Advanced Pathophysiology Exam 4 Questions with Answers, Exams of Nursing

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Advanced Pathophysiology Exam 4 Questions with Answers 20-25% - answers Kidneys require at least ______ of cardiac output. renin-angiotensin-aldosterone - answers Reduced perfusion of a kidney activates the _____ system, which causes constriction of peripheral arterioles. calcium oxalate - answers most common type of kidney stone referred pain - answers Passage of kidney stones can be extremely painful and may produce ______ to the umbilicus area. umbilicus - answers Referred pain from kidney stones is seen in the ______ area. 10th - answers Sensory innervation of the upper part of a ureter arises from the _____ thoracic nerve root. urinary tract infection - answers Common clinical manifestations of a ________ in older adults include confusion and poorly localized abdominal discomfort. pyelonephritis - answers infection of one or both upper urinary tracts, including ureter, renal pelvis, and kidney interstitium urinary obstruction, reflux of urine from the bladder - answers ____ and _____ (vesicoureteral reflux) are the most common underlying risk factors for development of pyelonephritis. E. coli, Proteus, Pseudomonas - answers What are the three most common microorganisms associated with acute pyelonephritis? alkaline - answers Urine that is acidic/alkaline on the pH scale increases the risk of stone formation. ammonia - answers Microorganisms split urea into ____, which makes the urine more alkaline and therefore increases risk of stone formation. interstitial cystitis - answers Painful bladder syndrome, also termed ______, is a condition that includes nonbacterial infectious cystitis and noninfectious cystitis. autoimmune - answers The exact cause of painful bladder syndrome/interstitial cystitis (PBS/IC) is unknown, but a(n) ______ reaction may be responsible for the inflammatory response, which includes mast cell activation, altered epithelial permeability, neuroinflammation, and increased sensory nerve sensitivity. nonbacterial - answers _______ infectious cystitis includes viral, mycobacterial, chlamydial, and fungal causes of the condition. noninfectious - answers _____ cystitis includes radiation, chemical, autoimmune, and hypersensitivity causes of the condition. urine culture, urinalysis - answers Diagnosing cystitis from pyelonephritis is done by these two lab tests: _____ and ______, as well as the clinical signs and symtpoms. white blood cell - answers _______ casts indicate a diagnosis of pyelonephritis, rather than cystitis. However, these are not always present. urea, creatinine, renal creatinine - answers Reduced glomerular filtration rate during glomerular disease is evidenced by elevated plasma _______, ______ concentration, or reduced ______ clearance. acute glomerulonephritis - answers ____ includes renal diseases in which glomerular inflammation is caused by immune mechanisms that damage the glomerular capillary filtration membrane including the endothelium, basement membrane, and epithelium (podocytes). acute glomerulonephritis - answers The classic symptoms of ______ include sudden onset of hematuria including red blood cell casts and proteinuria (milder than nephrotic syndrome), and in more severe cases, these symptoms are also accompanied by edema, hypertension, and impaired renal function. 3.0 - answers Nephrotic syndrome is the excretion of _____g or more of protein in the urine per day. hypoalbuniemia - answers _____ is the excretion of less than 3.0g/dl of albumin per day. nephrotic syndrome - answers ______ is the excretion of massive proteinuria in the urine each day, hypoalbuminemia, hyperlipidemia, and peripheral edema. glomerular - answers Nephrotic syndrome is characteristic of ____ injury. primary - answers ____ causes of nephrotic syndrome include minimal change disease, membranous glomerulonephritis, and focal segmental glomerulosclerosis. secondary - answers ______ forms of nephrotic syndrome occur in systemic diseases including diabetes mellitus, amyloidosis, and systemic lupus erythematosus. GERD - answers ____ may be a trigger for asthma or chronic cough. abdominal - answers Upper ____ pain accompanies GERD and usually occurs within 1 hour of eating. It can be relapsing or remitting. lies