NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 20, Exams of Nursing

Download NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 20 and more Exams Nursing in PDF only on Docsity! NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Pathophysiology Final Study Guide GRADED A Patho Section 1 Cell & Tissue Function/Dysfunction Atrophy: decrease in size of cells. Hypertrophy: increase in cell size. Hyperplasia: increase in number of cells. Metaplasia: mature cell type is replaced by a different mature cell type. Dysplasia: cells vary in size & shape within a tissue. Anaplasia: undifferentiated cells with variable nuclear & cell structure. Neoplasm: tumor. Cell Damage Ischemia: oxygen deficit due to respiratory or circulatory problems. Hypoxia: reduced oxygen in tissue. Oxygen Deficit: decreased energy production, loss of Na pump ↑ intracellular Na. Temperature: inactivation of some enzymes, damages organelles, protein coagulation, disruption of cell membrane. Micro-organisms Abnormal Metabolites: caused by genetic disorders or altered metabolism. Nutritional Deficits Cell Death Apoptosis:programmed cell death controlled by genetics. Necrosis:lysis of a cell, cell components leak into blood. Liquification:dead cells liquefy due to release of enzymes. Coagulation:cell proteins are altered or denatured causing coagulation. Caseous:form of coagulation necrosis, thick, yellowish, cheesy. Fat: fatty tissue is broken down into fatty acids. Tissue Damage from Chemicals Exogenous: from environment. Endogenous: from inside the body, Tissue Damage from Physical Agents Hypothermia: vasoconstriction, ↑ blood viscosity, hypovolemic shock ↓ blood pressure. Hyperthermia: causes general vasodilatation, decrease in circulating blood volume. Radiation: primarily affects actively dividing cells Biological Agents Insects/Animals: direct injection of toxin, transmission of infectious NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade agent, allergic reaction to insect proteins. Food Poisoning Normal Defenses of the Body 1st Line Defense NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Resolution: minimal tissue damage, cells can repair themselves. Regeneration: damaged tissue is replaced by identical tissue. Replacement: functional tissue replaced by scar or fibrous tissue. NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade 1st Intention: wound is clean, edges are close together with minimal gap. 2nd Intention: large break in tissue, longer healing process with more scar tissue. Scar Formation: fibroblasts proliferate, abnormal amount of collagen. Hypertrophic: overgrowth of fibrous tissue, keloid. Ulceration: blood supply around scar is impaired resulting in tissue breakdown. Wound Staging 1. Partial thickness ulcer-red or pink ie. Sunburn. 2. Partial thickness ulcer-blister, scrape, abrasion. 3. Full thickness ulcer- through dermis. 4. Full thickness ulcer that includes muscle or bone. Drainage Transudate: clear & watery. Serosanginous: clear w/ tinge of red/brown. Contains serum/blood thin & watery. Exudate: creamy yellowish. Contains proteins & WBC’s Thick. Purulent: yellowish. Contains leukocytes and necrotic debris, thick. Infected Pus: hues of yellow, green or blue. Contains pathogens, thick. Venous Insufficiency Clinical Presentation Incompetent Valves medial leg area Inefficient Calf Pump edema Distended Capillary Bed wet wound Decreased Fibrolysis scaring, red base Fibrin Leakage hemosiderin deposits(purple/brown on leg) Trauma Ulcer Documentation of Pulses Normal: 2+ Diminished: 1+ Absent: 0 Arterial Insufficiency: decreased arterial blood supply. Acute(thrombosis) vs Chronic(arteriosclerosis) Characteristics Dry Gangrene: nonviable dry tissue. Wet Gangrene: tissue necrosis + bacterial infection. Drainage w/ odor. Black Gangrene: gangrenous borders, mummified skin. Pain w/ walking=Claudication Skin is atrophic(no hair) slow nail growth & Diminished Pulse Ankle Pressure Index: SBP LE/SBP UE >1 no arterial occlusive disease .9-1 min sx in LE .5-.9 claudication pain(leg pain w/ walking) .3-.5 ischemic rest pain <.3 ischemic w/ tissue necrosis Assessment of arterial flow, skin color w/ elevation/dependency NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade 1. LE Elevation to 60º for 1 minute. Normal=no color change. 2. Lower the LE & record time for color to return.>30seconds means arterial insufficiency. Will look hyperemic(bright red). NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Interventions/Treatment:avoid triggers, medicate. Peak flow 50-80% of person’s best signal moderate attack, >50% below best PF = major attack. Autoimmune Multiple Sclerosis: autoimmune demyelinization of nerves in brain &CNS Classification Clinically Isolated Syndrome-only suffer 1 attack. MS-multiple attacks at least 1 month apart & damage to at least 2 separate CNS areas & r/o all other possible causes. Tests & Measures: MRI, visual evoked potentials, CSF analysis. Interventions: modify disease course, treat attacks, manage sx. Myasthenia Gravis: antibodies destroy Ach receptors at NM junction. Guillen Barre Syndrome: demyelination of peripheral nerves. Fibromyalgia: generalized musculoskeletal pain > 3 months, multiple tender points affecting all 4 quadrants, 11/18 points, 4Kg force painful Rheumatiod Arthritis:autoimmune destruction of joints affects multiple joints in symmetrical pattern, inflammation can affect organs. Scleroderma:affects microvessels causing hypoxia in all tissue. Skin & organs commonly affected. Sjogren’s Syndrome: autoimmune disease » loss of fluid for tears/saliva Hashimoto’s Disease: autoimmune thyroid disease, causes hypothyroidism Graves Disease: hyperthyroidism, Type 1 Diabetes: autoimmune destruction of pancreas cells » no insulin. Inflammatory Bowel Disease: group of disorders with inflammation of intestines Crohn’s: ulcers throughout intestines, except rectum. Ulcerative Colitis: ulcers in lower intestines, may begin in rectum. Immunosufficiency HIV Meningitis: photophobia is red flag. Toxoplasmosis: parasitic infection. Contaminated cat feces in 1st trimester. Histoplasmosis: fungal infection diagnoses based on organ involved Micro-organisms Bacteria-unicellular organisms, no nucleus, divide by binary fission. Cocci-staph, strep, diplococci- pneumococcus Bacilli-tetanus, botulinum. Spirochetes-syphillis, cholerae. Gram