NR 283 / NR283: Pathophysiology Final Exam Study Guide (Latest 2021 / 2022) Chamberlain, Study Guides, Projects, Research of Nursing

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NR I 283 IFinal IExam IGuide I CHAPTER I2: IFLUID, IELECTROLYTE IAND IACID-BASE IBALANCE I (5 Iquestions)

1. EDEMA Increased Icapillary Ipermeability 2. HYPOKALEMIA/HYPERKALEMIA -Cardiac Idysrhythmias 3. PARATHYROID IHORMONE I(4 IScenarios) -produced Iin Iparathyroid Igland Iwhich Iare Ifour Ipea-sized Iglands Ithat Ilie Ibehind Ithe Ithyroid Igland -Calcium Ibalance Iand Iphosphorus Ilevel Iis Icontrolled Iby Iparathyroid Ihormone -Hypoparathyroidism Ican Ilead Ito Ihypocalcemia -Hyperparathyroidism Ican Ilead Ito Ihypercalcemia Iand Ibone Idemineralization Ithat Imay Icause IspontaneousIfractures. 4. ACIDOSIS I(He Isaid Igeneral/systemic Ieffect Iof Iacidosis) -Excess Ihydrogen Iions -Decrease Iin Iserum IpH -Addition Iof Ibicarbonate Ito Ithe Iblood Ito Ireverse Iacidosis I(lactate Isolution) ******Effects Iof IAcidosis** Direct Ieffect Iof Iacidosis Iare Imanifested Iby ItheINervous ISytem: -Impaired Inervous Isystem Ifunction -Headache -Lethargy -Weakness -Confusion -Coma Iand Ideath -Compensation -Deep Irapid Ibreathing I(Kussmaul’s Irespirations) -Secretion Iof Iurine Iwith Ia Ilow IpH 5. RESPIRATORY IDEPRESSION I (related Ito Ianesthesia/drugs Ion Ihow Icompensation Ihappens) -Compensation Ihappens Ifor Ianesthesia, Iincrease Iin Isecretion Iof IH+ Iions Iinto Ifiltrate

CHAPTER I5: IINFLAMMATION IAND IHEALING I (5 Iquestions)

1. TEARS

-nonspecific/First Iline Iof Idefense/mechanical Ibarrier

2. CONTROLLING IELEVATED ITEMPERATURE -body Iresponse Ithru Ivasodilation, Isweating, Ilethargy Iand Ibody Iextend 3. ICE IAND IEDEMA -Ice/cold Icause Ivasoconstriction, Idecreasing Ipain Iand Iedema 4. ASPIRIN

-aspirin Iin Ipediatrics Irisk Ifor IReye’s ISyndrome, Icomplication Iinvolves Ibrain Iand Iliver Idamage Iand Ican IbeIfatal.

5. NEUTROPHILS -nonspecific, Iphagocytize Ibacteria -neutrophils I(a Ileukocytes) Iand Imacrophage Irandomly Iengulf Iand Idestroy Ibacteria, Icell Idebris Iand IforeignImatter CHAPTER I12: ICARDIOVASCULAR ISYSTEM IDISORDERS I (10 Iquestions) *1. ANGINA NITROGLYCERIN I -Occurs Iwhen Ithere Iis IaIdeficit Iof Ioxygen Ito Imeet Imyocardial Ineeds 2. MYOCARDIALIINFARCTION I(MI) -death Iof Icardiac Imuscle Iresulting Ifrom Iprolonged Iischemia *****How Iis IMI IDiagnosed? -Diagnosis Iis Iconfirmed Ithrough Ielectrocardiogram I(ECG) Ichanges Iand Iserum Ienzyme Iand IisoenzymeIlevels. I -Serum Ilevels Iof Imyosin Iand Icardiac Itroponin Iare Ielevated; -serum Ielectrolyte Ilevels Imay Ibe Iabnormal; -leukocytosis Iand Ian Ielevated IC-reactive Iprotein I(CRP) Iand Ierythrocyte Isedimentation Irate I(ESR) IareIcommon; -arterial Iblood Igas Iis Ialtered.

