Patho Exam 2 Questions with Answers 100% Correctly Verified Updated Solutions 2024/2025, Exams of Pathophysiology

Download Patho Exam 2 Questions with Answers 100% Correctly Verified Updated Solutions 2024/2025 and more Exams Pathophysiology in PDF only on Docsity! 1 / 39 Patho Exam 2 Questions with Answers 100% Correctly Verified Updated Solutions 2024/2025 1.Two major types of stroke include ischemic and hemorrhagic (T/F): True 2. Stroke is defined as: A. Bruising of the brain during blunt trauma in a closed-head injury B. An open head injury C. Sudden movement of the brain resulting in a diffuse but transient and reversible injury to the brain D.The rapidly developing loss of brain functions due to a disturbance in the blood vessels supplying blood to the brain: D. 3. Stroke may be caused by: A. Embolism B. Any of the above may contribute to stroke. C. Hypoperfusion D.Thrombosis: B. 4.Stroke is most commonly the result of a traumatic brain injury (T/F): false 5.A man experiences a stroke with left-sided hemiparesis. Based upon this information, you would expect his lesion to be on the left side. (T/F): false 6. Early signs of stroke include: A. Speech difficulty B. Facial droop C. Arm weakness D. Any of the above could be an early warning sign of stroke.: D. 7. Which of the following is a nonmodifiable risk factor for stroke? 2 / 39 A. High cholesterol B. High blood pressure C. Smoking D. Age: D. 8.Transient ischemic attacks (TIAs) can indicate you are at risk for stroke. (T/F): true 9. Treatment for stroke may include tissue plasminogen activator that acts to: A. Mechanically dislodge a clot B. Increase vasodilation C. Prevent clots from forming D. Dissolve already formed clots: D. 10.Angioplasty can be used to help restore blood flow. (T/F).: true 11.The region of the brain that contains the hypothalamus is the: A. Cerebral hemispheres B. Diencephalon C. Brain stem D. Cerebellum: B. 12.Head injuries are often characterized by problems with: Hypoxia Increased intracranial pressure Edema Any or all of the above: All of the above 13.Proprioception is relayed through which of the following sensory tracts: A. Fast myelinated fibers 5 / 39 Primary progressive Progressive relapsing: Relapsing-remitting 21.Which of the following statements is CORRECT about Alzheimer's disease (AD)? A. AD is a rare form of dementia. B. AD is highly curable but requires early detection. C. AD is progressive and eventually leads to death. D. AD has a rapid onset.: C. 22.A chronic neurodegenerative disorder associated with amyloid-beta in plaques that leads to memory losses would best be described as: Parkinson's Disease Alzheimer's Disease Multiple Sclerosis Amyotrophic Lateral Sclerosis: AD 23.The part of the brain that is largely responsible for regulating respiratory and cardiovascular function is the Cerebral hemispheres Diencephalon Brainstem Cerebellum: Brainstem 24.Nontraumatic disruption of the blood supply to an area of the brain is called Concussion Contusion 6 / 39 Stroke Aneurysm: Stroke 25.The sensory tracts that carry information about proprioception are char- acterized as ascending A. contralateral B. anterolateral system C. fast myelinated fibers D. carrying temperature information: C. 26.A neurologic disease that involves the destruction of the motor neurons is: Multiple sclerosis Parkinson's Disease Huntington Disease Amyotrophic Lateral Sclerosis: ALS 27.Voluntary movement may involve A. initiation of a motor command from the association cortex. B. creation of motor programs by regions of the brain such as the subcortical nuclei. C. transmission of these motor pathways along the descending motor path- ways to the brainstem and spinal cord. D. All of the above.: D. 28.Giving a patient atropine would result in A. blockage of synaptic transmission at all autonomic ganglia. B. prevention of sympathetic responses. 