Positive: doesn’t retain crystal violet, has outer membrane layer. Gram Negative: retains crystal violet, no outer layer, thick peptidoglycan layer Toxins Exotoxins: produced by gram+ bacteria. Endotoxins: gram- bacteria. Released when bacteria die causing shock. Virus Active Viral Infection: virus attacks host cell injects genetic material, uses NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade host cell to produce viral proteins & nucleic acids. New viruses made in cytoplasm & released by lysis or budding from host cell. NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Latent Viral Infection: virus enters cell similar to active infection, replicates slowly or delays replication, viral proteins are inserted into cell membrane of host cell causing immune response. Ie. Herpes virus. Fungi: eukaryotic organisms, primarily affect skin or mucous membranes. Protozoa: eukaryotic organisms, usually parasites. Ie. Malaria, dysentary Prions: protein like agent that can change shape of proteins in host cell. Mad Cow. Modes of Transmission Direct Contact Indirect Contact Droplet Aerosol Vector Nosocomial Infections: infections that occur in healthcare setting. Development/Stages of Infection Incubation Period: time of organism entering body to appearance of clinical signs Prodromal Period: infection is developing, nonspecific symptoms. Acute Infection: fully developed infectious disease with peak clinical signs. Chronic Infection: microorganism continues to replicate in body, sx milder. Subclinical Infection: Microbe can reproduce in body but no signs present. Septicemia: bacteria reproducing & circulating in bloodstream. Complimentary Medicine Red Flags: refer to Dr. Chest pain/discomfort, unusual SOB w/ acute pain in chest, arm, throat or jaw, unexplained dizziness, persistent hoarseness or cough, difficulty swallowing, persistent abdominal pain/discomfort, coughing up blood, unexplained weight gain/loss, persistent unexplained fatigue, changes in a mole, change in bowel/bladder habits, blood in stool, unexplained vaginal bleeding, lump in breast or discharge or change in size or shape, changes in testicles, severe HA, blurred vision, sores that don’t heal, persistent unexplained lumps/swelling, persistent back pain even w/ rest, unexplained leg swelling/pain. Screening Lab Fingernails Absent Lunula: anemia, malnutrition. Pyramidal Luluna: trauma or excessive manicures. Red Luluna: cardiovascular disease, collagen disease of vessels, blood CA Mee’s Lines: metal toxicity, chemotherapy exposure. Longitudinal Lines: Addison’s disease, breast CA, melanoma, trauma. Splinter Hemorrhages bacterial endocarditis, lupus, renal failure, psoriasis Terry’s Nails:half& half appearance:edema & anemia »renal/liver disease. Cancerous Moles-asymmetry, border, color, diameter NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade ELECTROLYTES Intracellular electrolytes: potassium, phosphate, magnesium Blood electrolytes: sodium, calcium, less extent bicarbonate EXCESS/DEFICIENT ELECTROLYTE CAUSES of EFFECTS of HypoNatremia Excessive sweating, vomiting, diarrhea, insufficient aldosteerone, kidney failure, excessive water- intake Impaired nerve conduction, fatigue, mm cramps, Abdom issues, decreased Osmotic pressure in ECF- THUS fluid into cells HyperNatremia Insufficient ADH, loss of thirst mechanism, watery diarrhea, rapid respiration, Fluid shift out of cells, weakness, dry tongue mucous membranes, increased BP HypoKalemia Diarrhea, diuresis, excessive aldosterone, low dietary intake, Insulin forces K+ into cell Cardiac Dysrythmias, interference with neuromm junc, decreased dig. Tract motility HyperKalemia Renal failure, deficit aldosterone, leakage of K+ from ICF into ECF, prolonged acidosis (H+ replaces) Cardiac dysrythmias, mm weakness common progressing to paralysis, respiratory arrest HypoCalcemia Hypothyroidism, malabsorption syndrome, deficient serum albumin, increased serum pH Increased permeability/ --excitability of nerve membranes,spont stim of skeletal mm, Tetany, weak Heart contractions HyperCalcemia Uncontrolled release from bones -demineralization from immobil. -increased intake Depressed neuromm activity -interference with ADH function -increased strength cardiac contractions HypoMagnesmia Malabsorption of assoc with alcoholism, use of diuretics Neuromuscular hyperirritability -heart arrythmia HyperMagnesmia Renal failure Depressed neuromm funct GENETIC DISORDERS CAUSE(S) CHARACTERISTICS Angelman syndrome X-linked, lose “bit” of chromosome Flat head. PROTUDING TONGUES odd bouts of Laughter, Balance disorders Cri du Chat Missing part chromosome 5, mutation at Hi “CAT-like” cry, webbed toes & fingers, DOWNward slant to wide set eyes, skin tags ant. ears Downs syndrome Trisomy 21 Flat face, Upward slanted eyes, single DEEP crease palm of hand, HYPOtonia (low muscle tone), NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Fragile X syndrome Fragile x retardation protein Large head w/ prominent forehead, boys develop long face, tactile defensiveness Neurofibromatosis Autosomal dominant, Esp. effects nervous syst and skin, birthmarks called café-au- lait, freckles in armpits and groin, NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade purplish RUBBERY lesions on skin GENETIC DISORDERS CAUSE(S) CHARACTERISTICS Prader Willi syndrome Chromosome XV Extreme hunger/overeating, obsessed w FOOD, temper tantrums, violent outbursts, @ 1 Y.O. become ravenously hungry Smith-Magenis Syndrome Deletion @ XVII Broad nasal bridge, PROTRUDING jaw, ear anomalies, SPEECH & middle ear problems, SLEEP disturbances Sudden Mood changes Klinefelter’s Syndrome Men w/ extra X chromosome Teenagers less developed, prepubescent testosterone helps, testosterone levels to diagnose, infertility Turner Syndrome Females w/ only 1 X chromosome WEBBED neck!! Underdeveloped BREASTS High BP, Type II diabetes Triple X syndrome Extra X chromosome Girls TALL, often not diagnosed, no long term problems Williams syndrome Random mutation chrom. 