• IPulmonary Iartery Ipressure Imeasurements Ishould Ibe Iconducted Ito Idetermine Iventricular Ifunction. 3. CONGESTIVE IHEART IFAILURE I(CHF) -Heart Iis Iunable Ito Ipump Iout Isufficient Iblood Ito Imeet Imetabolic Idemands Iof Ithe Ibody. 4. BETA-ADRENERGICS I(slows Iheart Irate) -Prevent Iincreased Iheart Irate Iin Iresponse Ito ISympathetic INervous ISystem Iand ICholamines -example: IMetoprolol I(Lopressor), IAtenolol, IPropranolol, INadolol 5. ENDOCARDITIS I(Infective IEndocarditis) *Subacute Iis Icaused Iby I Streptococcus Iviridans ---- (Low Ivirulent) *Acute Iis Icaused Iby I Staphylococcus Iaureus --- **(High Ivirulent)

6. PERICARDITIS** -leads Ito Ia Ilarge Ivolume Iof Ifluid Iaccumulating Iin Ithe Ipericardial Icavity, Ifilling Iof Ithe Iheart Iis Irestricted Iand Icardiac Ioutput Iis Ireduced Iby Ipreventing Iventricle Iin Ifilling. 7. SEPTALIDEFECT -Shunt Ifrom Ileft I→ Iright Ibecause Ipressure Iis Ihigher Iin Ileft Iventricle 8. SEPTIC ISHOCK I(Endotoxic) -endotoxin Ifrom Igram Inegative Ibacteria Ican Ilead Ito Ivasodilation Ileading Ito Ilife Ithreatening Ihypotension CHAPTER I13: IRESPIRATORY ISYSTEMIDISORDERS I (10 Iquestions) 1. ARTERIALIBLOOD IGAS ILEVELS??????????? --Know Ithe Ivalues/ranges I???????? --know Iif Idecompensated Ior Icompensated??????

--know Iif Iacidosis Ior Ialkalosis??????

2. PNEUMONIA *******Lobar IPneumonia** - Streptococcus Ipneumonia I is Icausative Iagent -Productive Icough Iwith Irusty Isputum *****Bronchopneumonia** -Several Ispecies Iof Imicroorganisms Imay Ibe Ithe Icause. -Productive Icough Iwith Ipurulent Isputum—usually Iyellow Ior Igreen 3. TUBERCULOSIS I (question Iis Iabout Iwhich Ione Iis I NOT I applicable Ito ITB— infection Iis Ilimited Ito Ilungs) - Mycobacterium ItuberculosisI transmitted Iby Ioral Idroplets Ifrom Ipersons Iwith Iactive Iinfection

-Occurs Imore Ifrequently Iwith: -People Iliving Iin Icrowded Iconditions -Immunodeficiency -Malnutrition -Alcoholism -Conditions Iof Iwar -Chronic Idisease -HIV Iinfection -Usual Icaused Iby IM. Ituberculosis -Somewhat Iresistant ItoIdrying Iand Imany Idisinfectants -Can Isurvive Iin Idried Isputum IforIweeks -Destroyed Iby Iultraviolet Ilight, Iheat, Ialcohol, Iglutaraldehyde, Iformaldehyde -Normal Ineutrophil Iresponse Idoes Inot Ioccur -Cell-mediated Iimmunity Inormally Iprotection -Primarily Iaffects Ilungs; Iother Iorgans Imay Ialso Ibe Iinvaded ******PRIMARY IINFECTION** -When Iorganism Ifirst Ienters Ithe Ilungs -Engulfed Iby Imacrophages—local Iinflammation -If Icell-mediated Iimmunity Iis Iinadequate: -Mycobacteria Ireproduce Iand Ibegin Ito Idestroy Ilung Itissue. -This Iform Iof Idisease Iis Icontagious -If Icell-mediated Iimmunity Iis Iadequate: -Some Ibacilli Imigrate Ito Ilymph Inodes—granuloma—formation Iof Itubercle I(contains Ilive Ibacilli)— Iwalled Ioff Iand Icalcifying -Tubercle Imay Ibe Ivisible Ion Ichest Iradiograph. -Bacilli Imay Iremain Iviable Iin Ia Idormant Istage Ifor Iyears.