7 / 39 C. vasodilation of blood vessels in skeletal muscle. D. an increase in heart rate.: D. 29.Which of the following do autonomic nerves NOT control? Heart Rate Skeletal Muscle Contraction Vasoconstriction Intestinal Motility: skeletal muscle contraction 30.Which of the following statements about synaptic transmission is correct? A. Voltage-gated calcium channels in the pre-synaptic neuron allow calcium influx to cause neurotransmitter-containing vesicles to exocytosis neuro- transmitter into the synaptic cleft. B. Neurotransmitter is released from the postsynaptic cell once calcium enters the synaptic cleft. C. Neurotransmitter binding to the postsynaptic cell causes calcium uptake into that cell and action potential formation. D. All of the above: A. 31.The sensation of pain may be increased by histamine. prostaglandin E2. bradykinin. All of the above are correct.: all of the above 32.The type of hemorrhage or hematoma that involves collection of blood between the dura mater and the arachnoid mater is called a 10 / increase in the shunt fraction. D. Increased airway resistance would result from an increase in airway radius.- : C. 44.Which of the following respiratory structures would be found in the respi- ratory zone? Mucociliary escalator Trachea Bronchi Alveoli: alveoli 45.The rate and depth of ventilation depends upon A.The central chemoreceptors, located in the carotid and aortic bodies. B.The peripheral chemoreceptors, located in the medulla. C. The central chemoreceptors, which are the major receptors that stimulate ventilation in response to carbon dioxide. D.The peripheral chemoreceptors, which are most sensitive to changes in carbon dioxide and are not responsive to oxygen levels.: C. 46.A breathing pattern associated with metabolic acidosis that might be observed in a patient with diabetic ketoacidosis would be: a.Tachypnea b. Dyspnea c. Cheyne-stokes respiration d. Kussmaul respiration: D. 47.Which of the following variables is primarily altered in a person that suffers from pulmonary fibrosis? 11 / a. Increase the thickness of the respiratory membrane b. Decrease the surface area for gas exchange c. Decrease in the concentration gradient for oxygen across the respiratory membrane d. Increase in the diffusion constant for carbon dioxide across the respiratory membrane: a. 48.Jason smoked a considerable amount in college. One day, he experienced sharp chest pain and could not catch his breath. His roommate took him to the emergency room, where he was diagnosed with a collapse lung. Based upon the above information, Jason's condition would most likely be described as a a.Tension pneumothorax b. Secondary pneumothorax c. Spontaneous pneumothorax d. Traumatic pneumothorax: C. 49.Which of the following would most likely be associated with an increase in lung compliance? a. Pulmonary fibrosis b. Pulmonary edema c. Emphysema d. Pneumonia: C. 50.An abnormal collection of exudate in the pleural cavity that forms during an infection or as a consequence of an autoimmune disorder such as lupus, would be classified as which of the following types of pleural effusion? 12 / a. Hydrothorax b. Empyema c. Hemothorax d. Chylothorax: B. 51.Jane had a chest infection and was feeling short of breath, experiencing a sharp pain in her chest. Her nurse practitioner detected diminished breath sounds and chest x-ray revealed that Jane was suffering from a pleural effusion. Thoracentesis (a pleural tap) was performed to remove a sample of the fluid causing the effusion, and lymph was detected. Based upon this information, Jane is most likely suffering from a(n): a. Hydrothorax b. Empyema c. Hemothorax d. Chylothorax: D. 52.Which of the following about ventilation—perfusion matching is correct? a. Generally, both ventilation and perfusion are matched across the lungs with the lower portions of the lungs receiving less ventilation and perfusion. b. Blockage of an alveolus bc of a mucous plug would increase dead space. c. Blockage of a capillary bc of an embolism would increase the shunt fraction. d. A person with pulmonary edema would likely have an increase in the shunt fraction, which could lead to hypoxemia.: D. 53.A pulmonary vascular disease characterized by occlusion of blood flow because of a thrombus, lipids, or air bubble is best described as: a. Pulmonary