NUR 2063 Pathophysiology final exam Questions with Verified Answers (Latest Update 2025) G, Exams of Nursing

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Gastritis and Etiology and patho - correct answers ✅inflammation of stomach's mucolas lining (can involve entire stomach or region) can be acute or chronic. may be caused by h. pylori infection (imbeds in mucosal layer activating toxins and enzymes that cause inflammation. NSAIDS, chronic alcohol consumption, stress, trauma, burns, or infections, autoimmune conditions manifestations of gastritis - correct answers ✅indigestion, heartburn, epigastric pain, abdominal cramping, nausea, vomiting, anorexia, fever, malaise. hematemesis and dark, tarry stools indicate ulceration and bleeding. chronic gastritis increases risk for peptic ulcers, gastric cancer, anemia, and hemorrhage. gastritis diagnosis/treatment - correct answers ✅h&p, GI tract x ray, egd, serum h. pylori antibodies, h. pylori breath test, stool analysis (h. pylori and occult blood treatment-acute is self limiting ususally resolves meds-antacids, acid-reducing agents, and mucosal barrier agents other strategies include those for GERD (diet, small meals, antacids)

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Peptic ulcer disease (PUD) - correct answers ✅refers to erosive lesions affecting the muscularis mucosa of the stomach or duodenum. ulcers vary in size and severity, ranging from superficial erosions to complete penetration through GI tract wall peptic ulcer disease etiology and patho - correct answers ✅ETIOLOGY: most commonly H. pylori and NSAID use. PATHO: develops because of an imbalance between destructive forces and protective mechanisms PUD duodenal ulcers - correct answers ✅most commonly associated with excessive acid or H. pylori infections typically present with epigastric pain relieved in the presence of food PUD gastric ulcers - correct answers ✅less frequent-more deadly typically associated with malignancy and NSAIDS pain worsens with eating

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PUD Stress ulcers - correct answers ✅develop because of major physiological stressor on body due to local tissue ischemia, tissue acidosis, bile salts entering stomach, and decreased GI motility most frequently develop in stomach; multiple ulcers can form within hours of the precipitating event often hemorrhage is the first indication (vomiting blood or blood in stool) PUD manifestations/treatment - correct answers ✅epigastric, abd. pain, abd. cramping, heartburn, indigestion, chest pain, nausea/voimiting, melena (dark, tarry stools), fatigue, unexplained weight loss Treatment: same as gastritis: antacids, mucosal barrier agents, acid-reducing agents possible surgical repair Iron-deficiency Anemia - correct answers ✅Not enough iron for hemoglobin production erythrocytes pale and small Etiology: decreased iron consumption/absorption, increased bleeding manifestations in addition to "anemia": brittle nails, headache/irritability, pica, cyanosis of sclera of eyes, delayed healing

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Anemia - correct answers ✅common acquired or inherited disorder of erythrocytes that impairs the bloods oxygen-carrying capacity. ETIOLOGY: decrease in # of circulating erythrocytes, reduction in hemoglobin content, presence of abnormal hemoglobin MANIFESTATIONS: weakness, fatigue, pallor, syncope, dyspnea, tachycardia Pernicious anemia - correct answers ✅B12 deficiency or megaloblastic anemia large, immature erythrocytes. usually lack of intrinsic factor (protein necessary for b12 absorption in stomach) b12 is needed for cell division and maturity. too little b12 gradually causes neuro problems because of the breakdown in myelin, neuro effects may be seen before anemia is diagnosed. Additional manifestations: bleeding gums, diarrhea, impaired smell, DTR loss, anorexia, personality/memory changes, + babinski sign, stomatitis, paresthesia of hands and feet, unsteady gait

