NR 507: Advanced Pathophysiology Midterm Advanced Pathophysiology: Questions With 100% Ver, Exams of Nursing

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NR 507: Advanced Pathophysiology Midterm Advanced Pathophysiology: Questions With 100% Verified Answers Latest Update 2024/2025 Asthma - - correct Answer Chronic disease due to bronchoconstriction and an excessive inflammatory response in the bronchioles What are 5 s/s of asthma - - correct Answercoughing wheezing shortness of breath rapid breathing chest tightness Pathophysiology of asthma (5) - - correct Answer-airway inflammation, bronchial hyper- reactivity and smooth muscle spasm -excess mucus production and accumulation -hypertrophy of bronchial smooth muscle -airflow obstruction -decreased alveolar ventilation Bronchioles - - correct Answersmaller passageways that originate from the bronchi that become the alveoli 3 layers of the bronchioles - - correct Answerinnermost layer middle layer - lamina propria outermost layer lamina propria - - correct Answerthe middle layer of the bronchioles structure of the lamina propria - - correct Answerembedded with connective tissue cells and immune cells purpose of the lamina propria - - correct Answerwhite blood cells are present to help protect the airways How does the lamina propria effect the lungs in regards to asthma - - correct Answerthe WBCs protective feature goes into overdrive causing an inflammatory response that damages host tissue What does the innermost layer of the bronchioles contain - - correct Answercolumnar epithelial ells and mucus producing goblet cells What does the outermost layer of the bronchioles contain - - correct Answersmooth muscle cells what does the outermost layer of the bronchioles do - - correct Answercontrol the airways ability to constrict and dilate alveolar hyperinflation - - correct AnswerWhen air is unable to move out of the alveolar like it should due to bronchial walls collapsing around possible mucus plug thus trapping air inside how does hyperinflation occur? - - correct Answerthe ongoing inflammatory process of asthma produces mucus and pus plug that the bronchial walls collapse around Effect of hyperinflation of the alveolar - - correct Answer-expanded thorax and hypercapnia (retention of CO2) - respiratory acidosis What are two anticholinergic drugs used for asthma - - correct Answertiotropium and ipratropium What do anticholinergics do in the lungs? - - correct AnswerThese drugs block the effects of the parasympathetic nervous system - increasing bronchodilation MOA of anticholinergic drugs for asthma - - correct Answerthe parasympathetic system is stimulated by the vagal nerve to release acetylcholine which binds to the cholinergic receptors of the respiratory tract to cause bronchial constriction = decreased airflow - blocking the cholinergic receptors prevents acetylcholine binding preventing the bronchial constriction bronchitis - - correct Answerinflammation of the bronchial tubes 3 characteristics of bronchitis - - correct Answerbronchial inflammation hypersecretion of mucus chronic productive cough for at least 3 consecutive months for at least 2 successive years Perfusion - - correct AnswerThe supply of oxygen to and removal of wastes from the cells and tissues of the body as a result of the flow of blood through the capillaries. results of chronic bronchitis/ low perfusion - - correct Answercyanosis right to left shunting chronic hypoxemia What can cause decreased preload - - correct Answercardiac tamponade and hypovolemia What are two common causes of hypovolemia - - correct Answerdehydration and hemorrhage Afterload - - correct Answerthe amount of resistance to open the semilunar valves and eject of blood from the ventricle what influences afterload (3) - - correct Answerventricle wall thickness (muscle strength) arterial pressure (resistance to ejection) ventricle chamber size (blood volume capacity) what can cause an increase in afterload - - correct Answersystemic hypertension valve disease COPD (pulmonary hypertension) what can decrease afterload - - correct Answerhypotension or vasodilation what influences cardiac contractility (inotropic state) - - correct Answerlevels of electrolytes High levels of ATP level of oxygen available synchronous muscle contraction What electrolytes are used for cardiac muscle contraction? - - correct Answersodium potassium and calcium What increases cardiac muscle contraction - - correct Answersympathetic stimulation; fear anxiety and increased thyroxine what decreases cardiac muscle contraction - - correct Answerlow ATP levels; ischemia hypoxia or acidosis Stimulation of what set a resting HR (chronotropic state) - - correct Answerparasympathetic system what stimulates the parasympathetic system - - correct Answerthe vagus nerve What does the parasympathetic system do? - - correct AnswerIt releases acetycholine which decreases heart rate and causes vasodilation What can extreme vagal response result in? - - correct Answerlife threatening bradycardia What mediates the sympathetic system - - correct Answerepinephrine and norepinephrine What does the sympathetic system promote in the cardiac system - - correct Answervasoconstriction and increased HR What can uncontrolled tachycardia lead to? - - correct Answerreduced stroke volume and fatigue What are the two parts