hypertension 15 / 61.Our patient with COPD has a "prolonged expiratory phase" to his respi- rations. In the case of emphysema what is the most likely mechanism that underlies this slowing of forced expiration? a. Increased airway resistance due to mucous b. Loss of elastic recoil of the lungs c. Increased airway resistance due to inflammation d. Smooth muscle constriction of the airways: B. 62.Which of the following disorders best describes a condition characterized by acute lung inflammation and diffuse injury to the alveolocapillary mem- brane? a. Acute respiratory distress syndrome b. Asthma c. Bronchitis d. Emphysema: A. 63.The subjective sensation of not being able to get sufficient air is best described by which of the following terms? a. Dyspnea b. Eupnea c.Tachypnea d. Apnea: A. 64.Pleural effusions may result from a. increased capillary hydrostatic pressure b. decreased capillary permeability c. increased colloidal osmotic pressure d. decreased pressure in the lymphatic system: A. 16 / 65.Which of the following is NOT associated with the development of atelec- tasis? a. an increased production of surfactant b. airway obstruction by a mucous plug c. ineffective cough reflex d. anesthesia from surgery that promotes accumulation of bronchial secre- tions: A. 66. In ventilation and perfusion mismatching a. impaired ventilation leads to increases in dead space b. impaired perfusion leads to increases in the shunt fraction c. hypoxia rather than hypercapnia is characteristic, unless mismatching is severe d. increasing the inspired oxygen fraction will improve hypercapnia, but not hypoxia: C. 67.Restrictive disorders a. are characterized by an increased compliance. b. are characterized by a reduced forced expiratory volume of one second (FEV1). c. are characterized by decreased lung volumes such as vital capacity. d. include chronic bronchitis.: C. 68.Pulmonary vascular diseases include a. pulmonary embolism, where blood flow to the lungs are increased b. pulmonary hypertension, where increased hydrostatic pressure can lead to pulmonary edema c. cor pulmonale, characterized by enlargement of the left ventricle of the heart 17 / d. pulmonary edema, where decreased capillary permeability leads to fluid collection in the lungs: B. 69.Which of the following characteristics or parameters would be consistent with urinary or renal dysfunction? A. Extrarenal findings include edema or hypertension B. All of the above could be attributed to urinary or renal dysfunction. C. Increased frequency, urgency, and pain upon urination D. Elevated blood urea nitrogen (BUN) or creatinine levels: B. 70.Patients with renal failure may: A. Have both a decrease in hydrostatic pressure and an increase in osmotic pressure, which would account for the edema B. Require calcium supplementation because the kidneys normally activate vitamin D, which is required for the absorption of calcium from dietary sources C. Have an increased GFR that would account for the elevated creatinine and blood urea nitrogen (BUN) levels D. Suffer from anemia because they are unable to produce sufficient levels of renin: B. 71.A patient with renal failure is likely to also have hyperalbuminemia. (T/F)- : false 72.Loss of may result in shifts in colloidal osmotic pressure and contribute to edema in a patient with renal failure.: albumin 73.Renal failure may contribute to electrolyte disturbances including decreas- es in and increases in in the blood.: sodium; potassium 74.Renal failure is determined mainly by a in glomerular filtration 20 / 85.Patients with renal failure may a. suffer from anemia bc they are unable to produce sufficient levels of renin. b. require calcium supplementation bc the kidneys normally activate vitamin D, which is required for the absorption of calcium from dietary sources. c. have both a decrease in hydrostatic pressure and an increase in osmotic pressure, which would account for the edema d. have an increased GFR that would account for the elevated creatinine and blood urea nitrogen (BUN) levels.: B. 86.Diabetes insipidus a. is due to a lack of insulin