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aplastic anemia - correct answers ✅bone marrow fails to make enough blood cells leading to pancytopenia MANIFESTATIONS: general anemia, leukcytopenia, and recurrent infections can be caused by cancers, cancer treatment, pesticides Sickle cell anemia - correct answers ✅genetic, hemoglobin-s trait vs. gene crescent shape during times of hypoxia, can clump together and clog vessels. MANIFESTATIONS: swelling in hands and feet, sickle cell crisis, abd. pain, bone pain, jaundice, skin ulcers, stroke, chest pain tissue ischemia and necrosis. electrophoresis and stem cell transplant may cure thalassemia - correct answers ✅genetic, not RBC problem, hemoglobin problem. lack one or 2 proteins that make up hemoglobin MANIFESTATIONS: heart failure, splenomegaly, hepatomegaly, bone deformities, jaundice, fatigue, dyspnea Idiopathic thrombocytopenia purpura (ITP) - correct answers ✅hypocoagulopathy due to immune system destroying its own platelets

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(autoantibodies) Circulating IgG reacts with the platelets which are then destroyed in the spleen and liver. can be acute or chronic ETIOLOGY: idiopathic, autoimmune disease, live vaccines, immunodeficiency disorders, viral infections Manifestations: abnormal bleeding (petechiae, epistaxis [nose bleed], hematuria) ACUTE TREATMENT: glucocorticoid steroids, immunoglobulins, plasmapheresis and platelet pheresis CHRONIC TREATMENT: splenectomy, blood transfusions, immunosuppressants Thrombotic thrombocytopenia purpura - correct answers ✅coagulation disorter d/t deficiency of enzyme responsible for cleaving von Willebrand factor increased clotting which decreases available platelets --> bleeding under skin and purple colored spots called "purpura" manifestations: thrombi>thrombocytopenia>bleeding purpura, LOC changes, confusion, fatigue, fever

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Thrombocytopenia - correct answers ✅a condition in which there is an abnormally small number of platelets circulating in the blood hemostasis - correct answers ✅stoppage of bleeding

1. vasospasm (vasoconstriction)-brief reflex blood vessel narrows to decrease blood flow to injury and increase bp
2. platelet plug formation-involves activation, aggregation, and adherence of platelets into a plug that serves as a barrier against blood flowing out of vessel. 3 coagulation-or clotting changes blood into gel through cascade of events. fibrin mesh is cleaved from fibrinogen. fibrin acts like glue during clot formation holding the platelet plug together. Once blood flow is stopped tissue repair can begin parathyroid hormone (PTH) - correct answers ✅Works in opposite way to calcitonin to regulate serum calcium levels. PTH secreted with Ca levels drop. PTH increases osteoclast activity which releases Ca from bone. Also increases absorption of Ca in GI tract and kidneys. PTH also regulates phosphate levels by reducing renal reabsorption of phosphate in proximal tubule and increasing the uptake from the intestines and bones into blood

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hyperparathyroidism and etiology - correct answers ✅condition of excessive PTH production by parathyroid glands causes: tumors, hyperplasia, chronic hypocalcemia (renal failure) hyperparathyroidism manifestations/treatment - correct answers ✅osteoporosis, renal calculi, polyuria, abd. pain, constipation, fatigue, weakness, flaccid muscles, dysrhythmias, hypertension, depression, forgetfulness, Cushing's syndrome - correct answers ✅excessive cortisol that results from the increased ACTH levels Cushing's syndrome etiology - correct answers ✅iatrogenic from ingestion of glucocorticoid meds, adrenal tumors that secrete glucocorticoids, pituitary tumors that secrete ACTH and cortisol, and paraneoplastic syndrome (rare disorders triggered by abnormal immune response to a cancerous tumor called neoplasm) Cushing's syndrome treatment - correct answers ✅gradual tapering of any glucocorticoids

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tumors may need surgery and radiation meds to control cortisol production interventions to manage complications Cushing's manifestations - correct answers ✅moon face, obesity, buffalo hump, muscle weakness/wasting, delayed growth, acne, broad purple striae, thin bruisable skin, delayed healing, hyperpigmentation (due to ACTH), increased infections, osteoporosis, hirsutism (abnormail hair growth), glucose intolerance, hypertension, dyslipidemia, edema, hypokalemia, mood changes Growth Hormone (GH) - correct answers ✅stimulates cell growth and fat breakdown. primary targets are muscle and bone, where GH stimulates amino acid uptake and protein synthesis. Anterior Pituitary gland Type 1 diabetes mellitus, etiology - correct answers ✅develops when body's immune system destroys pancreatic beta cells. etiology-unknown, most likely viral or environmental trigger in genetically susceptible people.