of the cardiac cycle? - - correct Answerdiastole and systole What causes blood to move from the atria to the ventricles - - correct Answergravity and atriole systole What causes the S1 heart sound? - - correct AnswerBicuspid/Mitral and Tricuspid valves closing What are the atrioventricular valves? - - correct Answertricuspid and bicuspid (mitral) valves What are the semilunar valves? - - correct Answerpulmonary and aortic valves What causes the semilunar valves to open? - - correct AnswerAs ventricles contract and intraventricular pressure rises, blood is pushed up against the SL valves, forcing them to open ejection fraction - - correct Answermeasurement of the volume percentage of left ventricular contents ejected with each contraction What causes the semilunar valves to close? - - correct Answerventricles relax and intraventricular pressure falls, blood flows back from the arteries, and fill the cusps of the semilunar valves What causes the S2 heart sound? - - correct Answerclosing of semilunar (aortic and pulmonary) valves What prevents the backflow into the ventricles - - correct Answersemilunar valves Stenosis of heart valve - - correct AnswerA narrowing of the valve opening, causing turbulent flow and enlargement of the emptying chamber Stenosis of a heart valve, may result in what? - - correct AnswerNarrowing of the heart valves means that blood moves with difficulty out of the heart. Results may include chest pain, edema in the feet or ankles, and irregular heartbeat. and hypertrophy heart failure - - correct Answercardiac dysfunction caused by the inability of the heart to provide adequate CO resulting in inadequate tissue perfusion Left sided heart failure characteristic - - correct Answerinability of the left ventricle to provide adequate blood flow into systemic circulation Causes of left sided heart failure - - correct Answersystemic hypertension left ventricle MI LV hypertrophy Aortic SL valve or bicuspid valve damage Secondary to right heart failure How does LV hypertrophy lead to left sided heart failure - - correct AnswerThe hypertrophy is secondary to cardiac damage resulting in an enlarged by weaker structure that holds more blood How does Aortic SL valve or bicuspid valve damage lead to heart failure - - correct Answerdamage leads to back flow into the left atrium or ventricle after ejection Biventricular failure - - correct Answerunresolved left sided heart failure will increase pressure on the right side of the heart contributing to right sided heart failure as well How does heart failure progress from hypertension? - - correct Answer- high systemic vascular pressure causes high after load requires the left ventricle to increase contraction force to eject the blood - damage causes reduced ejection fraction and left ventricle gets tired and becomes unable to eject normal amount of blood - increased amount of blood remaining in left ventricle and increased left ventricle preload causes the left atrium unable to eject the normal amount of blood into the left ventricle - blood volume and pressure backs up into the pulmonary veins - increased pressure will force fluid from the pulmonary capillaries into the pulmonary tissues What does fluid in the pulmonary tissue result in - - correct Answerthe areas are flooded and results in pulmonary edema and dyspnea cor pulmonale - - correct Answerright-sided heart failure right sided heart failure - - correct Answerinability of the right ventricle to provide adequate blood flow into the pulmonary circulation anemia risk factors - - correct Answeracute or chronic blood loss, increased hemolysis, inadequate dietary intake or malabsorption, bone marrow suppression, age function of hemoglobin - - correct AnswerIn red blood cells, carries oxygen from the lungs to body's tissues and returns carbon dioxide from tissues back to lungs. It also maintains the shape of red blood cells. causes of anemia - - correct Answer- impaired RBC production - excessive blood loss - increased RBC destruction hemolytic anemia - - correct Answerpremature destruction of RBCs causes of hemolytic anemia - - correct Answerinfection transfusion reaction hemolytic disease of the newborn (Rh incompatibility) autoimmune reaction drug induced development of anemia due to gastrectomy - - correct Answerloss of intrinsic factor from surgery results in the loss of protein necessary for vitamin B12 absorption an can lead to anemia what kind of anemia can result from incorrect blood transfusion - - correct Answerhemolytic anemia normocytic normochromic anemia - - correct AnswerCharacterized by red cells that are relatively normal in size and hemoglobin content but insufficient in number hemolytic anemia is what kind of anemia - - correct Answernormocytic normochromic anemia polycythemia vera - - correct Answercondition characterized by too many erythrocytes; blood becomes too thick to flow easily through blood vessels Kidney Anatomy - - correct Answerrenal artery renal vein cortex, medulla, renal pelvis ureter renal pyramid nephron Nephron Anatomy - - correct Answer1. glomerulus 2. bowman's capsule 3. collecting duct 4. tubule 5. capillary Bladder anatomy - - correct Answer- ureter - bladder -urethra reabsorption (kidney) - - correct Answermovement of solutes from filtrate to blood things taken back that were secreted of filtered by the kidney