secretion by the pancreas. b. may be caused by a lack of Anti-Diuretic Hormone (ADH, or vasopressin) secretion from the anterior pituitary. c. may be caused by a decreased ability of the kidney to respond to available ADH. d. is characterized by an elevated fasting blood glucose level.: C. 87.Which of the following statements is about diabetes insipidus is COR- RECT? a. Central diabetes insipidus may be treated by dDAVP, which is a synthetic replacement for vasopressin (or ADH). b. Nephrogenic diabetes insipidus may be treated with dDAVP, which is a synthetic replacement for vasopressin (or ADH). c. A person with central diabetes insipidus would have a normal level of ADH. d. Central diabetes insipidus is most often caused by chronic lithium inges- tion.: A. 21 / 88.A person with a recent sore throat that subsequently develops glomeru- lonephritis (GN) would most have their GN attributed to: a. Bacterial endocarditis b. Streptococcal infection c. Lupus d. Goodpasture's syndrome: B. 89.Which of the following complications of glomerulonephritis is character- ized by proteinuria, hypoalbuminemia and edema? a. Acute kidney failure b. Chronic kidney failure c. High blood pressure d. Nephrotic syndrome: D. 90.Which of the following would most likely be considered to be an ischemic cause of acute tubular necrosis (ATN)? a. Rhabdomyolysis b. Heavy metal exposure c. Shock d. Cisplatin treatment for cancer: C. 91.The Syndrome of Inappropriate Anti-Diuretic Hormone (SIADH) may be caused by a. excessive release of ADH from the kidney. b. excessive water intake. c. release of ADH from an ectopic source. d. increased reabsorption of sodium.: C. 92.The most common cause of acute renal failure (ARF) is 22 / a. acute tubular necrosis b. glomerulonephritis c. uremic syndrome d. obstructive uropathy: A. 93.A person in renal failure might also exhibit: a. hypercalcemia (increased concentration of calcium in blood). b. hyperaldosteronism c. anemia d. decreased BUN and serum creatinine concentration: C. 94.Urinary incontinence resulting from weak pelvic muscles or obesity is called a. stress incontinence. b. reflex incontinence. c. functional incontinence. d. overflow incontinence.: A. 95.A person with acute tubular necrosis (ATN) most likely would have a. Decreased BUN and creatinine levels b. Hyperkalemia c. Increased urine output d. Alkalosis: B. 96.The kidneys a. Regulate water and ion homeostasis b. Secrete hormones c. Make glucose from non-carbohydrate sources during starvation d. Carry out all of the above activities.: D. 25 / 108. Seth suffered a blow to his head that left him blind. Which one of the following brain structures would most likely result in blindness if sufficiently damaged? A.Thalamus B.Occipital lobe C.Cerebellum D.Brain stem: B. 109. Sam is in a coma. Which one of the following regions of the brain contains the "respiratory" and "cardiovascular" control centers, and governs "essen- tial" functions? A.Cerebral hemispheres B.Diencephalon C.Brain stem D.Cerebellum: C. 110. More severe TBI with bruising, may be partially reversible, but depends upon severity of injury: contusion 111. Focal pooling of blood: hematoma 112. Dilation of blood vessel that can lead to rupture: aneurysm 113. Sudden, uncontrolled electrical disturbance of brain: seizure 114. Deep state of prolonged unconsciousness: coma 115. Focal neurologic deficit due to ischemia or hemorrhage: stroke 116. Mild TBI with change in mental state, considered transient and reversible- : concussion 26 / 117. Sally suffered the sudden and focal neurological deficit from a vascular disorder that involved a thrombus. Which one of the following disorders would Sally most likely be suffering? A.Traumatic brain injury B.Subdural hematoma C.Ischemic stroke D.Aneurysm: C. 118. Pt was in a car crash and got a head injury. He was lucid, but later went into a coma. Which of the following is INCORRECT? A.He went into coma bc of secondary brain injury, which occurred as the body responded to initial injury. B.Secondary brain injury is structural damage that occurs at moment of trauma. C.Fluid