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manifestations of diabetes mellitus - correct answers ✅polyuria, polydipsia, polyphagia hyperglycemia, glucosuria, weight loss, blurred vision, fatigue hypoglycemia manifestations - correct answers ✅weak, double or blurred vision, hunger, tachycardia, palpitations hyperglycemia manifestations - correct answers ✅-urinary frequency, anorexia, dry mouth long term complications of diabetes mellitus - correct answers ✅hyperglycemia, DKA, hypoglycemia, heart disease, stroke, HTN, diabetic retinopathy, blindness, kidney disease, amputations, periodontal disease, preg complications, increase susceptibility to infections, erectile dysfunction. high blood glucose can harden vasculature Type 2 diabetes causes - correct answers ✅starts out as insulin resistance. ofter overweight

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treatment for diabetes mellitus - correct answers ✅Type 1 Insulin therapy Type 2 Lifestyle changes Oral drug therapy Insulin when the above no longer provide glycemic control Diabetes insipidus etiology - correct answers ✅-almost half of the cases are idiopathic -The other half are usually attributed to head trauma resulting in damage to the pituitary gland or hypothalamus -Causes insufficient secretion of antidiuretic hormone (ADH) -This allows excessive water to be excreted by the kidneys Addisonian crisis/adrenal crisis - correct answers ✅onset of severe symptoms usually triggered by acute infection, trauma, surgery, or sodium loss.

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manifestations: profound fatigue, dehydration, vascular collapse (decreased BP), renal shut down, decreased serum Na, increased serum K Hyperthyroidism etiology - correct answers ✅excessive iodine, graves disease (autoimmune stimulates thyroid hormone production), thyroid tumors nonmalignant, goiter, inflammation, thyroid hormone replacement meds, high levesls of serum human chorionic gonadotropin hyperthyroidism manifestations and treatment - correct answers ✅sudden weight loss, tachycardia, dysrhythmias, hypertension, increased appetite, nervousness/anxiety, diff. concentrating, tremor, diaphoresis, increased sensitivity to heat, diarrhea, goiter, exophthalmos thyroid storm - correct answers ✅a relatively rare, life-threatening condition caused by exaggerated hyperthyroidism. fever, decreased mental alertness, abdominal pain hypothyroidism etiology - correct answers ✅iatrogenic, hashimotos

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hypothyroidism manifestations and treatment - correct answers ✅fatigue, sluggishness, pale dry skin, hoarseness, hypercholesterolemia, myalgia, weakness, brittle fingernails, bradycardia, hypotension, constipation, depression, goiter increased TSH, low t3 and t hormones to treat-levothyroxine stress hormones - correct answers ✅Epinephrine and norepinephrine, secreted as part of the reaction of the nervous system to stress. hormones that increase glucose - correct answers ✅glucagon, epinephrine, growth hormones, cortisol stress response - correct answers ✅bodys effort to restore balance, damaging when repeatedly activated. fight or flight, epinephrine, norepinephrine, cortisol tumor staging - correct answers ✅T-tumor N-nodes involved

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M-metastasis staging-location and patterns of spread, size, extent, lymph node and organ involvement, distant metastsis Malignant tumors - correct answers ✅can kill host confirmed by invasive or metastasizing nature tissue specific differentiation (does not closely resemble tissue of origin) grows rapidly, established blood supply (angiogenesis) may initiate tumor vessel growth frequently necrotic dysfunctional-invade and overrun neighbors, gain ability to migrate Benign tumors - correct answers ✅can be life threatening because of area or size does not invade adjacent tissue or spread many are encapsulated more closely resemble original tissue type slower growing