• Individual’s Iresistance Iand Iimmune Iresponses Ihigh, Ibacilli Iremain Iwalled Ioff -Primary Ior Ilatent Iinfection—individual Ihas Ibeen Iexposed Iand Iinfected, Ibut Idoes Inot Ihave IdiseaseIand Iis Iasymptomatic -Individual Icannot Itransmit Idisease *****SECONDARY IOR IREINFECTION IOF ITB** -Occurs Iwhen Iclient’s Icell-mediated Iimmunity Iis Iimpaired Ibecause Iof: -Stress -Malnutrition -HIV Iinfection -Age -Mycobacteria Ibegin ItoIreproduce Iand Iinfect Ilung. -Active ITB, Iwhich Ican Ibe Ispread Ito Iothers! *****MILIARY IOR IEXTRA IPULMONARY ITB** -Rapidly Iprogressive Iform Imore Icommon Iin Ichildren I< I 5 Iyears -Early Idissemination Ito Iother Itissues -If Ilesions Iare Inot Ifound Iin Ithe Ilungs, Ithis Iis Inot Icontagious. -Common Isymptoms Iinclude Iweight Iloss, Ifailure Ito Ithrive, Iand Iother Iinfections Isuch IasImeasles. *****ACTIVE ITBI(PRIMARY IOR ISECONDARY)** -Organisms Imultiply, Iforming Ilarge Iareas Iof Inecrosis. -Cause Ilarge Iopen Iareas Iin Ilung—cavitation -Cavitation Ipromotes Ispread Iinto Iother Iparts Iof Ilung. -Infection Imay Ispread Iinto Ipleural Icavity. -Cough, Ipositive Isputum, Iradiograph Ishowing Icavitation -Disease Iin Ithis Iform Iis Ihighly Iinfectious Iwhen Ithere Iis Iclose Ipersonal Icontact IoverIa Iperiod Iof Itime.

*****Diagnostic Itests** -First Iexposure Ior Iprimary Iinfection -Indicated Iby Ipositive Ituberculin I(skin) Itest Iresults -Active Iinfections -Acid-fast Isputum Itest -Chest Iradiograph -Sputum Iculture Iand Isensitivity Treatment: Long-term Itreatment IwithIa Icombination Iof IdrugsILength Iof Itreatment Ivaries Ifrom I 6 Ito I 12 Imonths. -Effective Itreatment Irequires Imonitoring Iand Ifollow-up Iand Iis Iexpensive. -TB Iis Ibecoming Ian Iincreasingly Iserious Iproblem Ibecause Iof: -Homelessness Iand Icrowding Iin Ishelters -HIV Iinfection -Lack Iof Ihealth Icare -Multidrug Iresistant ITB