down, pressure - answers Symptoms of GERD worsen if an individual _____ or if intra-abdominal ____ increases as a result of coughing, vomiting, or straining on the toilet. adhesions - answers the most common occurring small bowel obstruction is related to _______ and account for 50-70% of small bowel obstructions. abdominal distention - answers Small bowel obstructions usually present early with _____. alkalosis - answers If the obstruction is at the pylorus or high in the small intestine, metabolic acidosis/alkalosis develops initially as a result of excessive loss of hydrogen ions that normally would be reabsorbed from the gastric juice. prolonged - answers In short/prolonged intestinal obstruction, the lack of circulation produces lactic acid. acidosis - answers In prolonged intestinal obstruction, the lack of circulation produces lactic acid because of decreased tissue perfusion, thus causing metabolic acidosis/alkalosis. intussusception - answers ___ is the telescoping of part of the intestine into another, usually causing strangulation of the blood supply. hernia, adhesions, volvulus, intussusception - answers Causes of intestinal obstructions: h_____, constriction from a______, v_____, and i______. peptic ulcer - answers A _____ is a break, or ulceration, in the protective mucosal lining of the lower esophagus, stomach, or duodenum. genetic, H. pylori, NSAIDs - answers Risk factors for peptic ulcer disease include ____ predisposition, ____ infection of the gastric mucosa, and habitual use of ______. prostaglandin - answers Chronic use of NSAIDs suppresses mucosal ______ synthesis, resulting in decreased bicarbonate secretion and mucin (gut barrier component) production and increased secretion of hydrochloric acid. dumping - answers _____ syndrome often follows a partial gastrectomy or pyloroplasty and occurs 20 minutes after eating. It involves rapid gastric emptying and creation of a high osmotic gradient. dumping syndrome - answers Clinical manifestations of ______ include increased pulse, hypotension, weakness, pallor, sweating, and dizziness following a partial gastrectomy or pyloroplasty. dumping syndrome - answers The pathophysiology of _______ includes rapid gastric emptying and creation of a high osmotic gradient within the small intestine, causing a sudden shift of fluid from the vascular compartment to the interstitial lumen. diet - answers Dumping syndrome is usually managed very well with proper ____. small, fluid, protein, carbs - answers To manage dumping syndrome, an individual should eat frequent, ____ meals, consume no ______, include high ______, and low ______. Crohn - answers ____ disease is an inflammatory bowel disease with a strong familial history feature. ulcerative colitis - answers ___ is an inflammatory bowel disease that is located in the colon and rectum. Crohn - answers _____ disease is an inflammatory bowel disease with the presence of skip lesions. It can be present in all of the GI tract from the mouth to the anus. mucosal - answers Ulcerative colitis involves the ____ layer of the bowel. blood - answers _____ in stool is common in ulcerative colitis. Crohn disease - answers Bowel obstruction is more commonly seen in ulcerative colitis/Crohn disease. irritable bowel syndrome - answers _____ is considered a disorder of brain-gut interaction characterized by abdominal pain with altered bowel habits. IBS - answers Visceral hypersensitivity or hyperalgesia, particularly with distention of the rectum but also other areas of the gut, are typical manifestations of ______. IBS - answers Abnormal gastrointestinal permeability, motility, secretion, and sensitivity are associated with IBD/IBS. amino acids - answers One of the main functions of the liver is the synthesis of ______. food - answers All of the essential amino acids are obtained from _____. ammonia - answers Within hepatocytes, amino acids are converted to carbohydrates by removal of _____ (NH3). deamination - answers The removal of ammonia from amino acids is called ____. urea - answers Ammonia is converted to _____ by the liver and passes into the blood to be excreted by the kidneys. albumins, alpha, beta - answers The plasma proteins, including a_____ and ____ and _____ globulins are synthesized by the liver. hypoalbuminemia - answers Any condition that disrupts the normal