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little vascularity rarely necrotic often retains original function tumor grading (staging-tnm) - correct answers ✅grading histological characterization of tumor cells degree of anaplasia 3 or 4 classes of increasing degrees of malignancy greater degree of anaplasia=greated degree of malignant potential inflammatory response-innate defese - correct answers ✅triggered by damate/trauma to body tissue erythema, edema, heat, pain leukocytes line vessels walls and migrate to interstitial space phagocytosis begins fibrinogen > fibrin which walls area of injury and contains foreigh substances new cells formed as healing process begins

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innate defenses - correct answers ✅physical and chemical barriers skin/mucous membrane bacteriostatic layer on skin hydrochloric acid in stomach ters and saliva lysozyme (disolves bacteral cell walls) inlammation pyrogens-released by macrophages, travel to hypothal. cause fever interferons-interefere with spread of viral spread-cells last dying protection complement proteins-membrane attack complex, embeds in bacteria and allows water inflow and lysis. also stimulate vasodilation, increase cas. permeability, promote phagocytosis adaptive (acquired defenses) - correct answers ✅immune system, cellular and humoral Cellular immunity - correct answers ✅T cells produced in bone marrow, mature in thymus. regular cells : helper t cells activate b cells to produce antibodies

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supressor t cells turn it off Effector cells (killer cells/cytotoxic cells): destroy infected cells by degrading cell walls humoral immunity - correct answers ✅B cells mature in marrow-become memory cells or immunoglobulin secreting antibody cells Each B cell has receptor for antigen antibody-producing cells: quicker response on subsequent exposure because memory cells recall antigen as foreign and response is quicker (acquired immunity) capillary hydrostatic pressure - correct answers ✅outward push of vascular fluid against capillary walls interstitial fluid colloid osmotic pressure - correct answers ✅inward-pulling force of particles in the interstitial fluid antidiuretic hormone (ADH) - correct answers ✅tap water hormone=kidneys reabsorb plain water

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released from pituitary gland secreted in response to increased osmolality of ECF, decreased circ. blood volume, pain, nausea, stress ETOH (alcohol) decreased ADH release-promotes diuresis Aldosterone - correct answers ✅salt water hormone secreted in response to decreased circulating blood volume and in response to hyperkalemia kidneys reabsorb Na+ water; expands extracellular fluid volume, decreased urine volume Natriuretic peptides (ANP and BNP) - correct answers ✅stored in cardiac cells, released when tissue is streched from increased vascular volume promotes Na secretion in urine opposite action of aldosterone, not as strong Normal serum Na+ - correct answers ✅135-145 mEq/L

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Hyponatremia and causes - correct answers ✅<135 mEq/L, ECF has too much water from amount of sodium ions present, more dillute than normal Excessive ADH (SIADH) excessive intake of hypotonic solution, causes cells to swell diuretic use, GI losses, sweating, adrenal insufficiency, dietary sodium restrictions excessive water, hyperlycemia (excess glucose in blood attracts water from the intracellular and interstitial spaces), excessive water ingestion, renal failure, heart failure Hyponatremia manifestations - correct answers ✅Mild: malaise, anorexia, nausea, vomiting, headache Severe: confusion, lethargy, seizures, coma, fatal cerebral herniation poor skin tugor, dry mucous membranes, BP changes, pulse changes, edema, headache, diminished DTRs, muscle weakness treatment for Hyponatremia - correct answers ✅treat underlying cause