4. RESTRICTIVE ILUNG IDISORDERS -Group Iof Idisorders Iwith Iimpaired Ilung Iexpansion Iand Ireduced Itotal Ilung Icapacity 5. PULMONARY IEDEMA I(Select Iwhich Ione Iis INOT Ithe Icause Iof IPulmonary IEdema) *****SO, IKNOW ITHE ICAUSES:** -inflammation Iin Ithe Ilungs, Iincreasing Icapillary Ipermeability -plasma Iprotein Ilevels Iare Ilow, Idecreasing Iplasma Iosmotic Ipressure -pulmonary Ihypertension, Iincreasing Ihydrostatic Ipressure. 6. ADULT IRESPIRATORY IDISTRESS ISYNDROME I(PICK I 2 IOUT IOF I 4 ICAUSES) ------So, IKNOW ITHE I 4 ICAUSES….. -Causes Ithe Irelease Iof Ichemical Imediators: 1. Increases Ipermeability Iof Ialveolar Icapillary Imembranes 2. Increased Ifluid Iand Iprotein Iin Iinterstitial Iarea Iand Ialveoli 3. Damage Ito Isurfactant-producing Icells 4. Diffuse Inecrosis Iand Ifibrosis Iif Ipatient Isurvives 7. SARS ******SARS Iis Ian Iacute Irespiratory Iinfection Icaused Iby Ia Ipreviously Iunknown Ivirus.** *****Cause: ISARS-CoV I(SevereIAcute IRespiratory ISyndrome-associatedIcoronavirus) I** is Ithe ImicrobialIagent Iresponsible Ifor ISARS. IIt Iis Itransmitted Iby Irespiratory Idroplets Iduring Iclose Icontact. 8. PRIMARY IATYPICAL IPNEUMONIA I(PAP) I aka IInterstitial IPneumonia - Mycoplasma Ipneumoniae I is Icausative Iagent I(influenza Ivirus) -Viral Iform Icaused Iby Iinfluenza IA Ior IB, Iadenoviruses, IRSV --Common Iin Iolder Ichildren Iand Iyoung Iadults -Transmitted Iby Iaerosol -Nonproductive Ihacking Icough -hoarseness, Isore Ithroat, Iheadache, Imild Ifever, Imalaise -Infection Ivaries Igreatly Iin Iseverity. -Infection Iis Iusually Iself-limiting

CHAPTER I14: INERVOUS ISYSTEM IDISORDERS I(5 Iquestions)

- Intracranial Ipressure I (question Iis Irelated Ito Ipupil Ireaction) -Pressure Iin Ithe Icranial Inerve IIII - Collateral Icirculation I( when Idoes Iit Ioccurs) -occurs Iwhen ICVA Iresults Ifrom IATHEROSCLEROSIS. - Tetanus I(All IEXCEPT Iquestion. IKNOW ITHEM IALL)

- Caused Iby I Clostridium Itetani

- Spores Ican Isurvive Iin Isoil I(years).

- Wound

- Exotoxin Ienters Inervous Isystem

o Tonic Imuscle Ispasms o Jaw Istiffness o Difficulty Iswallowing o Stiff Ineck o Headache Iand Iskeletal Imuscle Ispasm o Respiratory Ifailure

- CVA I(Cerebrovascular IStroke)

- Predisposing Ifactors:

-Diabetes -Hypertension -Systemic Ilupus Ierythematosus -ElevatedIcholesterol Ilevels I(hyperlipidemia) -Atherosclerosis

• IHistory Iof ITIAs -Increasing Iage -Obstructive Isleep Iapnea -Heart Idisease -Smoking
• Epilepsy I(All IEXCEPT Iquestion) -old Iword Ifor Irecurrent Iseizures/ Iconvulsion -uncontrolled Iexcessive Ifiring/discharge Iof Ineurons Iin Ithe Ibrain -sudden Idepolarization Iof Inephrons Icause Iabnormal Imotor Ior Isensory Iactivity Iand Ipossibly Iloss IofIconsciousness
• Status Iepilepticus - Irecurrent Ior Icontinuous Iseizures Iw/o Irecovery Iof Iconsciousness **CHAPTER I16: IENDOCRINE ISYSTEMS IDISORDERS I(10 Iquestions) I
• Hypoparathyroidism**

- Leads Ito Ihypocalcemia

o Weak Icardiac Imuscle Icontractions o Increased Iexcitability Iof Inerves—spontaneous Icontractions Iof Iskeletal Imuscle

- Endocrine Idisorder Icauses

- Excess Ihormone Ilevel Iof Ideficit/decrease Ihormone Ilevel

- Hyperparathyroidism -Bone Idemineralization I(Hypercalcemia)

- Diabetes I(cellular Ilevel Iin Ikidney) *********-decrease Iin Itransport Iin Ikidney Iresulting Iin Iglucosuria**

- Diabetes Imellitus—basic Iproblem Iis Iinadequate Iinsulin Ieffects Iin Ireceptor Itissues

o Deficit Iof Iinsulin Isecretion o Production Iof Iinsulin Iantagonists

- Diabetes Iresults Iin Iabnormal Icarbohydrate, Iprotein, Iand Ifat Imetabolism.

