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BIOD331 Pathophysiology Final Exam
A patient is experiencing a severe reduction in GFR, and their GFR is 15 - 29 mL/min/1.73m2. What stage of kidney disease are they in?
...ANSWER✓✓✓ 4 A patient is experiencing kidney damage with a mild decrease in GFR, and their GFR is 60-89 mL/min/1.73m². What stage of kidney disease are they in? - ...ANSWER✓✓✓ 2 A patient is said to be in stage 2 kidney disease. What would you expect their GFR to be? - ...ANSWER✓✓✓70 mL/min/1.73m A patient is said to be in stage 4 kidney disease. What would you expect their GFR to be? - ...ANSWER✓✓✓25 mL/min/1.73m A patient presents in the emergency department with severe dehydration secondary to vomiting. The following are the results of their blood work: pH = 8.2, PCO2 = 39 mm, and HCO-3 = 33 mEq/L. Based upon these results, what type of acid-base disorder are they experiencing? Is compensation occurring?
Describe a treatment intervention for this disorder. Normal values are as follows: pH = 7.35-7.45, PCO2 = 35-45 mm, HCO3- = 22- 26 mEq/L. - ...ANSWER✓✓✓The patient is in metabolic alkalosis. The respiratory system is not compensating as PCO2 compensation falls within normal limits. Fluids are replaced with normal saline solution. A patient presents to the emergency department with complaints of sharp pain that comes in waves in the upper lateral quadrant of the abdomen. Their skin is clammy, and they have been experiencing nausea and vomiting all day long. They have a history of UTIS. Urinalysis reveals that the pH of their urine is 7.8. A CT scan reveals a renal calculi that is 7 mm in diameter. What is the best treatment plan for this patient? Explain your reasoning for this treatment plan. - ...ANSWER✓✓✓It must be removed through ureteroscopic removal or extracorporeal shockwave lithotripsy, as it is greater than 5 mm in diameter. The patient should be placed on antibiotics to treat the UTI, as well as medication for pain management. ____ is the transfer of gases between the alveoli and the pulmonary capillaries. - ...ANSWER✓✓✓Diffusion
6 y/o Tommy is brought in by his mom today for complaints of vomiting and diarrhea. He does not have a fever. His stool is hemoccult negative (no blood). His younger sibling has similar symptoms. You diagnose Tommy with viral gastroenteritis. Would you categorize this condition as inflammatory or noninflammatory? - ...ANSWER✓✓✓Noninflammatory A 10-year-old boy who is having an acute asthma attack is brought to the ER. He is observed to be sitting up and struggling to breathe. His breathing is accompanied by use of accessory muscles, a weak cough, and audible wheezing sounds. His pulse is rapid and weak, and both heart and breath sounds are distant on auscultation. His parents relate that his asthma began to worsen after he developed a "cold," and now he doesn't get relief from his albuterol inhaler. Explain the changes in physiologic function underlying his signs and symptoms. - ...ANSWER✓✓✓Recruitment of inflammatory cells from the bloodstream into the bronchial wall, where they directly attack the invading organisms and secrete inflammatory chemicals that are toxic to the organisms causes airway inflammation. Swelling of the bronchial wall, mucus secretion, constriction of the airway; bronchial hyperresponsiveness to stimuli causes airway obstruction or narrowing. They may discuss on a cellular level as well:
Upon a trigger, the cascade of neutrophils, eosinophils, lymphocytes, and mast cells cause epithelial injury. This causes airway inflammation, which further increases hyperresponsiveess and decreased airflow. Mast cells release histamine and leukotrienes. These cause major bronchoconstriction, inflammation, and mucus secretion. Mast cells can trigger multiple cytokine release, which causes more airway inflammation. The contraction of the airways and subsequent swelling leads to further airway obstruction. A 12-year-old female presents with itchy eyes, nasal congestion and drainage, and sneezing every spring when the pollen count is high. (1) Explain the immunologic mechanisms that are responsible for her symptoms. (2) What type(s) of treatment might be used to relieve her symptoms?
