacidosis
o nausea/vomiting, fatigue, weightless, hunger, thirst, abdomen pain, tired,
increased urination, fruity breath, deep/fast respirations
▪ What mechanisms control hormone release and regulation?
o Trophins from pituitary glands and hypothalamus
▪ What hormones are released by the anterior pituitary gland?
o TSH and ACTH (adrenocorticotropic hormone) – GROWTH HORMONE
▪ Clinical manifestations – diabetes insipidus; Cushing’s syndrome; secondary
hypothyroidism; primary hypothyroidism; primary aldosteronism; secondary aldosteronism-
o Diabetes insipidus- Too little ADH produced. Extreme polyuria with sudden onset,
increased thirst, weight loss (from water weight), dizzy, weak, constipation, seizures, tired, disorientation, hypernatremia b/c of H2O deficit. Cushing’s- S.T.R.E.S.S.E.D.- S: skin fragile, T: truncal obesity, R: round/mood face and reproductive issues, E: ecchymosis (easily bruise) and elevated BP, S: stretch marks on extremities and abdomen (red/purple), S: sugar high- hyperglycemia, E: excessive body hair, D: dorsocervical fat pad (buffalo hump) and depression Secondary Hypothyroid (TSH levels are not functioning properly): anterior pituitary is not producing enough TSH. defects in TSH production (Hyposecretion) to not make t3, t4.
GUIDE UPLOADED 2023 LATEST
Primary Hypothyroid: (problem is with the thyroid gland) l ow T3, T (hyposecretion of t3 and t4), TSH high Primary Aldosteronism: Conn Syndrome usually caused by aldosterone- secreting tumors Secondary Aldosteronism: increased adrenal production of aldosterone in response to nonpituitary, extra adrenal stimuli (such as: hypoperfusion) – target hormone for aldosterone is kidney
▪ Define: myxedema-
o This occurs in untreated hypothyroidism. Severely advanced
hypothyroidism. Lack of thyroid hormone that contributes to NON-pitting edema.
▪ Causes of hypothyroidism-
o May be congenital or acquired
▪ IF we are born with it = called cretinism
o Majority are primary b/c thyroid is malfunctioning
o Acquired hypothyroidism is hashimoto
▪ The 3 P’s in type I diabetes-
o Polyuria (increased urination)
o Polydipsia (increased thirst)
o Polyphagia (increase hunger)
▪ Difference between primary and secondary endocrine disorders-
o Primary= problem is with gland that produces hormone
▪ Example: type 1 diabetes is a primary disease
o Secondary= problem with the pituitary
▪ Cause of Cushing’s syndrome: PRIMARY
o Caused by the pituitary producing too much ACTH, which turns into
increased cortisol, excess glucocorticoids from adrenal glands
▪ Cushing Disease: Secondary
▪ Cushing Syndrome: primary- problem with the adrenal cortex
▪ Tertiary- problem with the hypothalamus
- Patient presents with lower right abdominal pain, nausea, occasional diarrhea. They have appendicitis
- Growth hormone mainly targets the liver
- Type 2 Diabetes- peripheral tissue insulin resistance
- Acromegaly- deep voice, increased ring/shoe size, coarse facial features
- 2 stress hormones that increase glucose production in liver= corticosteroids and catecholamines
- Bleeding between periods= metrorrhagia
- Pheochromocytoma key sign= very high blood pressure
- Hirschsprung’s Disease= inadequate innervation of the colon
- Diabetes insipidus= too little ADH production
GUIDE UPLOADED 2023 LATEST
- If a man has a hydroseal- what is this?
o Fluid buildup in the scrotum- tunica vaginalis
- Hydronephrosis- what’s a complication of this?
o Swelling and build up of fluid in the kidney- what happens in area where the
swelling is? Ischemia and necrosis
- What hormone is responsible for reabsorption in kidneys? AHD
o Where does the happen? Collecting ducts
o Hesitancy
o Painful prostate
- Kidney pain: called CVA tenderness, we call the pain renal colic
- Syphilis- what causes bacteria
o Anerobic spirochete
o Main problem with syphilis- cardiovascular, aortic stenosis, inflamed aorta,
brain, blindness, numbness and tingling, (get goofy…?)
o Filter, regulate BP, secretion, regulation of the fluid balance, removal
nitrogenous waste, acidic waste
- What do the kidneys do with vit D?
o Activate the Vit D
- GFR- this is a calculated number, what two values are used to make this calculation?
o Serum urea goes up
o Bicarb goes down
o Creatinine goes up, GFR goes down
- What kind of people are at risk for chronic renal failure?
o Diabetes (type 1)
o Someone who takes a lot of nsaids
o Hypertension
o Chronic kidney disease patients are more at risk
- Things that cause women to quit having period in a NON menopausal woman:
o HYPOthyroidism and adenomas and carcinomas
- Who can tell me about the RAS system?
o When is the RAS system activated?
▪ LOW BP or when blood flow in the afferent arterial is decreased
o How do we treat? Antiviral drug- not antibiotics
- Glomerulonephritis about you have strep throat? Post streptococcal gloferrial nephritis- what does urine look like?
o Dark urine
- Characteristics of Type 2 Diabetes:
o Peripheral tissue insulin resistance
- What is acromegaly caused by?
o Overproduction of adult growth hormone
- Goiter- we suspect: HYPERthyroidism- Grave’s disease
GUIDE UPLOADED 2023 LATEST
- Primary hypothyroidism and Secondary- know the T3, T4 and TSH
- Fasting- what happens in the alpha cells of the pancreas?
o Glucagon
o Weight gain, low energy, increase in hair, depression, anxiety, fatigue,
irritability, headaches
- Pt with type 2 diabetes: why do they need to control their blood sugar?
- Myxedema: occurs in hypothyroidism, you have non-pitting edema
- Kid who is bigger than all their peers:
o They might have gigantism
- Type 1 diabetes and stress:
o Blood sugar goes up b/c of release of glucocorticoids
o Not enough ADH
▪ So, they drink and urinate A LOT!!!
- Type 1 diabetes: Not producing insulin- they can use fat for energy- ADIPOSE TISSUE
- Type 1 diabetes (absolute insulin deficiency)
- Type 2 diabetes (relative insulin deficiency)
- Ketoacidosis- fat metabolism
- Type one diabetes uses adipose tissue for fuel
- Secondary hypothyroidism- untreated- TSH will be low, T4 will be high
- Primary hypothyroidism- TSH will be high, T4 will be low
- Syndrome of inappropriate ADH is caused by- low sodium caused by sodium not being absorbed (being secreted) the fluid is being retained. Increased sodium secretion and fluid retention
- Hyperthyroidism- irritability, weight loss (unintentional), heat intolerance, heart rate is increased, bulging eyes
o What happens to the eyeballs of people with hyperthyroidism? Bulging
- Diabetes insipidus- nothing to do with diabetes really
o Huge urine loss like we see in DM 1 and 2
o Huge Urine Output
o Dehydration related to fluid loss
- Hypothyroidism: What is the most common cause?
o Hashimotos
- SIADH- retaining fluid
- Pheochromocytoma: tumor on adrenal- biggest symptom is HBP
- Ketoacidosis symptoms: fruity breath, deep breathing, thirst, lethargic
- Cushing syndrome: too much cortisol
- Primary disorder- problem is coming from the secreting hormone
- Secondary- from the pituitary
o Thyroid isn’t making hormone- primary problem
o If pituitary isn’t sending signal to make thyroid hormone- then its secondary
- Common way your body regulates hormones:
o Negative feedback loop