functioning of the liver, thus hepatocyte dysfunction, can cause ______. cirrhosis - answers ____ is an irreversible, inflammatory, fibrotic liver disease. alcohol, hepatitis - answers _____ abuse and viral ____ are the most common causes of cirrhosis. jaundice, portal hypertension - answers When fibrosis occurs in the liver, it obstructs biliary channels and blood flow, causing ______ and _____. esophageal varices - answers _____ are the most common manifestation of portal hypertension. Thrombocytopenia - answers _____ is the most common manifestation of congestive splenomegaly and can contribute to an increased bleeding tendency. encephalopathy - answers Hepatic _____ results from a combination of biochemical alterations that affect neurotransmission. Neurotoxins and other harmful substances are allowed to accumulate and circulate to the brain. neurotoxins - answers Liver dysfunction and collateral vessels that shunt blood around the liver to the systemic circulation allow _____ and other harmful substances to accumulate and circulate to the brain, causing hepatic encephalopathy. ammonia - answers The most hazardous substances are end-products of intestinal protein digestion, particularly _____, which cannot be converted to urea by the diseased liver. acute pancreatitis. - answers Epigastric or midabdominal pain is the cardinal symptom of _____. hypocalcemia - answers What electrolyte balance is common with acute pancreatitis? sepsis - answers Tachypnea and hypoxemia are indicative of ____ when a patient presents with hypovolemia and systemic inflammatory response syndrome (SIRS). to increases in _____ in women treated without substantially decreasing the rates of cervical cancer. zika - answers ____ virus is a single-stranded RNA virus from the Flaviviridae family that is transmitted through bites from infected mosquitoes. However, vertical transmission occurs in infected women and sexual transmission has also been confirmed. infection, CNS - answers Infection with zika virus during pregnancy has been associated with severe fetal ___ and associated ____ abnormalities. cystocele - answers ____ is descent of a portion of the ANTERIOR bladder wall and trigone into the vaginal canal and is usually associated with the trauma of childbirth. cystocele - answers Increased bulging and descent of the ANTERIOR vaginal wall and urethra with presence of a _____ can be aggravated by vigorous activity, prolonged standing, sneezing, or coughing. recumbent, prone - answers To relieve symptoms of a cystocele, the patient should lay in a _____ or _____ position. rectocele - answers ____ is the bulging of the rectum and POSTERIOR vaginal wall into the vaginal canal. menopause - answers Symptoms of rectoceles typically do not occur until years after _____. rectoceles - answers Larger cystoceles/rectoceles can cause vaginal pressure, rectal fullness, and incomplete bowel evacuation. enterocele - answers A ___ is herniation of the rectouterine pouch into the rectovaginal septum (between the rectum and posterior vaginal wall). obesity, age - answers Two factors that increase risk of formation of enteroceles: ____ and ______ spermatoceles - answers ____ are benign cystic collections of fluid of the epididymis located between the head of the epididymis and the testis. sperm - answers Spermatoceles are filled with milky fluid that contains ____. clear - answers A spermatocele is differentiated from a hydrocele in that aspiration of a hydrocele recovers ____ fluid, and a spermatocele does not cover the entire surface of the testis. prostatitis - answers inflammation of the prostate gland acute bacterial - answers _______ prostatitis is an ascending infection of the urinary tract that tends to occur in men between the ages of 30 and 50 but is also associated with BPH in older me. inflammatory - answers Acute bacterial prostatitis stimulates a(n) _____ response in which the prostate becomes enlarged, tender, firm, or boggy. UTI, pyelonephritis - answers Clinical manifestations of acute bacterial prostatitis (ABP) are ____ and ____. acute bacterial prostatitis - answers Sudden onset of malaise, low back and perineal pain, high fever up to 104 degrees, and chills are common manifestations of _____, in addition to dysuria, inability to empty the bladder, nocturia, and urinary retention. endometriosis - answers ____ is the presence of functioning endometrial tissue or implants outside the uterus. pelvic, ovaries, uterosacral - answers Common sites of implantation outside the uterus include ____ peritoneum, _____, and ____ ligaments. endometriosis - answers Common belief about the cause of _____ is that endometrial tissue passes through the fallopian tubes and remains responsive to hormones. pain, infertility - answers Symptoms of endometriosis are variable in frequency and severity and include ____ and ______. ovarian - answers A history of endometriosis increases risk for ___ cancer. asymptomatic - answers Ovarian cancer is commonly _____ until the tumors have grown very large. silent - answers Ovarian cancer is often termed the ____ killer. Kussmaul - answers Hyperpnea (_______ respirations) are characterized by a slightly increased ventilatory rate, very large tidal volume, and no expiratory pause. cheyne-stokes - answers _____ respirations are characterized by alternating periods of deep and shallow breathing. Apnea lasting 15-60 seconds is followed by ventilations that increase in volume until a peak is reached, after which tidal volume (ventilation) decreases again to apnea. brainstem - answers Cheyne-stokes respirations result from any condition that slows blood flow to the ____, which in turn slows impulses sending information to the respiratory centers of the brainstem. hypoventilation - answers ____ is inadequate alveolar ventilation in relation to metabolic demands. carbon dioxide - answers When alveolar ventilation is normal, ____ is removed from the lungs at the same rate at which it is produced by cellular metabolism. 40 - answers Normal arterial CO2 pressure is____mmHg. hypercapnia - answers ____ is PaCO2 greater than 44mmHg. hydrogen - answers Hypercapnia (high carbon dioxide levels) result in an increase in ____ ions in the blood, termed respiratory acidosis, which can affect the function of many tissues throughout the body. acidosis - answers Respiratory _____ occurs when hydrogen ions increase in the blood due to hypoventilation. hyperventilation - answers ____ is a response to hypoxemia, anxiety, or pain. It occurs when the lungs remove CO2 faster than it is produced by cellular metabolism. hypocapnia - answers ____ occurs when PaCO2 is less than 36 mmHg. 36, 44 - answers Hypocapnia is defined as a PaCO2 less than ___mmHg, and hypercapnia is defined as a PaCO2 more than ___mmHg. alkalosis - answers Hypocapnia results in a respiratory ____ that also can interfere with tissue function. droplets - answers Tuberculosis is highly contagious and is transmitted from person-to- person through airborne _____. past, latent, active - answers The TB skin test does not differentiate between ___, ____ and _____ forms of TB. positive - answers Individuals will have a postive/negative skin TB tst with they were vaccinated with the bacille Calmette-Guerin vaccine. sputum - answers When active pulmonary disease is present, the tubercle bacillus can be cultured from the ___ and may be seen with an acid-fast stain. nodules, calcifications, cavities, hilar - answers N_____, c______, c______, and h____ enlargement are commonly seen in the upper lobes of a chest when a patient has TB. elastic, wall, gas, flow - answers Normal alterations in aging and the pulmonary system include loss of ____ recoil, stiffening of the chest _____, changes in ___ exchange, and increases in _____ resistance. chronic bronchitis - answers Cor pulmonale, paroxysmal nocturnal dyspnea caused by a buildup of fluid in the lungs (usually at night), and orthopnea are more commonly seen with chronic bronchitis/emphysema. pneumoconiosis - answers _____ represents any change in the lung caused by inhalation of inorganic dust particles, which usually occurs in the workplace. silicosis - answers pneumoconiosis caused by inhalation of silica dust asbestosis - answers the form of pneumoconiosis caused by asbestos particles in the lungs black lung - answers Coal worker's pneumoconiosis that is caused by inhalation of coal particles is not - answers Pneumoconiosis is/is not reversible. nonproductive, hemoptysis - answers Non-small cell lung cancers (NSCLC) tumors are typically located centrally near the hila and project into the bronchi. Because of their central location, ____ cough and ______ are