accumulation can result from inflammation/edema and may increase ICP and cause more damage D.Secondary brain injury can worsen the damage caused by primary: B. 119. A rare autosomal dominant disease that results in progressive degener- ation of nerve cells in the brain: Huntington's disease 120. Progressive disease that destroys memory and other mental functions: - AD 121. Inflammation of brain or spinal cord; infection virus or prion: encephalitis 27 / 122. Degenerative CNS disorder resulting from loss of dopamine- producing cells leading to movement issues including tremors: PD 123. Immune attack of myelin in CNS causing potentially debilitating disease of brain/spinal cord: MS 124. Rare neurological disease that leads to progressive loss of motor neu- rons in brain and spinal cord: ALS 125. Inflammation/infection of meninges; infection bacteria or virus (or other)- : meningitis 126. Saul is suffering from a degenerative disorder of the central nervous system that is characterized by tremor, bradykinesia, rigidity and postural instability. Most likely Saul is suffering from which one of the following dis- orders? A.Parkinson Disease B.Amyotrophic Lateral Sclerosis C.Multiple Sclerosis D.Guillain-Barre Syndrome: A. 127. Which one of the following statements about the spinal cord is COR- RECT? A.Gray matter of the spinal cord contains both the sensory and motor tracks. B.Sampling cerebral spinal fluid (CSF) at or above the L1 level in the adult would avoid any risk of damaging the spinal nerves. C.Sensory information enters the ventral root, whereas motor information exits the dorsal root of the spinal cord. D.White matter contains myelinated fibers or tracts.: D. 30 / receptor Location: sympathetic ( ): norepinephrine; vasoconstriction 139. N eurotransmitter: Receptor Subtype: beta receptor Location: sympathetic ( and increased heart rate) Antagonist: : norepinephrine; vasodilation; propranolol 140. Which one of the following movement types is best described as "initi- ated at will, goal directed, and includes learned behaviors that improve with practice". A.Voluntary movement B.Reflex responses C.Rhythmic motor patterns D.Involuntary movement: A. 141. Which one of the following major sensory tracts carries information about slow pain? A.Fast myelinated fibers B.Slow myelinated fibers C.Unmyelinated fibers D.Dorsal fibers: C. 142. Increased Respiratory Rate: tachypnea 143. Increased rate and depth of ventilation seen in metabolic acidosis: Kuss- maul 31 / 144. True breathing rate: eupnea 145. Waxing and waning tidal volume seen in congestive heart disease: - Cheyne-Stokes 146. Sensation of breathlessness: dyspnea 147. Cessation of breathing: apnea 148. Kevin is suffering from pulmonary fibrosis. Which one of the following parameters of Fick's Law of Diffusion is most likely compromised in a person with pulmonary fibrosis? A.D B.A C.C D.X: D. X 149. Kathy is experiencing congestive heart failure and has a breathing pat- tern that involves a waxing and waning tidal volume with periodic apnea. This breathing pattern would best be described by which one of the following terms? A.Dyspnea B.Tachypnea C.Cheyne-Stokes respiration D.Kussmaul respiration: C. 150. Classify the following respiratory disorders as contributing to (A) Dead Space, or (B) Shunt: Atelectasis Pneumonia Pulmonary Embolism 32 / Mucous Plugging Cardiovascular Shock: B B A B A 151. Which one of the following conditions would most likely increase pul- monary shunt? (lack of ventillation) A.Emphysema B.Pulmonary embolism C.Atelectasis D.Pulmonary hypotension: C.Atelectasis = collapsing of lung 152. Kayla suffers from interstitial lung disease. When you look at her fingers you notice that they are deformed, appearing enlarged and bulging (bulbous). This physical sign related to her respiratory disease would best be classified as which one of the following signs? A.Dyspnea B.Cyanosis C.Clubbing D.Chronic cough: C. 153. Pleural effusion characterized by lymphatic fluid in the pleural space: - 35 / 167. What happens to compliance in a restrictive lung disorder?: Compliance