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restricting water, increase sodium, administering corticosteroids for addison's disease Correction of sodium leves done slowly to not overload heard from fluid shifting into the intravascular space. Seizure precautions, neuro checks Hypernatremia causes - correct answers ✅>145 mEq/L ECF contains too little water from amt of sodium present, cells shrivel. also called water deficit, hypertonic syndrome, hyperosmolality causes: inadequate water intake or excess excretion concentrated tube feedings hypertonic saline infusion loss of more water that salt: osmotic diuresis, diabetes insipidus Hypernatremia manifestions - correct answers ✅mild: thirst, oliguria, confusion, lethargy severe: seizures, coma, death

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increased temp, warm flushed skin, dry and sticky mucous membranes, dysphagia, weak/thready pulse edema hypernatremia treatment - correct answers ✅underlying cause. replace water and remedy electrolyte deficits. glucose-electrolyte solutions. IV hypotonic solutions. don't want to do too rapid because of cerebral edema neuro checks Normal potassium K levels - correct answers ✅3.5-5 mEq/L most potassium is inside cell hypokalemia causes - correct answers ✅decreased intake shift into cell (insulin administration) increased excretion, usually renal v/d, ng suction, fistulas, laxatives, diuretics, cushing syndrome (decreases sodium excretion, with increases potassium excretion) corticosteroids

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alkalosis-decreased serum hydrogen causes potassium to shift into cells hypokalemia symptoms - correct answers ✅cardiac: ectopic beats, alteration in conduction, dysrhythmias, cardiac arrest abdominal symptoms: distension, diminished bowel sounds, paralytic ileus Muscle symptoms: bilateral muscle weakness, respiratory paralysis hypotension, paresthisa, hyporeflexia, hyperkalemia causes - correct answers ✅deficient excretion: renal failure, addison's disease, excessive intake, increased release from cells with acidosis, burns hyperkalemia manifestations - correct answers ✅intestinal cramping, diarrhea muscle weakness cardiac dysrhythmias or cardiac arrest

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hyperkalemia treatment - correct answers ✅underlying cause prior to treating hyperkalemia. calcium gluconate to minimize dysrhythmias decrease K+ intake kayexalate IVF potassium-losing diuretics, dialysis insulin infustion with glucose-containing IVF Normal serum calcium range - correct answers ✅8.6-10.2 mg/dL or 4-5 mEq/L Hypocalcemia causes - correct answers ✅decreased intake or absorping/lack of Vitamin D decreased physiologc availability-excessive phosphate, hypoparathyroidism increased excretion: steatorrhea and pancreatitis (Ca+ binds to fat and excreted in feces hypoparathyroidism, renal failure, hyperphosphatemia, hypomagnesemia, alkalosis, pancreatitis, calcitonin,

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hypocalcemia manifestations - correct answers ✅decreases the threshold potential, causing hyperexcitability of neuromuscular cells positve trousseau and chvostek sign paresthesias, twitching/cramping, tetany, laryngospasm, hyperactive reflexes, siezures, cardiac dysrhythmias or heart failure hypocalcemia treatment - correct answers ✅underlying cause, oral supplement, IV calcium gluconate, Vitamin D supplements, limit phosphorus intake hypercalcemia causes - correct answers ✅increased intake or absorption, shift from bone to ECF-hyperparathyroidism, immobilization, bone tumors hypercalcemia manifestations - correct answers ✅muscle weakness, diminished reflexes, cardiac dysrhythmias anorexia, nausea, emesis, fatigue, polyuria, constipation, headache, personality changes, renal calculi, pathologic fractures

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hypercalcemia treatment - correct answers ✅treat underlying cause. manage dysrhythmias oral phosphate increase mobility calcitonin IVF diuretics Normal Serum magnesium levels - correct answers ✅1.8-2.4 mEq/L magnesium ions present in bound and unbound ionized forms hypomagnesemia cuases - correct answers ✅decreased intake/absorption: chronic alcoholism, malnutriton, diarrhea excessive excretion hypomagnesemia manifestations - correct answers ✅insomnia, hyperactive reflexes, muscle cramps, twitching, grimacing, positive Chvostek and Trousseau sign nystagmus, dysphagia, ataxia, tetany, seizures, cardiac dysrhythmias