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211 terms

Pathophys Test

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hyperventilation can cause
respiratory alkalosis
HCO-3 + H+ H2CO3CO2 + H2O
Circulating hydrogen ions and bicarb are shift through the carbonic acid intermediate to make more carbon dioxide.
How is respiratory failure defined?
PaO2 = 50 and PaCO2 = 50, pH = 7.35
Hypoxia
a decreased or insufficient level of O2 in the tissues. May develop because of pneumonia because fluid in the lungs prevents diffusion of O2.
Cystic fibrosis
impedes growth and development due to lack of a pancreatic enzyme which leads to nutritional deficits. A defective gene affects a protein that controls the normal movement of sodium chloride in & out of cells and causes thick, sticky secretions in the respiratory, digestive and reproductive tracts.
Risks of Cystic Fibrosis
may develop respiratory issues such as bronchiectasis, chronic infections, collapsed lung, respiratory failure; digestive issues like diabetes, blocked bile duct, rectal prolapsed and intussusceptions.
Signs of CF in newborn
can't excrete meconium, salty skin, trouble with weight gain, cough or wheezing and large, greasy stools
Why does hypercalcemia occur because of a tumor with bronchogenic carcinoma?
Tumors secrete PTH which promotes absorption in the digestive tract, resorption of calcium from bone and inhibits secretion from the kidneys.
progressive emphysema prevents
gas exchange because increased residual lung volume prevents sufficient inhalation of O2 for the exchange
Tension pneumothorax contributes to hypoxia because
the victim can breathe in but, because of the flutter valve, air does not leave the plural space. As the condition progresses, there is less room to breathe in new air and mediastinal shift can compress the inferior vena cava
What confirms a diagnosis of TB?
The use of X-rays to detect calcifications in lungs.
Pancytopenia
a decrease or lack of all types of blood cells
Name a sign of sickle cell anemia
jaundice
Why does jaundice occur in sickle cell anemia?
RBCs deoxygenate, harden and take on the typical sickle shape. The repeated change in shape shortens the life span of an RBC to about 20 days.
signs of anemia
pallor, chills, dyspnea, tachycardia and irritability. Anemia can cause angina in stressful situations. Chronic severe anemia can lead to CHF.
Why does pernicious anemia have an effect on RBCs?
The lack of B12 shortens the life span of RBCs.
What formed blood particles do leukemias decrease?
platelets in blood
Secondary polycythemia increases
hemoglobin due to chronic hypoxia. Doing a phlebotomy can lower the amount of RBCs.
Iron deficiency anemia is caused by
vegetarian diets, excessive menstrual flow, and hemorrhage due to hemorrhoid or cancer. Only 5-10% of ingested iron is absorbed but that increases to approx. 20% when there is a deficit.
Severe hypoxia with pneumonia occurs because
there is less O2 perfusion due to congestion in the lungs. Hypoxia is also caused by the residual volumes caused by emphysema.
Define Premature Ventricular Contraction (PVC)
an additional beat arising from a ventricular muscle cell or an ectopic pacemaker. These are related to pulse deficit (difference in rate between apical pulse and radial pulse). With premature ventricular contraction, no blood is being pumped; the PVC is only an extra beat. Occasional PVCs don't interfere with heart function, but as frequency increases or with paired PVCs, V-Fib can result and lead to cardiac arrest.
Define Preload
venous return to heart (pre-beat) while atria are relaxed
Afterload is determined by
peripheral resistance to opening of semilunar valves. It is increased by high diastolic pressure resulting from excessive vasoconstriction.
Epinephrine and Norepinephrine increase
systemic vasoconstriction
What is important about CSF?
an equal amount of cerebro-spinal fluid must be absorbed and produced simultaneously to maintain correct pressure
strabismus
crossed eye or deviated eye, occurs when focusing on an object, causes diploplia. could lead to a reduction in vision of the affected eye
nystagmus
involuntary, sideways jerking motions of eyes; involuntary unilateral, bilateral or rhythmic eye movement; caused by Meniere's disease, brain tumor, brain injury, stroke, alcoholism, labrynthitis, stroke, some drugs
pink eye is caused by
an infection of S. aureus.