4 50% retardation, PUFFINESS around eyes, long neck, sloping shoulders, Poor DEPTH perception Cystic Fibrosis Single point mutation CFTR Life limiting (30s), frequent coughing w/ thick sputum, salty- skin, frequent lung infections, Muscular Dystrophy Dystrophin-over 30 different genetic diseases -Duschenne most common (missing dystrophin), affects skeletal & cardiac Muscle -Fascioscapulohumeral-faulty dystrophin -Myotonic; congenital, juvenile, adult, late onset-over 50 ACID-BASE Imbalance -> Normal 7.4, ranges from 7.35 to 7.45 o Enzymes act in narrow pH range ● 20:1 base to acid ratio ▪ Respiratory system- alters carbonic acid levels Acidosis-> CO2 up ▪ Kidneys- modifies excretion rates of acids, Most effective control system Acidosis: excess Hydrogen ions Alkalosis: deficit in Hydrogen ions Acidosis HCO3- down Alkalosis HCO3- down **compensation occurs to balance relative ratio (20:1), NOT total concentration NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade ANEMIAS CONT. ● Polycythemia NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade o Primary polycythemia->Increased rate of RBC production ▪ Secondary polycythemia-> Increased RBC production due to prolonged Hypoxia o Concerns for both: ▪ Sluggish blood flow ▪ Increased BP & hypertrophied heart ● Indications of Blood clotting Disorders o Persistent bleeding in gums & nose bleeds, bleeding into joint, coughing up/vomiting blood, blood in feces, vomiting, low BP ● Causes of clotting disorders o Defective platelet function o Long term use of warfarin ● Hemophilia A (classic) o Most common inherited clotting disorder o Varying severity o Spontaneous bleeding into joints ● Disseminated Intravsascular Coagulation o Excessive clotting & excessive bleeding in circulation o Clotting factors reduced to dangerous level o Widespread uncontrollable bleeding o HIGH fatality rate THE LEUKEMIAS Acute High proportion of IMMATURE, nonfunctional cells in marrow and circulation Onset is abrupt SIGNS: Frequent uncontrolled infections ,BONE PAIN, Weight loss, fatigue, drowsiness, vomiting Chronic Higher proportion of MATURE cells Insidious onset Mild signs & better prognosis Diagnostics for all leukemias Peripheral blood smears Bone marrow biopsy confirmation Treatment-> Chemo, Biologic therapy using INTERFERONS, Can stimulate immune system Histology: Differential diagnosis of Systemic Pain versus Musculoskeletal Category Sytemic disease Musculoskeletal Course/duration Cyclic, progressive symptoms Constant or may come & go Sudden (gradual when related to overuse) NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Relieving Factors Usually NONE : if relieved by rest or position, there is typically cyclic progression of increasing frequency, intensity, or duration until Decrease with Rest NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade -Decreased CO (cardiac output) one side →compensation mechanisms – vasoconstriction, water & sodium retention, increased blood volume →increased work for the heart -Eventually muscles of affected side weaken →congestion behind affected side → unaffected side pumps against increased resistance → Previously unaffected side weakens Right side failure – systemic congestion Left side failure – pulmonary congestion -pericarditis → effusion → fibrous adhesions -myocarditis → arrhythmias -endocarditis → infection of heart valves →can lead to fibrosis Dx tests for heart diseases -auscultation – listen to valves -exercise stress test -imaging -doppler blood flow -blood test – can detect enzymes release from infracted myocytes -EKG EKG – usually 12 leads – at least 3 The basics – -P wave – depolarization of atria -QRS complex – depolarization of ventricles -T wave – Repolarization of ventricles EKG Abnormalities -PAC –premature atrial contrx – slight flutter, benign -PVC – premature ventricular contrx – many times benign, can lead to ventricular fib (life threat) -atrial flutter – atria contract quickly, but in rhythm – P waves not always followed by QRS -atrial fibrillation – atria quiver ineffectually (can live without coordinated atrial contraction) -ventricular tachycardia -ventricular fibrillation – will die without swift intervention Heart block – problem with SA node communication with AV node -1st degree AV block – long PR interval – slow communication -2nd – Missing QRS after P wave -3rd – 2 consecutive missing QRS after P waves Auscultation -Sound 1 = tricuspid and mitral valves -Sound 2 = semilunar valves Nervous control of heart -medulla of brain stem – control center of heart -baroreceptors in aorta and internal carotid (peripheral a’s - stretch recepts for BP NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade monitoring) -Autonomic system – increase and decrease HR Vasculature NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Artery layers -tunica intima –endothelial cells -endothelial cells respond to hormones, signal smooth muscle to contract, relax -tunica media – muscle cells -tunica externa (adventicia) – connective tissue Venous return – thinner walls, valves prevent backflow Hypertension -95% idiopathic -can cause endothelial cells to shear off -epinephrine in blood stream = inhibitory for endothelial cells, excitatory for smooth muscle underneath → vasoconstriction and incr. BP -fat deposits in hole in intima →atheroma -blood can begin running between tunica intima and media →dissecting aneurysm Angiotensin Renin complex -angiotensinogen +renin -Angiotensin I +ACE (angiotensin converting enzyme) -Angiotensin II **ACTION = angiotensin II → receptor → vasoconstriction, incr. BP Aneurysms -fusiform – bulge in all directions -saccular – sac forms on one side – pooling of blood causing clotting →thrombus formed -dissecting – most dangerous – blood runs between tunica intima and media – dissecting aortic aneurysm =ticking time bomb Circulatory shock – severe hypotension -causes = hypovolemic, cardiogenic, septic, distributive (vasogenic, neurogenic, anaphylactic) -compensations – SNS incr. HR, force of heart contraction; kidneys release renin, aldosterone, ADH Diff Dx Kawasaki’s Disease -antibod’s produced against endothelial cells and smooth mm -Presentation – red tongue, rash @ distal extremity, skin sloughing, edema -recovery usually spontaneous Raynaud’s Disease -insufficient blood supplied to distal phalanges – Women>men -prolonged ischemia can → gangrene. Venous insufficiency -valves fail due to age, injury, sendentary life, obesity -chronic pooling of blood in LE -brown, blue, purple skin in feet and toes – waste accumulation! -minor trauma → large wound! Hard to treat NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade -Cystic Fibrosis -Single gene