is decreased, and this is an important indicator of a restrictive disorder 168. Identify three disorders that are restrictive airway disorders.: Pulmonary Fibrosis, Pulmonary Edema, Pneumonia 169. Blood/casts in urine with hypertension: nephritic syndrome 170. Most common type of GN often after respiratory infection in young adult that is isolated and self-resolving: IgA Nephropathy/Berger's Disease 171. Asymptomatic with elevated protein in urine detected during routine urinalysis: Isolated hematuria and/or proteinuria 172. Mild symptoms 1 - 4 weeks after Streptococcus pyogenes infection: - Post-infectious GN 173. Massive proteinuria with edema: Nephrotic syndrome 174. Goodpasture syndrome is one type, characterized as an autoimmune process and crescents with fibrin deposits: Rapidly progressive GN 175. Glomerular disorder characterized by massive protein losses in the urine and edema: A.Nephritic syndrome B.Nephrotic syndrome C.Post-infectious glomerulonephritis D.Chronic glomerulonephritis: B. 176. Sue is suffering from Goodpasture syndrome, a glomerular disease with a poor prognosis characterized by the formation of crescents that are initiated by the passage of fibrin into Bowman's space. Sue's glomerular 36 / disease would best be classified as which one of the following? A.Acute nephritic syndrome B.Rapidly progressive glomerulonephritis C.Nephrotic syndrome D.Chronic glomerulonephritis: B. 177. Which of the following causes of Acute Tubular Necrosis would be clas- sified as (A) ischemic, and which would be classified as (B) nephrotoxic? Rhabdomyolysis Embolism of renal arteries Shock Hemolysis Ingestion of "anti-freeze": B A A B B 178. Which one of the following statements about Acute Tubular Necrosis (ATN) is CORRECT? A.ATN is the most common cause of acute kidney injury. B.ATN would be classified as nephrotoxic if there is decreased perfusion or inadequate oxygenation to the renal tubules. 37 / C.ATN, would be classified as ischemic when there is direct exposure of the kidney to substances that are harmful to the kidney. D.All of the above statements about acute tubular necrosis are correct.: A. 179. Which of the following would most likely result in nephrotoxic acute tubular necrosis? A.Rhabdomyolysis B.Shock C.Hypoperfusion D.Renal artery stenosis: A. 180. A. Pre-Renal; B. Renal/Intra-Renal/Intrinsic; C. Post- Renal Acute Tubular Necrosis Renal Calculi Shock Polycystic Kidney Disease Urethral Stricture: B C A B C 181. Seth was in a car accident and lost a lot of blood. Consequently, he suffered acute kidney injury. Based upon blood loss alone, you surmise that Seth's acute kidney injury would most likely be classified as: A.Prerenal B.Intrinsic renal 40 / Urge Incontinence 191. Increased urea in the blood: Uremia 192. Frequent or constant dribbling of urine due to a bladder that does not completely empty: Overflow Incontinence 193. Failure to empty the bladder, typically due to LMN dysfunction and can result in overflow incontinence: Flaccid Neurogenic Bladder 194. Clinical S/S related to excess nitrogen-containing substances in the blood: Uremic Syndrome 195. The loss of which one of the following processes (related to renal func- tion) would contribute to the negative calcium balance observed in some end stage renal patients? A.Excretion of urea B.Secretion of erythropoietin C.Activation of vitamin D D.Gluconeogenesis: C. 196. Suzanna is a four-year-old with aniridia (absence of the iris) and hemihy- pertrophy (enlargement of one side of the face or body). Most likely Suzanna is suffering from which one of the following disorders? A.Urinary incontinence B.Urinary tract infection C.Wilms' tumor D.Bladder cancer: C. 197. Regions of the Brain: - : higher perceptual, cognitive, motor functions, visual cortex - : hypothalamus + thalamus 41 / - : medulla + pons + midbrain (reticular formation) - : movement: - cerebral hemispheres - diencephalon - brainstem - cerebellum 198. Protections of the CNS: - —the brain and spinal cord are enclosed in the skull and vertebral column that offer protection. - —three connective