- Some Itissues Ican Itransport Iglucose Iin Ithe Iabsence Iof Iinsulin:

o CNS, Ikidney, Imyocardium, Igut, Iskeletal Imuscle ▪ Skeletal Imuscle Ican Ipartially Imeet Itissue Ineeds Iwithout Iinsulin.

- Type I 1 I (mostly Iin Ichildren)

o Autoimmune Idestruction Iof Ibeta Icells Iin Ipancreas I(Insulin) o Insulin Ireplacement Irequired o Acute Ionset Iin Ichildren Iand Iadolescents o Not Ilinked Ito Iobesity o Genetic Ifactors Imay Iplay Ia Irole. o Metabolic Ichanges ▪ Catabolism Iof Ifats Iand Iproteins

• Excessive Iamounts Iof Ifatty Iacids Iand Imetabolites
• Ketones Iin Ithe Iblood ▪ Ketonuria
• Decreased Iserum Ibicarbonate
• Decrease Iin IpH Iof Ibody Ifluids
• Ketoacids Iexcreted Iin Iurine ▪ Decompensated Imetabolic Iacidosis

- Type I 2 I (Occurs Iin Iadults)

o Non – insulin-dependent o Oral Ihypoglycemic Imedications Imay Ibe Iused. o Caused Iby Idecreased Iproduction Iof Iinsulin Iand/or Iincreased Iresistance Iby Ibody Icells ItoIinsulin o Onset Iis Islow Iand Iinsidious, Iusually Iin Ithose Iolder Ithan I 50 Iyears o Associated Iwith Iobesity o Component Iof Imetabolic Isyndrome o Increasing Iincidence Iin Iteens Iand Iyoung Iadults o Control Iof IType I 2 ▪ Diet Ishould Icontain:

• Increased Ifiber
• Reduced Ilipids Iand Isimple Icarbohydrates ▪ Regular Iexercise Ito Ireduce Iglucose Ilevels ▪ Reduce Iinsulin Iresistance Iby Ireducing IBMI ItoInormal Irange ▪ Monitoring IbloodIglucose Ilevels Ias Iordered ▪ Medication Ito Istimulate Ithe Ibeta Icells Iof Ithe Ipancreas Ito Iproduce Imore Iinsulin ▪ If Iinsulin-dependent—proper Iadministration Iof Iinsulin Ito Imaintain Iglucose Ilevels IinInormal Irange ▪ Routine Ifollow-up Iand Iblood Itesting

- General IManifestations

o Insulin Ideficit Iresults Iin Idecreased Itransport Iand Iuse Iof Iglucose Iin Imany Icells. ▪ Polyphagia ▪ Fatigue o Blood Iglucose Ilevels Irise—hyperglycemia o Excess Iglucose Iin Iurine—glucosuria

▪ Dehydration Iresults Ifrom Ihyperosmolar Ifiltrate. ▪ Polyuria ▪ Polydipsia

- Acute Icomplications

o Hypoglycemia I (insulin Ishock) ▪ More Icommon Iwith Iinsulin Ireplacement Itreatment ▪ Can Ioccur Ibecause Iof Iexcess Ioral Ihypoglycemic Idrugs ▪ Excess Iinsulin Iin Icirculation