mutation -increased mucus in the lungs, increased risk of infections -Lung Cancer NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade -90% smoking related, 3rd most common cancer -can be result of metastasis -Lung Tumor -inflammation and bleeding in lungs →cough blood -pleural effusion, pneumothorax -can secrete hormones –“paraneoplastic syndrome” -Asthma -Type 1 hypersensitivity – IgE formed in response to allergen -inflammation of mucosa → bronchoconstriction, obstructive mucus -can cause atelectasis –collapse of lung because of airway blockage (-pneumothorax involves a collapsed lung caused by mechanical damage or a rupture of a small airsac or “bleb” on outside of lung) -presents with hypoxia, respiratory alkalosis (initially due to hyperventilation), cyanosis, cough, tightness in chest, thick mucus, tachycardia -treat with inhalers and glucocorticoids COPDs –progressive degeneration -Emphysema –“pink puffers” – red face, overinflation -destruction of alveolar walls →permanent inflation -smoking eliminates anti-trypsin that inhibits enzyme that destroys elastin →elastin of alveoli destroyed→loss of septae between alveolar sacs →decreased surface area for gas exchange -presents with “barrel chest” – ribs fixed in inspiration position -Chronic Bronchitis – “blue bloater” -inflammatory obstruction →repeat infections, progressive, irreversible damage of bronchioles -hypertrophy, hyperplasia of mucus glands, fibrosis -Present with constant cough, SOB, cyanosis -treat by Stopping Smoking, O2 supplementation, available vaccinations for at risk infections Emphysema Chronic Bronchitis Alveoli affected Bronchioles affected Septae walls destroyed Increased secretions Some cough Lots of coughing Little sputum Lots of sputum No cyanosis Cyanosis Some infections Frequent infections -Bronchiectasis -permanent dilation of medium-to-large-sized bronchi -caused by recurrent inflammation Restrictive Pulmonary Disorders – impaired lung expansion -often abnormal chest wall or lung inself -Pneumoconiosis NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade -exposure to irritants – coal workers -inflammation→fibrosis, “stiff lung” - insidious onset NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Digestive System Overview 5 layers of gut wall (inner to outer): mucosa, submucosa, circular muscle layer, longitudinal muscle layer, serosa *Peristalsis (involuntary contractions) occurs in circular and longitudinal smooth muscle layers Stomach Gastrin cells (G cells): initiated by food entering stomach, stimulates chief and parietal cells Intrinsic factor (parietal cells): needed for absorption of vitamin B12 HCL (parietal cells): activates pepsinogen, creates optimal pH ~2, denatures proteins Pepsinogen (chief cells): pepsin not activated until pH of 6 Liver “Metabolic factory of the body” 1)Storage of nutrients 2) Maintains blood glucose 3) Blood reservoir 4) Produces bile, plasma proteins, blood clotting factors, cholesterol/lipoproteins 5) Metabolic processes (detoxification, conversions) Glucose -> Glycogen = Glycogenesis (when glycogen supply low) Protein, Fat -> Glycogen = Glyconeogenesis Glycogen -> Glucose = Glycogenolysis (maintains blood glucose levels) Pancreas Exocrine (secreting digestive enzymes and electrolytes) and endocrine organ Trypsin, chymotrypsin, carboxypeptidase-break proteins Ribonuclease-break nucleic acids Pancreatic amylase-break starch Lipase-break lipids GI tract Ileum=major site of nutrient absorption, villi (folds of mucosa) Large intestine=fluid and electrolyte reabsorption, movement slow to allow absorption of water, vitamin K synthesis (essential for blood clotting) Neural and hormonal control PNS (vagus mainly): increased motility and secretions, SNS: inhibits GI activity Gastrin: increases gastric motility and promotes stomach entering, Secretin: decreases gastric secretions, Cholecystokinin: inhibits gastric emptying NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Upper GI Tract Disorders (includes differential diagnosis) NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Disorder Description Causes Dysphagia Difficulty swallowing 1) Neurological deficit 2) Muscular disorder 3) Mechanical obstruction -congenital atresia -stenosis -esophageal diverticulum -tumors Esophageal Cancer Squamous cells in distal esophagus, poor prognosis Chronic irritation -chronic esophagitis -hiatal hernia Hiatal hernia Part of stomach protrudes into thoracic cavity Gastroesoph a geal Reflux Disease Gastric substances reflux into distal esophagus,often seen with hiatal hernia Decreased competence of lower esophageal sphinctor Gastritis Stomach mucosa inflamed (either acute or chronic) *Helicobacter pylori infection typically present w/ chronic Acute: Infection, allergies to food, spicy food, excessive alcohol, ulgerogenic drugs Chronic: Most idiopathic Gastroenteri ti s Inflammation of stomach AND intestine Usually an infection Peptic Ulcers (gastric and duodenal) Erosion in mucosa Common in proximal duodenum and antrum of stomach (ulcers in general rarely found in large intestine) 1) H. pylori infection 1) Increased acid- pepsin secretions 2) Inadequate blood supply 3) Excessive glucocorticoid secretion 4)Ulcerogenic subtances Stress Ulcers Rapid onset, may form within hours of precipitating event Severe trauma: Burns (curling’s ulcers), head injury (cushing’s ulcers) Systemic: hemorrage, sepsis (ischemic ulcers) Gastric Cancer Primarily in mucous glands and in antrum or pyloric area, poor prognosis Gone down bc we have preservatives w/ food Pyloric Stenosis Narrowing and obstruction of pyloric sphinctor May be developmental anomaly or acquired later in life Liver and Pancreas Disorders (includes differential diagnosis) Gallbladder Disorders Description Cholelithiasis Formation of gallstones* Cholecystitis Inflammation of gallbladder and cystic duct NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade *Viral Hepatitis Hepatitis A: Infectious hepatitis, RNA virus, transmitted by fecal-oral route in areas of inadequate sanitation, no carrier or chronic stage, vaccine available NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Hepatitis B: Serum hepatitis, DNA virus, incubation period of 2 months, primarily transmitted by infectious blood (may also be sexual transmission or from mother to fetus), carriers asymptomatic but