what solutes are typically reabsorbed - - correct Answerglucose, ions, amino acids and urea Where is most of the solute reabsorbed? - - correct Answerproximal convoluted tubule What effects amount of water and solute reabsorption - - correct AnswerADH and aldosterone secretion (kidney) - - correct Answermovement of solutes from blood to filtrate anywhere besides bowman's capsule able to secrete salts, acids, bases and urea directly into the tubule via *active or passive transport* what is secreted into the tubule depends on what the body needs at that time ex. eating a lot of protein nitrogen waste is a product of protein metabolism (ammonia) liver converts ammonia to urea and the kidneys secreted urea into the tubule for secretion also possible to eliminate products that are in excess in the blood -- potassium, hydrogen, metabolites or medications can secrete things that were too larger to fit through the glomerulus's pore filtration (kidney) - - correct Answermovement of solutes from blood to filtrate at bowman's capsule 20% of the blood that goes through the glomerulus is passed as filtrate into the bowman's capsule depends on the hydrostatic and oncotic pressures/ starling forces between the glomerulus and bowman's capsule hydrostatic pressure: a lot higher in the glomerulus (move into the nephron/bowman's capsule) oncotic pressure: higher in the blood/glomerulus than in the bowman's capsule (move into the blood/glomerulus) hydrostatic pressure is greater so there will be movement into bowman's capsule usually favors the filtrate to go into the bowman's capsule each persons full body is filtered about every 40 minutes Conditions associated with renal failure - - correct Answer- congenital abnormalities in the urethral tract development - kidney and bladder cancer - infections - glomerulonephritis - acute/ tubular necrosis - AKI vesicoureteral reflux - - correct AnswerAbnormal ureter-bladder connection allowing retrograde flow of urine from bladder to ureters and/or kidneys renal agenesis - - correct Answerunilatral or bilateral failure of the kidneys to develop in utero Potter syndrome - - correct AnswerSyndrome characterized by bilateral renal agenesis and incompatibility of live birth Wilms tumor - - correct Answer- Embryonal kidney tumor associated with defective tumor (WT) genes - Tumors are typically not clinically diagnosable until age 1-5 even though they are present at birth polycystic kidney disease - - correct Answer- Mutant PKD genes cause fluid accumulation in kidney tubules "cysts" - The cysts can be the size of grapes or oranges and compress and destroy nephrons Why are kidneys and bladders at high risk for cancer - - correct Answer- UT is the route of excretion for many toxins and contains highly mitotic cells Descending infection - - correct AnswerThe blood can carry bacteria from a focus of infection in another part of the body to the kidneys. The bacteria then pass with the urine down the ureters to the bladder. Ascending infection - - correct Answer- urethra to bladder, and then to kidney - due to: bacteria from residual fecal contamination glomerulonephritis - - correct Answerinflammation of the glomeruli of the kidney tubular necrosis - - correct Answerthe renal tubules cells are highly sensitive to low oxygen levels or presence of toxins and leads to tubular necrosis Azoetmia - - correct Answerpresence of elevated plasma creatinine Why is there azoetmia with renal failure? - - correct AnswerDecreased GFR means waste is remains in the bloodstream and is not excreted Why is there oliguria with renal failure? - - correct Answerwhen the glomerual structure has sustained enough damage the nephron structure is no longer functional as a filtration unit What happens in renal failure when the coagulation cascade is activated - - correct Answerfibrin is deposited in the glomerular structure and decreases capillary perfusion by causing blockages and further decreases GFR further blood hydrostatic pressure - - correct Answerthe pressure produced by a fluid against a surface filtration (kidney) - - correct Answermovement of solutes from blood to filtrate at bowman's capsule 20% of the blood that goes through the glomerulus is passed as filtrate into the bowman's capsule depends on the hydrostatic and oncotic pressures/ starling forces between the glomerulus and bowman's capsule hydrostatic pressure: a lot higher in the glomerulus (move into the nephron/bowman's capsule) oncotic pressure: higher in the blood/glomerulus than in the bowman's capsule (move into the blood/glomerulus) hydrostatic pressure is greater so there will be movement into bowman's capsule usually favors the filtrate to go into the bowman's capsule each persons full body is filtered about every 40 minutes angiotensin converting enzyme (ACE) - - correct Answeran enzyme that converts angiotensin I to angiotensin II What does angiotensin II do? - - correct Answerincreases blood pressure by vasoconstriction Role of macrophages - - correct Answer-In Innate: 1. Phagocytosis PRR or opsonization w/ complement 2. Secrete Cytokines: Recruit more cells, inflammation, fever, etc. -In Adaptive: 1. Phagocytosis: opsonization with complement or Abs 2. Secrete cytokines: recruit more cells etc. 3. Antigen presentation: peptides from the broken down pathogen are displayed on surface of the cell.