What causes DIC (disseminated intravascular coagulation)?
multiple clots which have used up all the clotting factors; heparin may be used to thin the blood and make more clotting factors available; caused by cancers of lung, pancreas, prostate, stomach and by acute myeloid leukemia, abruption placenta, pre-eclampsia, massive tissue injury, gram negative infections, liver disease.
What is the primary treatment for leukemia?
chemotherapy
Is stroke volume identical from both ventricles?
YES
Why is there a normal delay in conduction in the AV node?
It allows the ventricles to fill completely.
Increased HR and force of contraction is caused by:
epinephrine
vasodilation in the skin and viscera results from
relaxation in the smooth muscles of the arterioles
diuretics cause
a decrease in Na and fluid retention in the body
What causes thrombus formation?
immobility, vascular damage, atrial fib, artificial valves, hypercoagulability
With total heart block, what happens to ventricular contractions?
They are not as forceful and are irregular.
What are two characteristics of paroxysmal nocturnal dyspnea?
rales and hemoptysis
What are the effects of rheumatic fever?
changes in heart, can cause an abnormal immune response that affects all layers of the heart. signs include subQ nodules, epistaxis, fever, leukocytosis, issue with large joints like knees and hips.
Intermittent claudication
pain in legs during exercise (progresses to pain while resting) due to interruption of flow in the iliac artery. Intermittent claudication is a symptom od PAD.
dissecting aortic aneurysm
tear in endothelium that allows bleeding between layers of arterial wall
What is a common adverse effect of anti-hypertensive meds?
orthostatic hypotension
What's the most dangerous cardiac dysrhythmia?
Ventricular fibrillation because it's hard to shock the heart back into a normal sinus rhythm.
What is a confirming diagnosis of MI?
Changes in EKG and in isoenzymes like troponins, CKs and NBs
Does quiet expiration requires energy?
No
What is vital capacity?
The maximum amount of air that can be exhaled after the maximum amount of air is inhaled.
What is the air left in lungs between breaths?
Residual volume
Hypercapnia or increased PaCO2(too much CO2) causes
respiratory acidosis
Patients with respiratory alkalosis will
have too little CO2.
What is the most effective compensation for respiratory acidosis?
Kidneys increase production of bicarb.
Why do humans suffer repeated flu virus infections?
The virus mutates continually so that our immune systems are unable to recognize it.
Fibrosis of bronchial wall causes
chronic bronchitis
Atelectasis with airway obstruction causes
decreased breath sounds on the side of the affected lung
Adults or infants with ARDS have
respiratory alkalosis
Why does collateral circulation develop?
develops in a brain affected by atheroma if the condition develops over time. This may help prevent a CVA.
Where does a Berry aneurysm normally occur?
in bifurcations of the circle of Willis
What are the signs of a Berry aneurysm?
they are asymptomatic until they burst, then indicated by blood in CSF collected by LP.
What are the signs of meningitis?
nuchal rigidity, headache, vomiting, seizures, confusion, fever, lack of hunger or thirst, sleepiness or difficulty staying awake and skin rash, in some cases.
What causes encephalitis?
tick (spirochete) and mosquito bites
What is a depressed skull fracture?
A skull fracture where the broken bone is pushed to a level below the rest of the skull.
After a head injury, what causes secondary damage?
infection, pressure, bleeding
Secondary damage after SCI can include
catecholamine release, fracture of vertebrae, BP issues
How is seizure diagnosed?
EEG
What is flail chest?
a break of consecutive ribs in two places
What is tension pneumothorax?
a hole in the chest that allows air into the pleural cavity, air can't move back out because of a flap of skin or tissue that covers the opening on expiration.
Where is lumbar puncture performed and why?
between L3 and L4 because there is a wider opening there to accommodate the needle. At this level, there is less chance of damage to the spinal column because this is below the level of the cord.
What are the signs of Parkinson's disease?
difficulty swallowing and chewing, urinary retention problems and orthostatic hypotension.