contagious, vaccine available, chronic hepatitis B (ascites) =engorgement of blood vessels, can’t filter toxins anymore NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Hepatitis C: RNA virus, most common type transmitted by blood transfusion, has carrier state, increases risk of hepatocellular carcinoma Hepatitis D: Delta virus, incomplete RNA virus (needs hepatitis B to produce active infection), transmitted by blood Hepatitis E: RNA virus, transmitted by oral-fecal route, no chronic or carrier state Lower GI tract disorders (includes differential diagnosis) Disorder Description Caus es Celiac disease Malabsorption syndrome: prevents further digestion of gliadin (breakdown product of gluten) Atrophy of villi Primarily a childhood disorder Autoimmune disease (1% of US population) -defect in intestinal enzyme Crohn’s disease (included in chronic Inflammatory Bowel Disease) Progressive inflammation and fibrosis cause obstructed areas Normally affects small intestines (but may affect any part of GI tract) Inflammation occurs in “skip lesions” Genetic factor (often occurs during adolescence) Ulcerative Colitis (included in chronic IBD) Blood and mucous in stool Inflammation starts in rectum and progresses to colon Genetic factor (often occurs during 2nd or 3rd decade) Appendicitis Obstruction of appendiceal lumen, wall inflamed as fluid builds in appendix Occurs in 10% of population Symptoms=LRQ rebound tenderness, periumbilical pain Fecalith, gallstone, or foreign object cause obstruction Diverticular Disease Diverticulum=outpouching of mucosa through muscular layer of colon Diverticulosis=asymptomati c Diverticulitis=inflammation of diverticula (very painful) Symptoms=cramping, tenderness nausea, fever, elevated WBC, do NOT see blood in stool May be genetic link NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Blood: if large amount=increased glomerular permeability or hemorrhage, if small amount=infection, NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade inflammation or tumors in urinary tract Dark color-hematuria, excessive bilirubin, highly concentrated urine Unusual smell or odor-infection, diet, or medication NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Elevated BUN and creatine=failure to excrete nitrogen waste Metabolic acidosis (low pH, low bicarbonate)=failure of tubules to control acid/base balance Urinary System Disorders (includes differential diagnosis) Disorder Description Caus e Urinary Tract Infection Lower=cystitis and urethritis (hyperactive bladder and reduced capacity), may have systemic signs w/ painful urination Upper=pyelonephritis (in one or both kidneys: purulent exudate and abscess block blood and urine flow), systemic sign of high fever *can lead to renal failure* E.coli Predisposing factors=incontinence, retention of urine, direct contact w/ fecal material Glomerulonephriti s Decreased GFR rate (decreased urine output, elevated blood pressure and edema) Metabolic acidosis Bloody, foamy urine and pain Acute poststreptococcal glomerulonephritis caused by presence of anti- streptococcal antibodies Nephrotic Syndrome Increased permeability in glomerular capillaries Hypoalbuminemia,increased aldosetrone, severe edema Bladder cancer Often develops as multiple tumors Early signs:hematuria and dysuria Predisposing factors: working w/ chemicals (analine dyes, rubber, aluminum), smoking, recurrent infections, heavy analgesics intake Vascular Disorders Thickening/hardening of walls and small arteries Reduces blood to kidney- stimulation of renin (increases blood pressure) Some normal w/ aging Adult Polycystic kidney disease Manifests around 40 Multiple cysts in both kidneys- leads to chronic renal failure Autosomal dominant gene on chromosome 16 Polycystic disease in children Manifested at birth, child dies in first month or is stillborn Autosomal recessive mutation NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Common symptoms=weight gain, cold intolerance, fatigue Myxedema- lots of fluid (would not pit), can look like fibromyalgia bc of muscle aches and trigger point tenderness, sparse hair, brittle nails, may have buffalo hump NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Thyroid storm-dumps T3 and T4 into system -> causes tachycardia, fever, and agitation Thyroid cancer Very treatable, most are benign (only 5% malignant and they normally dont metastasize) Palpation will be painless, unilateral, and in one spot Parathyroid glands Maintain calcium levels between bone and blood Parathyroid cancer=can’t easily be distinguished from thyroid cancer Renal glands Release epinephrine and aldosterone Trousseau’s sign- positive sign would be tremors and twitching bc of nerve or muscle irritability (Non specific sign) Chvostek’s sign-elicit this by having the patient relax face and then the therapist taps the facial nerve, watch for twitch of mouth or side of face Addison’s Diseases (hypoadrenal)- autoimmune, skin changes color to a slight grey Cushing’s Syndrome (hyperadrenal)- too much glucocorticoids in system, can cause muscle wasting, bone demineralization, and ligaments to be lax, might see buffalo hump on back (does NOT feel like fluid) Diabetes (fasting plasma glucose >126mg/dL) Action of insulin-when insulin gets to cell, it makes glucose transporters close to membrane (Below 100 mg/dL is normal for FPG) Type 1=autoimmune (insulin producing B cell destruction), typically under age 20 Risk factors: sibling has Type 1, parents have type 1 Type 2=obesity (insulin resistance...receptor not binding to insulin as well, pancreas intact), hyperglycemia develops slowly, may have genetic predisposition, 85-90% of all diabetes Risk factors: overweight, over 45 yrs old, inactive, women who had a baby over 9ilbs, low HDL Gestational=associated with type 2, glucose intolerance w/ pregnancy, increased risk of diabetes later on, if continues >6 weeks after pregnancy...no longer GDM Acute Hyperglycemia Early signs: blood sugar >180mg/dL, blurred vision, thirsty, ketones,dry skin, increased urination, tired Late signs: blood sugar >240mg/dL, nausea/vomiting, deep/rapid breathing, large ketones in urine, fruity breath, some diabetes pts don’t sense changes bc of neuropathy NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Acute Hypoglycemia Caused by: over treatment w/ insulin, missed meal, exercising when