- ...ANSWER✓✓✓(1) Mast cells, basophils, and eosinophils play an important role with type I reactions because they contain histamines. Primary response is vasodilation, vascular leakage, and smooth muscle contraction. Late-phase response is more intense with eosinophils and other acute and chronic inflammatory cells, as well as tissue damage. (2) Antihistamines. A 23-year-old African-American man with a history of severe lifelong anemia requiring many transfusions has nonhealing leg
A 75-year-old male is brought to the emergency department by his spouse at 8 pm. The spouse reports that they were cleaning up after dinner at approximately 6:30 pm, and she noticed that her husband's speech was very unclear. When she asked him what was going on, he said that he didn't know and that the entire right side of his face felt numb. She reports that he is very active, but he has a past medical history of atrial fibrillation. A CT scan confirms that this patient has suffered from an ischemic CVA. What is the best treatment plan for this patient? Explain your reasoning. - ...ANSWER✓✓✓This patient should receive tPA drugs, as they are within the 3-4.5 hour treatment window. A 75-year-old male is brought to the emergency department by his spouse at 8 pm. The spouse reports that they were cleaning up after dinner at approximately 6:30 pm, and she noticed that her husband's speech was very unclear. When she asked him what was going on, he said that he didn't know and that the entire right side of his face felt numb. She reports that he is very active, but he has a past medical history of atrial fibrillation. Given the patient's past medical history and presentation, what is your initial diagnosis? - ...ANSWER✓✓✓Stroke or CVA A 75-year-old male is brought to the emergency department by his spouse at 8 pm. The spouse reports that they were cleaning up after dinner at approximately 6:30 pm, and she noticed that her husband's speech was very unclear. When she asked him what was going on, he said that he didn't know and that the entire
right side of his face felt numb. She reports that he is very active, but he has a past medical history of atrial fibrillation. What do you suspect this patient is experiencing? Specifically, categorize the disease process based upon his past medical history and his current presentation and explain how you arrived at this specific diagnosis. - ...ANSWER✓✓✓He is more than likely experiencing an ischemic stroke. A past medical history of atrial fibrillation puts him at an increased risk for clots. A 75-year-old male is brought to the emergency department by his spouse at 8 pm. The spouse reports that they were cleaning up after dinner at approximately 6:30 pm, and she noticed that her husband's speech was very unclear. When she asked him what was going on, he said that he didn't know and that the entire right side of his face felt numb. She reports that he is very active, but he has a past medical history of atrial fibrillation. You suspect this patient has suffered an ischemic CVA. What diagnostic test would you run to confirm your diagnosis? - ...ANSWER✓✓✓A CT scan and MRI would be needed to determine if a clot is blocking blood flow to the brain tissue and to rule out a hemorrhagic stroke. A 75-year-old male is brought to the emergency department via ambulance at 5 pm. The patient's spouse reports that when they woke up (approximately at 6 am) he reported to her that he was having some blurred vision but decided to go about his day. As the day progressed, he started experiencing tingling and feelings
Grade II: hypotension, tachycardia, dyspnea, and GI manifestations, like nausea, vomiting, diarrhea, and abdominal cramping from mucosal edema Grade III: bronchospasm, cardiac dysrhythmias, and cardiac collapse. Grade IV: cardiac arrest (2) No (3) Epinephrine (4) Identification about allergy, EpiPen A decrease in the size of an organ or tissue resulting from a decrease in the mass of pre-existing cells is called: - ...ANSWER✓✓✓Atrophy A patient experiences a seizure that manifests with motor weakness on the right side, a tingling sensation on the right side,
and flushing. They have experienced which type of seizure? - ...ANSWER✓✓✓Focal seizure without impairment of consciousness or awareness A patient experiences a seizure that manifests with repetitive hand rubbing and reports of hallucinations right before the seizure occurred. They have experienced which type of seizure?
- ...ANSWER✓✓✓Focal seizure with impairment of consciousness or awareness A patient has experienced a seizure affecting the left temporal lobe. The family reports that the patient exhibited repetitive lip smacking and hand rubbing followed by a period of great fear and insecurity. They have experienced which type of seizure? - ...ANSWER✓✓✓Focal seizure with impairment of consciousness or awareness A patient is admitted to the hospital with pneumonia. The following are the results of their blood work: pH = 6.9, PCO2 = 52 mm, and HCO3- = 30 mEq/L. Based upon these results, what type of acid- base disorder are they experiencing? Is compensation occurring? Describe a treatment intervention for this disorder. Normal values are as follows: pH = 7.35-7.45, PCO2 = 35-45 mm, HCO3 - = 22-26 mEq/L. - ...ANSWER✓✓✓The patient is in respiratory acidosis. The renal system is attempting to compensate as HCO3- concentration is elevated above normal
A patient presents to the emergency department with complaints of sharp pain that comes in waves in the upper lateral quadrant of the abdomen. Their skin is clammy, and they have been experiencing nausea and vomiting all day long. They have a history of UTIs. Urinalysis reveals that the pH of their urine is 7.8. You suspect that the patient may have a kidney stone. What diagnostic test would you run to confirm your diagnosis? - ...ANSWER✓✓✓In addition to the urinalysis already run, a CT scan would be needed to confirm your diagnosis and determine the size of the stone. A triglyceride reading of 175 would be considered: - ...ANSWER✓✓✓Borderline high An abnormal cellular growth, resulting in cells that vary in size, shape, and organization is called: - ...ANSWER✓✓✓Dysplasia An endocrine hormone is released into circulation to act on a target organ. - ...ANSWER✓✓✓True An increase in the size of an organ or tissue due to the increase in size of the cells that comprise it is called: - ...ANSWER✓✓✓Hypertrophy