common symptoms. true - answers True/false: non-small cell lung tumors can remain fairly well localized and tend not to metastasize until late in the course of the disease. neuroendocrine - answers Small cell lung carcinomas (SCLCs) are the most common type of ______ lung tumors. small cell lung carcinomas - answers Non-small cell lung carcinomas/small cell lung carcinomas have the strongest correlation to tobacco smoking. false - answers Small cell lung carcinomas are well localized and don't metastasize easily. small cell lung carcinoma - answers What lung cancer has the worst prognosis? limited/extensive - answers Small cell lung carcinomas only have two categories: ____ and _____. lower - answers Aspiration of oropharyngeal secretions is the most common route of upper/lower respiratory tract infections. nasopharynx/oropharynx - answers What two areas serve as the first line of defense for most infectious agents? pneumonia - answers Most cases of _____ are preceded by an upper respiratory tract infection, which is usually viral. pneumonia - answers If a person presents with history of an upper respiratory tract infection, coughing, difficulty breathing, and fever, and upon assessment has inspiratory crackles, tactile fremitus, egophony, and whispered pectoriloquy, what would you diagnose them with? embolus - answers Pulmonary ____ is an example of alveolar dead space causing hypoxemia due to absent blood flow to a lung segment that causes a ventilation- perfusion mismatch (increased alveolar dead space with decreased production of surfactant). heparin - answers Prophylactic treatment for pulmonary emboli includes a dose of low- molecular-weight ____ to inhibit thrombin. CXR, blood gas, ECG - answers What three labs are immediately drawn when an individual is suspected to have a pulmonary embolism? true - answers True/false: chest x-ray findings are nonspecific in pulmonary embolism and often can be normal for the first 24 hours until atelectasis occurs in the lung. d-dimer - answers The serum ____ level measures a product of thrombus degradation by the fibrinolytic system and, if normal, makes the presence of a PE highly unlikely. hydrothorax - answers watery fluid in the pleural cavity; associated with cardiovascular disease that causes high BP, liver or kidney disease that disrupts plasma protein production hemothorax - answers blood in the pleural cavity; associated with traumatic injury, surgery, rupture, or malignancy ARDS - answers ____ is a spectrum of acute lung inflammation and diffuse alveolocapillary injury. pulmonary, capillary, edema - answers All disorders that result in ARDS cause acute injury to the alveolocapillary membrane, producing massive _____ inflammation, increased _____ permeability, and severe pulmonary _____. direct - answers An example of direct/indirect alveolocapillary injury is the aspiration of highly acidic gastric contents or toxic gases. indirect - answers An example of direct/indirect alveolocapillary injury occurs with circulating inflammatory mediators released in response to systemic disorders, such as sepsis and trauma. first - answers The _____step of ARDS is dyspnea and hypoxemia with poor response to oxygen supplementation. second - answers The _____step of ARDS is hyperventilation and respiratory alkalosis. third - answers The ____ step of ARDS is decreased tissue perfusion, metabolic acidosis, and organ dysfunction. fourth - answers The _____ step of ARDS is increased work of breathing, decreased tidal volume, and hypoventilation. fifth - answers The ___ step of ARDS is hypercapnia, respiratory acidosis, and worsening hypoxemia. last - answers The ___ step of ARDS is decreased cardiac output, hypotension, and death. water - answers Pulmonary edema is excess ____ in the lung. lymphatic - answers The normal lung contains little fluid that is kept dry by ____ drainage and a balance among capillary hydrostatic pressure, capillary oncotic pressure, and capillary permeability. surfactant - answers ____ lining the alveoli repels water, keeping fluid from entering the alveoli. left, injury, toxic gas, lymphatic - answers Common predisposing factors for pulmonary edema include ____-sided heart disease, causing increased pulmonary venous pressure, ____ to pulmonary capillary endothelium, inhalation of _____, and ____ obstruction.