insulin peaking, stress Early signs: tachycardia, hunger, headache, dizziness, sweating, shaking, pale skin, tingling around mouth, NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade o Involuntary, motor and sensory innervation: cardiac muscle, smooth muscle, glands, sympathetic/parasympathetic, neural pathway: preganglionic fibers (in brain or spinal cord) → postganglionic fibers (outside CNS) ● Sympathetic Nervous System: o “Fight or flight”; stress response, increase general level of activity: cardio, respiratory, neurologic, Neurotransmitters: preganglionic fibers release acetylcholine (cholinergic); postganglionic fibers release norepinephrine (adrenergic) ● Parasympathetic Nervous System: o Dominates digestive system, aids recovery after sympathetic activity, vagus N: innervates heart and GI, neurotransmitter: acetylcholine; receptors (cholinergic): nicotinic and muscarinic Acute Neurologic Disorders Problem/Disorder Description Treatment Increased Intracranial Pressure Expansion of fluids/tissue → Increase in pressure→ Ischemia and infarction Herniation Displacement of brain tissue caused by large mass (clot/tumor) Brain Tumors Lesions that cause increased ICP If accessible then removal Vascular Disorders Hemorrahagic (increased ICP) or ischemic Transient Ischemic Attacks Temporary reduction of blood flow in the brain Small mini-strokes occurring continually Connected to dementia Cerebrovascular Accidents Infarction of the brain due to lack of blood Clot busting agents, surgery, glucocorticoids, team approach Cerebral Aneurysms Localized dilation in the wall of an artery Surgery before rupture, antihypertensive drugs Meningitis Bacterial infection of the meninges of the CNS Antimicrobial therapy, glucocorticoids, vaccines Brain Abscess Localized infection; necrosis of tissue Surgical drainage, antimicrobial therapy Encephalitis Infection of the parenchymal or conn tissue in the brain and spinal cord Antimicrobial therapy, antiviral drugs (depends on the type of encephalitis) Rabies Viral transmitted by bite of rabid animal or transplantation of contaminated tissues Prophylactic immunization Tetanus Infection by puncture wound Immunizations advised NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Poliomylitis Polio virus; attacks motor neurons of the spinal cord and medulla Immunization available NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Herpes – Zoster (shingles) Caused by varicella – zoster in adults Vaccine available for ages 60+ Post-polio syndrome Occurs 10 – 40 years after initial infection Reye Syndrome Viral infection linked to children treated with aspirin No immediate cure Guillain – Barre syndrome Inflammatory condition of the PNS Recovery usually spontaneous; supportive treatment Chronic Neurologic Disorders Problem/Disorder Description Treatment Hydrocephalus Excess CSF within the skull Non-communicating (flow of CSF through ventricular system is blocked) Communicating: absorption of CSF through subarachnoid villi impaired Spina Bifida Failure of the posterior spinous processes to fuse → meninges and spinal cord herniated Diagnostic Tests: alpha – fetoprotein (AFP) elevated, ultrasound Surgical repair, OT/PT afterwards Cerebral Palsy Motor impairment due to brain damage: intellectual function, behavior, communication / speech, seizures, visual or hearing deficits Causes: genetic mutations, abnormal fetal formation, brain damage, difficult delivery, hypoxia (ischemia) Spastic paralysis: hyperreflexia Dyskinetic: loss of coordination with fine movement Ataxic: loss of balance and coordination Speech, PT/OT, assistive devices, monitor hearing/vision, alternate modes of communication NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Huntington’s Disease Rapid, jerky movements, chronic progressive neurodegenerative chorea, hereditary, autosomal dominant (~40 years of age) Progressive atrophy of brain S&S: mood swings, Diagnositc test: DNA analysis Treatment: no therapy to slow progress, only symptomatic therapy NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade personality changes, restlessness, choreiform movements in arms and face, intellectual impairments Dementia Intellectual deterioration that interferes with occupational or social function S&S: impaired cognitive skills, impaired thinking, judgment, and learning, memory loss, confusion, behavioral and personality changes Causes: vascular disease, infections, toxins, genetic disorders Alzheimer’s Disease Progressive cortical atrophy: neurofibrillary tangles and amyloid plaques Cause: unknown S&S: onset insidious, behavioral changes (irritability, hostility, mood swings), gradual loss of memory and lack of concentration, impaired learning, poor judgment, decline in cognitive function, memory and language, change in food intake, inability to recognize family, environment unawareness, incontinence 1st stage: short term memory loss, social withdrawal, no sense of humor 2nd stage: general confused stage, wandering (sundown syndrome) 3rd stage: terminal stage, incontinent, apathetic, institutionalized No diagnostic tests available Treatment: anti-acetylcholine esterase drugs, OT/PT, psychologists, speech therapists, team approach Creutzfeld – Jacob Disease (Mad Cow Disease) Rapidly progressive Cause: prion ingested or transmitted through contaminated blood S&S: memory loss, behavioral changes, motor dysfunction, progressive disorders, dementia Diagnosis: blood tests Fatal: within 6 months = dead NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade AIDS Dementia Common in later stages of AIDS, virus invades brain tissue Gradual loss of memory and cognitive ability, impaired NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade O’ Donoghue’s Maneuver AROM > PROM = + sign McBride’s Test Stand on one leg and raise other leg to chest = should decrease LBP Hoover’s Test Supine, hold pt.’s heels off table and have them raise one leg, feel downward pressure if they try to lift the leg ● Symptom magnifier: magnifying their symptoms vs. Malingerer: knowingly manipulating the system for their own gain, purposely deceiving the health care providers ● Look at pt’s work history SEIZURES ● Review types of seizure table ● Seizure: abnormal discharge of a group of cortical or subcortical neurons ● Epilepsy: syndrome characterized by experience of recurrent