An LDL cholesterol reading of 90 would be considered: - ...ANSWER✓✓✓Optimal Anne is a 48 y/o female who presents with excessive vaginal bleeding x 6 months. Her skin is pale, she reports feeling fatigued, and often craves a large cup of Sonic crushed ice. A quick in-office H&H shows a hemoglobin of 9 and hematocrit of 30%. Given the patient's past medical history and presentation, what is your initial diagnosis? - ...ANSWER✓✓✓Anemia Anne is a 48 y/o female who presents with excessive vaginal bleeding x 6 months. Her skin is pale, she reports feeling fatigued, and often craves a large cup of Sonic crushed ice. A quick in-office H&H shows a hemoglobin of 9 and hematocrit of 30%. She is given a diagnosis of blood loss or iron deficiency anemia. What is the best treatment plan for this patient? Explain your reasoning. - ...ANSWER✓✓✓If low ferritin, she would need iron supplementation. Also find the cause of the bleeding and try to control. Anne is a 48 y/o female who presents with excessive vaginal bleeding x 6 months. Her skin is pale, she reports feeling fatigued, and often craves a large cup of Sonic crushed ice. A quick in-office H&H shows a hemoglobin of 9 and hematocrit of 30%. You suspect Anne is anemic. What diagnostic test would
Bill and Angela have brought their mom into your office today. They tell you that their mom has experienced dementia for some time now, but they have not been too concerned because, for the most part, she has been able to care for herself, only needing assistance here and there for her daily activities. However, recently things have changed. Her ability to recall recent events has drastically decreased; she is experiencing difficulty with sleep; they've noticed some mood changes, and the most alarming thing is that she has started to wander outside of her home. They are concerned for her safety. You suspect the patient has Alzheimer's. How would you stage the disease process this patient is experiencing? What about her current presentation leads you to this conclusion? - ...ANSWER✓✓✓Moderate Alzheimer's Disease. Changes in sleep, changes in mood, and wandering episodes are all characteristic of moderate Alzheimer's. Bill and Angela have brought their mom into your office today. They tell you that their mom has experienced dementia for some time now, but they have not been too concerned because, for the most part, she has been able to care for herself, only needing assistance here and there for her daily activities. However, recently things have changed. Her ability to recall recent events has drastically decreased; she is experiencing difficulty with sleep; they've noticed some mood changes, and the most alarming thing is that she has started to wander outside of her home. They are concerned for her safety. You suspect the patient
has Alzheimer's. What are the diagnostic criteria or processes for your suspected diagnosis? - ...ANSWER✓✓✓A neurologic exam will determine if there are other disease processes that may be causing symptoms such as Parkinson's disease, hydrocephalus, small or large vessel strokes, or the presence of a tumor. The Mini Mental State Exam (MMSE) or the Mini-Cog test are standardized tests used to determine whether someone has dementia and the severity of it. MRI and CT scans are primarily used to eliminate other disease processes as a diagnosis but can be used to measure levels of Aβ. As previously discussed, higher levels of Aβ would indicate Alzheimer's disease as a diagnosis while normal levels would suggest it is not the cause of the presenting dementia. Blood circulates through bone by what means? (mark all that apply) - ...ANSWER✓✓✓Via the central Haversian and Volkmann canals An anastomosis between perforating and nutrient arteries Diffusion through the endosteal surface of the bone and the canaliculi Bob is a 55 y/o male here for his annual physical exam. He has no current complaints. His BMI is 31, BP 150/90, HR 72, RR 16. He does not smoke, drinks alcohol occasionally, and has a family history of cardiovascular disease. His BP was retaken in the opposite arm and was 155/86. Given the patient's past medical
confirm ulcerative colitis. How does this disease differ from Crohn disease? - ...ANSWER✓✓✓Crohns disease has granulomatous inflammation, involvement primarily submucosal, extent of involvement- skip lesions, Ulcerative- ulcerative and exudative inflammation, involvement primarily mucosal, extent of involvement- continuous Compare and contrast the two types of gangrenous necrosis. - ...ANSWER✓✓✓In dry gangrene the affected tissue becomes dry and shrinks, the skin wrinkles, and its color changes to dark brown or black. The spread of dry gangrene is slow. It results from a cut-off in arterial blood supply and is a form of coagulation necrosis. In wet gangrene, the affected area is cold, swollen, and pulseless. The skin is moist, black, and under tension. Blebs form on the surface, liquefaction occurs, and a foul odor is caused by bacterial action. The spread of tissue damage is rapid. Complications of gallstones include each of the following except: - ...ANSWER✓✓✓Cirrhosis Diagnosis of an autoimmune disease is made by following patient history, physical evidence, and serological findings. Explain why blood tests alone are not enough to diagnose an autoimmune disorder. -
...ANSWER✓✓✓Blood testing can be imprecise, as some tests are more generic and can be elevated in the presence of other diseases. Each of the following are risk factors for secondary hyperlipidemia except? - ...ANSWER✓✓✓Autosomal dominant disorder of LDL receptor YES --> obesity, DM, high cholesterol diet Each of the following can lead to atelectasis except: - ...ANSWER✓✓✓Thrombus Each of the following factors are associated with increased incidence of peptic ulcer EXCEPT: - ...ANSWER✓✓✓Dietary history Each of the following is characteristic of Addison's Disease except? - ...ANSWER✓✓✓Emotional disturbances Each of the following is true of apoptosis except: - ...ANSWER✓✓✓It sets off an inflammatory immune response Each of the following is true of necrosis except: -