Define cor pulmonale.
right side congestive heart failure which affects venous return to the heart, so blood backs up into the system.
What does left sided heart failure cause?
blood backup into lungs.
What do focal and generalized seizures indicate?
a tumor because of pressure from inflammation
How is CO2 transported through the blood?
as bicarb on an amino acid on the globin portion of hemoglobin
Necrosis
groups of cells die
ischemia
decrease of blood flow to tissue
preventative measures
sunblock and other measures meant to prevent injury or disease
examples of specific defenses
lymphocytes, macrophages,
phagocytosis
destruction of foreign substances, microbes, debris, etc.
generalized cutaneous dilation
blood vessels enlarge & can reduce temperature
granulation tissue
highly vascular tissue which appears pink or red in color; fragile & easily broken
rule of nines
can help determine fluid replacement needs, esp. in case of burns and protein shift
prostaglandins
manufactured in mast cells & causes vasodilation; increase capillary permeability
neutrophils
phagocytosis of microorganisms
signs/symptoms of AIDS
Kaposi's sarcoma; low Tcell count; loss of body fat; lymphoma
tests to diagnose HIV
ELISA, Western Blot and RNA/DNA testing; test lasts 20 minutes
opportunistic infection
can be caused by yeast or other resident flora
local signs of infection
hyperemia, pain, edema, loss of function, exudates
antiviral drugs
interfere w/ attachment of virus to host cells; interfere w/ shedding of protein coat
example of ionizing radiation
gamma rays from cobalt machine
neutropenia (during chemo)
low white blood cell count; will delay chemo id WBC is below threshold
glucocorticoids (steroids)
given during chemo or radiation can decrease inflammation around the tumor
increase in osmotic pressure
will cause water to shift from high to low; water shifts from interstitial fluid into blood
osmotic pressure, high to low
a high concentration will facilitate movement of nutrients from the arteriolar end (higher pressure) into tissue. At the venous end, low pressure allows wasters to flow back into the vascular system. Na+ highest outside cells; K+ highest concentration is intracellular
hyponatremia
most common cause is sweating
hypernatremia
condition in which too much sodium is present
hypokalemia and hyperkalemia
both cause cardiac dysrhythmias
PTH
causes increased absorption of calcium in the digestive tract
phosphate ions
important in ATP production & important in acidbase balance (buffer system)
normal pH
7.35 to 7.45 below 7.35 is acidosis; above 7.45 is alkalosis
metabolic acidosis
caused by diabetic ketoacidosis, diarrhea
excess in acids (lactic acid)
bicarbonate levels will decrease because it's being used to counteract the acid
emphysema
causes respiratory acidosis due to decline in CO2 expulsion (obstructive disorder)
infants are more susceptible to dehydration because
they have less fluid to begin with
respiratory acidosis
due to sedation, respiration becomes shallow and less CO22 is expelled. bicarbonate levels decrease due to increased usage (counteracting increased acid)
metabolic acidosis leads to
an increase in K+, pulls K+ out of cells into blood
how many chromosomes does a human have?
23 pairs, including 1 pair of sex chromosomes
teratogens
can cause issues or defects during organogenesis
organogenesis
period during first 2 months of pregnancy when organs and systems differentiate
local sign of osteomyelitis
pain, redness, swelling
form of Staphylococcus
clustered (think of staph meeting)
form of Streptococcus
strip (think of strep bar)
hyponatremia
causes: sweating, low sodium diet, excessive water intake, use of diuretics; hormone imbalance (insufficient aldosterone or excessive ADH, due to water retention dilutes NA+ concentration), adrenal insufficiency, renal failure

effects: muscle cramps, hypovolemia, brain cells swell causing confusion, seizures, headache, decreased BP, fatigue, heart problems due to conduction issues
ileum
What is the primary site for absorption of nutrients?
forms the outer covering of the stomach
Where is the visceral peritoneum?
anabolism
In the liver, amino acids are used to created complex molecules through the process of _________ .
loss of acids in stomach and dehydration
Prolonged vomiting causes alkalosis because of...
lactic acid
Dehydration causes acidosis because of increased production of _______ .
