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Patho Exam 3
Urine, Shock, CV, Respiratory
Terms in this set (23)
T/F: when a patient has persistent high blood sugar, blood flow and filtration pressure decrease.
False: high blood sugars require an increase in filtration pressure and blood flow.
What are some criteria it looks at to determine renal issues? (RIFLE criteria)
Creatinine, urine output, GFR are used to determine severity of AKI
one of the most common causes of tubular necrosis is AKI. Why does this happen?
toxins, ischemia, tubular epithelial cells slough off, then obstruct the tubules, kidney not working: may need dialysis. High mortality rate or don't recover kidney function. Know the stages
Toxin from bacteria stick to glycoprotein receptors in intestines and glomeruli. What is this?
Hemolytic uremic syndrome.
How does angiotensin II play a role in chronic kidney disease?
Glomerular hypertension play a role
What are some electrolyte abnormalities with chronic kidney disease?
Elevated phosphorus, hypocalcemia, hyperkalemia (what supplements?)
What about hypertension? They should be on an antihypertensive medication.
You are teaching Mr. J about complications of his chronic kidney disease. What will you tell him?
You can get inflammation or infection around the heart (PERI, or endo carditis), plaque in the arteries can become worse which can lead to a heart attack (CAD), you can have heart failure.
You are caring for an infant in the NICU with kidney disease. What do you know about this in children?
These children can have developmental and growth delays. Osteodystrophy is common and other kidney issues such as nephrotic syndrome.
definition of shock
You have to be careful when treating cardiogenic shock. Other types of shock require aggressive fluids but with cardiogenic shock:
There may already be fluid build-up, so you don't want to overload their heart. They need vasopressors to contract the heart, not fluid as they already have interstitial edema.
What happens in anaphylactic shock. You ate peanuts and are allergic.
Bronchial constrict, you can't breathe, capillaries increase permeability, causes blood vessels to dilate, blood pressure drops, you need epinephrine immediately.
What are some characteristics of sepsis?
Understand lactic acid in sepsis and SIRS
infection, endotoxinia released from E coli. or pseudomonas. Inflammatory cells activate, pro-inflammatory cytokines release. Need fluids to decrease capillary permeability.
What changes happen when there is a decrease in oxygen delivery to your tissues?
Cell membranes destroyed, uptake of glucose to cells are impaired, Na+/K+ pump disrupted, impairing neuromuscular function. Blood volume decreases.
What's the most common renal stone?
Uric acid stone, phosphorus, and struvite (staghorn) are pointy jagged edge stones - painful
What is the difference between stress and urge incontinence?
Stress is a weakening of pelvic floor muscles (having children) where urge (overactive bladder) is an overactivity of the detrussor (bladder) muscle. Medication treats urge and surgery fixes stress inc.
If you have a blockage in the ureter to the right kidney, what happens to the left kidney?
It tries to compensate by trying to work too hard (hyperfunction) and swells (hypertrophy)
What are some risks of having a foley catheter?
Infections. it is usually a formation of biofilm which is part of the pathophysiology of a foley and UTI
Your patient has nephrotic syndrome and has some leg edema. What is the pathophysiology of this?
the plasma proteins are depleted which causes edema.
What test is most important during an episode of acute chest pain?
a. exercise stress test
b. echo-cardiogram (U.S. of heart)
c. cardiac catheterization
Inflammation after an MI of the tissue around the heart is called?
a. endocarditis (inflammation within the heart)
c. rheumatic heart disease
d. pericardial effusion and tamponade (fluid in heart)
You hear a systolic mitral murmur, what do you suspect?
a. mitral stenosis
b. mitral regurgitation
d. tetralogy of fallot
A patient has brownish discoloration of her lower legs, what do you suspect is the problem?
a. varicose veins
b. arterial clot
c. venous clot
d. venous insufficiency
A patient has cold pale hands with slowly healing sores on them. She says that they are numb, then they become bright red. What do you suspect?
a. Raynaud's disease
b. actue arterial obstruction
d. arterial aneurysm
Raynaud's disease (spasm of the arterial)
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