• Glucose Ideficit Iin Iblood
• Can Ibe Ilife-threatening Ior Icause Ibrain Idamage Iif Iuntreated
• Often Ifollows Istrenuous Iexercise
• Dosage Ierror
• Vomiting
• Skipping Imeal Iafter Itaking Iinsulin Manifestation: -Disorientation Iand Ichange Iin Ibehavior -May Iappear Iimpaired -Anxiety Ior Idecreased Iresponsiveness -Decreased Iblood Iglucose Ilevel -Decreased IBP, Iincreased Iheart Irate -Decreasing Ilevel Iof Iconsciousness *****Note: IImmediate Iadministration Iof Iglucose Iis Irequired Ito Iprevent Ibrain Idamage

o H yperglycemic I H yperosmolar I N onketotic I C oma I(HHNC) I–Greater Ithan I 1000

• IOccurs Iin Itype I 2 Idiabetes -Insidious Iin Ionset Iand Idiagnosis Imay Ibe Imissed -Often Ioccurs Iin Iolder Iclients Iand Iassumed Ito Ibe Icognitive Iimpairment -Results Iin Isevere Idehydration Iand Ielectrolyte Iimbalances Manifestation: -Hyperglycemia -Severe Idehydration -Increased Ihematocrit -Loss Iof Iturgor -Increased Iheart Irate Iand Irespirations -Electrolyte Iimbalances Iresult Iin: -Neurologic Ideficits -Muscle Iweakness -Difficulties Iwith Ispeech -Abnormal Ireflexes o Diabetic Iketoacidosis I (occurs Imost Iin IType I1) ▪ Occurs Iin Iinsulin-dependent Iclients ▪ More Icommonly Iseen Iin Itype I 1 Idiabetes ▪ Result Iof Iinsufficient Iinsulin Iin Iblood ▪ High Iblood Iglucose Ilevels ▪ Mobilization Iand Iuse Iof Ilipids Ito Imeet Icellular Ineeds Iresult Iin Iproduction Iof Iketoacids ▪ May Ibe Iinitiated Iby Iinfection Ior Istress

▪ May Iresult Ifrom Ierror Iin Idosage, Iinfection, Ichange Iin Idiet, Ialcohol Iintake, Ior Iexercise ▪ Signs Iand ISymptoms Iof IDiabetic Iketoacidosis

• Dehydration o Thirst, Idry, Irough Ioral Imucosa o Warm, Idry Iskin
• Rapid, Ideep Irespiration—acetone Ibreath o Lethargy, Idecreased Iresponsiveness
• Metabolic Iacidosis o May Ilead Ito Iloss Iof Iconsciousness
• Electrolyte Iimbalances o Abdominal Icramps, Inausea, Ivomiting, Ilethargy, Iweakness

- Chronic IComplications Iof IDiabetes

o Macroangiopathy —affects Ilarge Iarteries ▪ Result Iof Iabnormal Ilipid Ilevels

• High Iincidence Iof Iheart Iattacks, Istrokes, Iperipheral Ivascular Idisease
• May Iresult Iin Iulcers Ion Ifeet Iand Ilegs—slow-healing
• Frequent Iinfections Iand Igangrenous Iulcers
• Amputation Imay Ibe Inecessary. o Peripheral Ineuropathy ▪ Common Icomplication Icaused Iby Iischemia Iin Imicrocirculation Ito Iperipheral Inerves
• Impaired Isensation, Inumbness, Itingling, Iweakness, Imuscle Iwasting o Infections ▪ Common Iand Ioften Imore Isevere Iin Idiabetics ▪ Infections Iin Ifeet Iand Ilegs Icaused Iby Ivascular Iand Ineurological Iimpairment ▪ Fungal Iinfections Icommon
• Caused Iby I Candida
• In Ivagina Iand/or Ioral Icavity ▪ Urinary Itract Iinfections ▪ Dental Icaries ▪ Gingivitis Iand Iperiodontitis o Cataracts ▪ Opacity Iof Ilens Iin Ieye ▪ Related Ito Iabnormal Imetabolism Iof Iglucose o Pregnancy ▪ Complications Iin Iboth Imother Iand Ifetus Imay Ioccur. ▪ Increased Iincidence Iof Ispontaneous Iabortions ▪ Infants Iborn Ito Idiabetic Imothers:
• Increased Isize Iand Iweight Ifor Idate
• May Iexperience Ihypoglycemia Iin Ifirst Ihours Ipostnatally
• Cushing’s ISyndrome I(Increase Iin Icortisol Isecretion) I(2 Ior I 3 Iquestions) ****All IcharacteristicsIEXCEPT IExopthalmos I(staring Ieyes Iw/infrequent Iblinking) ****Condition Icauses Iimmunosuppression ****Which Iconditions Iprecipitate/exacerbate Iby Ihyperglycemia--- Cushing’s