5th, 9th, 10th and 12th (trigeminal, glossopharyngeal, vagus and hypoglossal)
Which cranial nerves are responsible for swallowing?
esophageal atresia (narrowing)
_______ causes the inability to get food or fluid into the stomach
floor of the mouth
A common location for oral cancer is the ________.
raw eggs and uncooked poultry
What causes gastroenteritis due to salmonella?
via the oral-fecal route (restaurants or day care centers)
How is hepatitis A transmitted?
lower left quadrant
Where is the pain from diverticulitis felt?
the liver
Where is the first area that colon cancer usually metastasizes?
cuts off blood supply
Volvulus (twisting of bowel on its mesentery) causes gangrene in the bowel because the twisting _________________ .
leakage of intestinal bacteria into the gut, paralytic ileus (paralysis of the intestinal muscles which prevents peristalsis) and shock.
Why does chemical peritonitis occur because of perforated gallbladder?
the proximal duodenum
What is the most frequent location for peptic ulcers?
dark-colored, bloody stool caused by bleeding in the GI tract. often a sign of peptic ulcer or bowel disease
What is melana?
eating smoked food or food with lots of nitrates, heredity
Predisposing factors for gastric carcinoma -
Cirrhosis
______ causes elevated serum bilirubin, both conjugated and unconjugated.
genetics, environmental factors & auto-immune issues
Inflammatory bowel disease is caused by __________.
the trigone
What is the area formed by the three openings of the bladder?
flank pain and urinary casts
What are the symptoms of pyelonephritis?
problems with tubular exchanges cause problems excreting bicarb
Why does metabolic acidosis develop with bilateral kidney disease?
gradual onset of chronic renal failure after age of 40
What is the onset of polycystic kidney disease?
cardiac dysrhythmias
Kidney disease can cause hypokalemia or hyperkalemia which both lead to ________.
chronic renal failure
persistent glomerulonephritis will eventually cause
sacral reflexes
Defecation reflex requires coordination of _____________.
hypertension and chronic renal failure
With nephrosclerosis (hardening of the kidney), you will likely also see ________________ and _____________ .
serious infection, dehydration, pancreatitis, surgery, trauma, myocardial ischemia
Precipitating factors for DKA include __________.
staggering gait, confusion, disorientation, sweating
Signs of hypoglycemia -
abnormal metabolism in the lens
Visual impairment in diabetes is caused by ______________.
Decreased glucocorticoids; increased glucocorticoids
____________ cause Addison's disease, _____________ cause Cushing's disease.
pendulous abdomen and breasts, truncal obesity, staring eyes, buffalo hump, increased levels of glucocorticoids, atrophy of lymph nodes
What are the characteristics of Cushing's disease?
a poor stress response. Symptoms include muscle weakness and fatigue or pain, joint pain, weight loss and decreased appetite, hyperpigmentation, low blood pressure and syncope, salt craving, hypoglycemia, irritability or depression
Addison's disease causes
deficiency of ADH
Diabetes insipidus caused by a __________________ .
immune complex causes deposits in glomerular tissue causing inflammation
Post-streptococcal glomerulonephritis -
microscopic hematuria
Initial sign of adenocarcinoma of kidney -
absorption of NA+ and water
Furosemide or Lasix decreases
negative feedback loop
Increased blood glucose causes increased secretion of insulin, which is an example of a _________________ .
prolonged use of steroids
Decreased secretion of glucocorticoids in the adrenal glands results from _______________ .
fever, hyperthermia, heart failure
Signs of thyrotoxic crisis -
Acetylcholine (Ach)
What chemical neurotransmitter is found at the neuromuscular junction?
joint movement
Articular cartilage facilitates ________ .
deformity of the joint
What is a sign of dislocation?
pannus in rheumatoid arthritis. A pannus will covers and deprives the cartilage of nutrients it would otherwise receive from the synovial fluid.