seizures ● Aura: subjective sensation or motor phenomenon that precedes a seizure (pre-ictal/prodomal) ● Ictal period: period of abnormal EEG activity; seizure S&S are evident ● Post-ictal period: period following acute seizure, time of confusion, EEG activity = normal ● Status epilepticus: series of rapidly repeated epileptic convulsions without any period of consciousness between them Seizures Epilepsy Inappropriate electrical activity Recurrent seizures or neurological syndrome associated with seizures Transient neurological signs (seizure) Seizures occurring with little or no provocation Altered consciousness, involuntary movements, and disturbed perception often occur Individual or multiple seizure types; characteristics may change with age Defined by neurological S&S and EEG patterns Spectrum of seizure types, EEG, clinical settings ● Etiology: genetic (inherited metabolic abnormalities, lowered threshold to electrical activity of the brain), structural (disturbed cerebral flow, disorders of blood composition), environmental (anoxia, toxins, drug withdrawal), head trauma, idiopathic causes ● Triggering mechanisms: visually induced, movement induced, hyperventilation, trauma, emotions, hydration/electrolyte imbalance, fever, alcohol or drug withdrawal, premenstrual period, lack of sleep, illness ● Diagnosis: medical history, diagnostic tests (lab studies, x-rays, lumbar puncture, CT, MRI, EEG), clinical observation ● Treatment: drugs, surgery, diet, microcomputers, education ● Differentiate from: disorders of cerebral blood flow or blood constitution, structural, psychiatric conditions, and migraine headaches Mental Health Disorders of Children Autism Spectrum Disorder ● Autistic disorder, pervasive developmental disorder, and Asperger’s disorder: differ in when the symptoms start, how fast they appear, and severity NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade ● Cause is unknown; genetic and environmental factors; structural brain abnormalities: larger total brain mass, smaller frontal cortex, abnormal cerebellum NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade ● S&S: lack of social skills, avoid eye contact and physical contact, echolalia, don’t listen, aggressive or passive (may switch), inflict self injury, resistant to change, diff in expressing needs, tantrums ● Early indications: no babbling or pointing, no single words, no response to name, loss of language or social skills, poor eye contact, excessive lining of objects, no social responsiveness ● Later indicators: impaired ability to make friends or initiate conversation, impaired play, echolalia, preoccupation with objects, inflexible adherence to routines and rituals ● Screening tests: Childhood Autism Rating Scale (CARS), Checklist for Autism in Toddlers (CHAT), Autism screening questionnaire, screening test for autism in 2 year olds ● Treatment: intensive behavior therapy Attention Deficit Hyperactivity Disorder (ADHD) ● Inability to focus on one thing in all aspects of life impairing function; diagnosis (must have all 3): inattention, hyperactivity, and impulsivity Tourettes Syndrome ● Characterized by tics; tics: involuntary, rapid, repetitive, and stereotyped movements of individual muscle groups ● Transient tic disorder: do not persist for more than 1 year vs. chronic tic disorder: duration over many years (unchanging character) vs. chronic multiple tics: several chronic motor tics vs. Tourettes: multiform frequently changing motor and phonic tics, unknown cause Bipolar Disease ● Combination of euphoria and depression; in kids: continuous, rapid-cycling, irritable, and mixed symptom state that may co-occur with disruptive behavior disorders School Refusal/Avoidance ● Refuse to go to school on a regular basis or problem staying in school once there Separation Anxiety Disorder ● Extreme anxiety when away from home or separated from parents Selective Mutism ● Fail to speak in situation where speech is expected or necessary Oppositional Defiant Disorder (ODD) ● Persistent / consistent pattern of defiance, disobedience, and hostility towards authority figures Conduct Disorder ● Fighting, bullying, intimidating, physically assaulting, sexually coercing, cruel to people and animals, vandalism, theft, truancy, drug and alcohol abuse, precocious sexual activity Adult Mental Health Disorders Dementia, Alzheimer’s, Vascular Dementia (TIAs), Creutzfeld – Jakob, Huntington’s refer to table General Anxiety Disorder ● Excessive worry for 6+ mo., focus of worry will shift between things Obsessive-Compulsive Disorder (OCD) ● Persistent, recurring thoughts and obsessions, obsessive behavior with repeated behavios Panic Disorder NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade cavity ● Functions: body movement, body position, stabilize joints, maintain body temp. NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade ● Skeletal Muscle: bundles of protein fibers covered by conn tissue, striated, voluntary, respiration: aerobic and anaerobic, glycogen for energy ● Joints: synarthroses (immovable), amphiarthroses (slightly moveable), diarthroses (freely moving) Disorder Description Treatment Fracture Bleeding, local inflammation, necrosis of tissue at the end of the broken bone Osteoporosis Decrease in bone mass and density, loss of bone matrix and mineralization Predisposing factors: 50+ yrs., sedentary, hormonal, low BMI, diet, Asian/European ancestry Dietary supplements (calcium, vitamin D), weight bearing activities, PT, fluoride, bisphosphonates, calcitonin Rickets and Osteomalacia Deficit of vitamin D and phosphates, kids = weak bones, adults = soft bones Paget’s Disease Excessive bone destruction with replacement by fibrous tissue and abnormal bone Tumors Common site of secondary tumors, majority of primary tumors are malignant Osteosarcoma: bone pain at rest Excision of tumor if possible Surgical amputation Chemotherapy Chondrosarcoma: cartilage cells (adults) Ewing’s sarcoma: shaft of long bones (adolescents) Muscular Dystrophy (MD) Autosomal recessive disorders, degeneration of skeletal mm, Duchenne MD most common (boys): deficit of dystrophin, skeletal mm replaced by fat and fibrous conn tissue Diagnostic tests: ID genetic abnormalities, elevated creatine kinase levels, EMG, muscle biopsy, blood test Treatment: no curative treatment, moderate exercise, assistive