- Changes Iassociated Iwith ICushing’s Isyndrome

o Change Iin Iperson’s Iappearance ▪ Round Iface, Iwith Iruddy Icolor ▪ Truncal Iobesity, Iwith Ifat Ipad Ibetween Iscapulae

▪ Thin Ilimbs ▪ Thin Ihair ▪ Fragile Iskin, Istriae

- Retention Iof Isodium Iand Iwater

- Suppression Iof Ithe Iimmune Iresponse

- Stimulation Iof Ierythrocyte Iproduction

- Emotional Ilability Iand Ieuphoria

- Increased Icatabolism Iof Ibone Iand Iprotein

- Delayed Ihealing

- Increased Iinsulin Iresistance Iand Ipossible Iglucose Iintolerance

- Antidiuretic Ihormone IADH I(Multiple Iquestions. IKNOW ITHEM IALL) - ISecreted Iby Ithe Iposterior Ipituitary -Reabsorption Iof Iwater Iin Idistal Iconvoluted Itubules Iand Icollecting Iducts

- Deficit Iin IADH Iresults Ito I DIABETES IINSIPIDUS!!!!!!!

o Adenoma o May Ioriginate Iin Ithe Ineurohypophysis ▪ Head Iinjury Ior Isurgery ▪ Possible Igenetic Iproblem ▪ Replacement Itreatment Irequired

- Inappropriate IADH Isyndrome

o Excess IADH ▪ May Ibe Itemporary, Itriggered Iby Istress; Imay Ibe Isecreted Iby Ian Iectopic Isource, Isuch Ias IaItumor o Treatment ▪ Diuretics ▪ Sodium Isupplements CHAPTER I17: IDIGESTIVE ISYSTEM IDISORDERS I(3 Iquestions) Liver I(hepatic Iportal Icirculation) -The Iarterial Iand Ivenous Iblood Imix I(oxygenated Iand Ideoxygenated Iblood Imix) Iand Iflow Ithrough Isinusioid. Oral ICandidiasis I(Thrush) -Candida Ialbicans— causative Iagent -Often Ipart Iof Ithe Iresident Iflora -Opportunistic Iinfection -Prolonged Iused Iof Iantibiotic I(broad Ispectrum) -During Iand Iafter Icancer Itherapy -Immunocompromised Iindividuals Ior Ithose Iwith Idiabetes Ulcerative IColitis I(Iron Ideficiency IanemiaIrelated) -cannot Ireabsorb Ithe Iiron Iback Ito Ithe Ibody -ulceration Icauses Ibleeding, Ifrom Iblood, Ibreaking Idown Iof Ihemoglobin Ioccurs, Ithe Iby Iproduct IisIbilirubin Iand Iiron. CHAPTER I18: IURINARY ISYSTEM IDISORDER I(2 Iquestions) RENAL IFAILURE I(study Itable Imix IandImatch Itype Iquestion)

- Acute IRenal IFailure I(reversible)

-Acute Ibilateral Ikidney Iinfection Ior Iinflammation -Sudden Ionset

- ChronicIRenal IFailure I(irreversible)

-Nephrosclerosis -Polycystic Idisease -slow, Iinsidious

- Specific Igravity -Indicates Iability Iof Itubules Ito Iconcentrate Iurine ****Renal Ifailure Idue Ito Itubule Idamage -Low Ispecific Igravity—dilute Iurine --- related Iacute Irenal Ifailure -High Ispecific Igravity—concentrated Iurine ---- related Ito Ichronic Ifailure