Articular cartilage is damaged by
redness and inflammation
What are the signs of RA?
tear in a tendon
Strain
tear in a ligament
Sprain
Sugar in the urine
What is glycosuria?
increased glucose in urine changes osmotic pressure
Polyuria in diabetes occurs because ____________________.
Polyphagia
is increased hunger because nutrients are not making it to the cells.
catabolism of fats
acidosis increases
What would increased capillary permeability cause?
edema
In what situations does phosphate play a key role?
Bone metabolism, ATP production, acid-base balance
What would correct the affect in the body from abnormally slow respiration?
carbonic acid
A serum pH of 7.3 in a patient with kidney disease is indicative of what?
metabolic acidosis
What is a compensation for anemia?
increased heart rate (tachycardia)
Why do patients with sickle cell anemia suffer infarctions and occlusions?
abnormal shape of RBC's obstructs capillaries which causes hypoxia
Which are the first arteries to come off the aorta?
coronary arteries
What's the basic pathophysiology of MI?
occlusion/block of coronary artery
How does blood flow in ventricular septal defect?
blood flows from the left ventricle to right ventricle (oxygenated to unoxygenated)
What are the common signs of juvenile RA?
redness and deformity in large joints
Which is the basic pathophysiological change in essential hypertension?
systemic vasoconstriction
Why do pregnant women get varicose veins?
because of pressure on the pelvic veins
What are some signs of circulatory shock?
pale, moist skin and restlessness
What are signs of septic shock?
warm, feverish, flushed face
Why does a rapid heart rate reduce cardiac output?
it reduces ventricular filling
What causes cystic fibrosis?
an autosomal recessive gene
How does atelectasis affect breath sounds?
it decreases breath sounds on the affected side
What is flail chest?
a break of consecutive ribs in two places which causes paradoxical motion during respiration
What is a sign of laryngotracheobronchitis?
barking cough
What is the reason for hypoxia in pulmonary edema?
blood flow is impaired
What is the first change in ABG's with diarrhea?
decreased level of bicarbonate
What causes encephalopathy in cirrhosis?
build up of ammonia in the blood
Why do patients with cirrhosis have an increase in ammonia?
because of increased bleeding in abdominal cavity
In inflammation of the glomerulus, ______ is not broken down.
albumin
What occurs in renal disease due to the increase of renin secretion and congestion in the glomeruli?
colloid osmotic pressure decreases
What results from nephroschlerosis?
chronic renal failure
What is aphasia?
the inability to understand or appropriately express language
What is an early indication of increased intra-cranial pressure?
decreased responsiveness
What causes projectile vomiting?
pressure on the emetic center in the medulla oblongata
What causes papilledema?
increased intra-cranial pressure on the optic disk
What color is normal cerebrospinal fluid?
clear
What is a classic sign of Guillain-Barre?
patient presents ascending paralysis
With damage to the right occipital lobe where do you lose visual field?
left side
What happens to herniation in IICP?
the brain may herniated through the foramen magnum
What are some signs of post-polio syndrome?
progressive fatigue and weakness
What are signs of hydrocephalus in a neonate?
bulging fontanelles, irritability, won't eat, eyes gaze downward
What are early signs of Parkinson's?
resting tremors, shuffling gait, orthostatic hypotension
What is the initial effect of injury to L3-L4?
low back pain which radiates into the legs
When does Type I onset?
childhood
Name a precipitating factor for DKA.
serious infection
What causes myxedema?
severe hypothyroidism w/deficit of T3 & T4
What causes diabetes insipidus?
ADH deficit
Why does diabetes insipidus cause polyuria?
ADH deficit
What are signs of compound fracture?
open wound over the fracture
What type of bone pain is caused by osteosarcoma?
persistent, severe pain
Why is a teenager more likely to have issues with diabetes?
more active, poor and irregular diet
How is articular cartilage destroyed in RA?
A pannus covers the cartilage and cuts off nutrients
What happens in autoimmune disease?
the body attacks self
Where is extra-cellular fluid?
all fluids outside the cells
Where is intra-cellular fluid?
fluid inside the cell