devices, PT/OT, massage, ventilator NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Osteoarthritis (OA) Degenerative, “wear and tear”, result of increased weight bearing or lifting, articular cartilage damage, surface = rough and worn, bone spurs, narrow joint space, inflammation, lack of ROM, pain, predisposition of falls Treatment: assistive devices, mild exercise program, orthotics, massage therapy, PT/OT, acupuncture, glucosamine- chondroitin suppletments, injection of synthetic synovial fluid, NSAIDS, analgesics, arthrotomy, jt. replacement Rheumatoid Arthritis Autoimmune, chronic systemic inflammatory, rheumatoid factor Treatment: rest/moderate activity, heat/cold, NSAIDS, NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Vascular events Cellular events Fibroplastic stage Fibroblasts Ground substance Tensile strength Collagen synthesis Granulation tissue Wound contraction Maturation phase Hypertrophic scar Keloid Rule of nines: front of leg, front upper torso, front lower torso, entire head, entire arm, each are 9% of body when estimating burn coverage. (Genital area 1%) Treatment of burns: Silicone pressure garments Grafts Allograft, xenograft, cultured skin, dermal substitutes, synthetic skin Splints ***Never put legs in dependent position without compression. Initially don’t move graft site! Ambulation guided by physician. Dermis: made of connective tissue (flexible/ strong), contains nerves(sensory receptors) and blood vessels. Skin accessory structures: hair follicles, sebaceous glands, sweat glands, nails. Subcutanous tissue: below skin includes connective tissue, fat cells, macrophages, fibroblasts, large blood vessels and nerves. Inflammatory Disorders Contact dermatitis: exposure to allergen (soap), sensitization on first exposure. Chemical irritation: doesn’t involve immune response. Urticara (Hives): Type 1 hypersensitivity. Ingestion of substance (shellfish). Lesion pruritic, part of anaphylaxis (check airway for breathing). Atopic dermatitis (eczema)- inherited allergy, moist pruritic rash on face/chest in infants. Dry, scaly in adults. Type 1 hypersensitivity. Treatment: glucocorticoids Psoriasis- chronic inflam. skin disorder, abnormal T- cell activation, excess keratinocytes. Lesions on face scalp elbow and knees. Treatment: gluco. Anti- metabolites, UV light NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Scleroderma: systemic skin disorder, increased collagen/ inflam. Shiny tight hard areas of skin. May lead to renal failure, intestinal obstruction, respiratory failure. NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Keratoses: Benign lesion assoc. w/ aging/ skin damage. Seborrheic keratoses- proliferation of basal cells, painless, round, dark, elevated Actinic keratoses- on UV exposed skin, common in fair skinned, looks scaly and may develop into squamous cell carcinoma. Squamous cell carcinoma- painless, malignant tumor of epidermis. From sun, smoking. Slow growing. Good prognosis with early removal. Malignant melanoma: highly metastic skin cancer, multicolored w/ irregular border, grows quickly and changes in appearance. ABC’s of melanoma: increase in Area. Change in Border. Change in Color. Increase in Diameter. Karposi’s sarcoma- occurs in AIDS and other immunocompromised pt.s Purple skin spots. Senescence: biological processes that lead to aging, begins prior to birth. Also the period from onset of old age to death. Cardio changes w/ aging: size/ # of cardiac muscle fibers decrease. Fatty tissue and collagen accumulate. Reduced strength in contraction. Heart valve thickens, less flexible. Less oxygen to heart, cardiac reserve diminished. Arteriosclerosis: loss of elasticity, accumulation of collagen, thickening of arteries Atherosclerosis- hyperlipidemia, accumulation of cholesterol. Common cause of heart attack. Osteoarthritis: degeneration of cartilage in joints. Associated with sports injury Neuro changes with aging: reduction in neurons, lipid accumulation in neurons, loss of myelin, slower response time. Vision changes with aging: lens less flexible, yellow, night/ color vision reduced. Falls account for 70% of all deaths in those over 75. 90% of hip fractures due to fall. Fall intervention: exercise, decrease meds, pressure stockings, gait training, balance exe. Geriatric physical exam should include: Up and Go Test, Tinetti gait and balance test. Reproductive System Menstrual abnormalities NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Pregnancy terminology: number of term infants, pre- term, abortions, kids currently alive (3-0-0- NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade 3) Avoid modalities on pregnant women. NUR 2063 / NUR2063: Essentials of Pathophysiology Final Exam Review Study Guide (Latest 2023/2024) Rasmussen PASSED[ A] Grade Ectopic pregnancy: implantation outside the uterus Prostatitis: inflammation of prostate. Acute bacterial: gland swollen, tender, bacteria in urine. Non-bacterial: urine has leukocytes Chronic bacterial- gland slightly enlarged, dysuria, frequency/ urgency. Bacterial infection- from e-coli Occurs in: young men w UTI’s, old men w/ prostatic hypertrophy, w/ STD’s, through a catheter and bacteria. Signs: low back pain, decrease urinary stream, muscle aches, anorexia, fever etc. Benign prostatic hypertrophy: signs- obstructed urinary flow, dribbling, nocturia etc. Cancer of prostate: often androgen dependent. Hard nodule on periphery of gland, hesitancy in urinating, recurrent UTI, etc. Diagnosis by serum marker: PSA, prostate specific antigen and prostatic acid phosphatase. Testicular cancer: most common solid tumor cancer in young men. Self exam preventative. Biopsy not performed. Tumor markers: hCG and AFP. Ultrasound Chlamydia: most common STD. Males: itchy, white discharge, painful swollen scrotum. Females: no symptoms until PID or infertility. May infect newborn. Gonorrhea: males: inflammation of urethra Females: asymptomatic until PID. May cause blindness in newborns. Syphillis: chancre at site of infection. Painless firm ulcerated nodule, 3 wks after exposure. If untreated flu like illness with rash. Tertiary stage: dementia blindness. Rx: antimicrobials. Genital herpes: blisters on genitals, itching, painful. Antivirals. Genital warts: HPV, incubation up to 6 months, asymptomatic, may predispose to cervical or vulvar cancer.