tissue membranes that protect CNS structures. - —is a watery broth (plasma-like) in ventricles that provides a watery cushion. - —separation between blood and neurons—relatively impermeable capillaries that prevent access to brain.: - bone - meninges -CSF - blood-brain barrier 199. : protective membranes that cover brain/spinal cord: dura mater + arachnoid mater + pia mater’ brain protection: -meninges 200. Causes of meningitis: - :Streptococcus pneumoniae (pneumococcus); Neisseria menin- gitidis (meningococcus); Haemophilus influenzae (haemophilus); Listeria monocytogenes (listeria) - Viral/other: enteroviruses, herpes virus, arboviruses:: cancer, drugs ( , , IV Ig), diseases ( ): - NSAID's, abx 42 / - lupus 201. S/Sx of meningitis (3): fever, headache, stiff neck 202. In our patient case, meningitis gave rise to ’ led to tension, left ventricular hypertrophy (an adaptation to the problems with the blood pressure ’ BP overtime; heart remodels to try to increase ), pulmonary edema, decreased EF: -sepsis - hypotension; low; contractility 203. level/state of awareness and orientation, response to stimuli (RAS): con- sciousness 204. deep state of prolonged unconsciousness: coma 205. mild TBI with change in mental state, considered transient and reversible- : concussion 206. more severe TBI with bruising, may be partially reversible, but depends upon severity of injury: contusion 207. Primary (1) vs Secondary (4) Brain Injury: Primary (immediate) Secondary (delayed, inflammation, edema, ICP) 208. hematoma: collection of blood under the dura mater: subdural 209. hematoma: collection of blood above the dura mater: epidural 210. hematoma: bleeding in the brain due to trauma, aneurysm, or hypertension: intracerebral 211. cerebrovascular diseases: 45 / = surgery, clipping, coiling: -type disease; genetics + environment; most common disorder affecting CNS; autoimmune process implicated: - de- myelinating -immune-mediated 216. S/Sx of MS: related to loss: autonomic, visual, motor or sen- sory : muscle , coordination, speech, visual, fatigue, pain.: - neurologic - losses - weakness 217. Classifications of MS: - = The first episode of neurologic symptoms; does not yet meet diagnostic criteria for MS - = fluctuating course of relapses with associated neurologic deficits, followed by periods of relative quiet - = Disease progression from onset, without plateaus or remissions or with occasional plateaus and temporary minor improvements - = initial relapsing-remitting MS that suddenly begins to have decline without periods of remission: - clinically isolated syndrome (CIS) - relapse-remitting MS (RRMS) - primary progressive MS (PPMS) - secondary progressive MS (SPMS) 218. : skin area supplied by single spinal nerve 46 / : skin area that sends information along a single afferent neuron : afferent neuron + all receptors send information along it: - der- matome - receptive field - sensory unit 219. Pain: - = no physiologic cause - = physiologic cause - = originates from within nervous system - = originates from outside nervous system: - Psychogenic - Somatogenic - neuropathic - nociceptive 220. Fast pain= sticky, stabbing, well pain; travels on the fibers; acute Slow= more dull, ache, very ; and travels on the fibers; chronic: - well localized; slow-myelinated - diffuse; unmyelinated 221. Pain Regions: = superficial pain usually involving the skin; fast pain; example = comes from sources such as blood vessels, joints, tendons, mus- cles, and bone; fast and slow pain; ex. (2) = a poorly localized, dull, or diffuse pain that arises from the abdom- inal organs; slow pain; ex. (2): - cutaneous; paper cut 47 / - deep somatic; arthritis and sprained ankle -visceral; MI and GI pain 222. Pain: pain perceived at a location other than the site of the painful stimulus Pain: pain coming from body part that is no longer there that results from sensations originating in the spinal cord and brain; use can reduce incidence of this pain by blocking mapping during amputation process Pain: transitory flare of pain in the context of chronic pain: - referred - phantom limb; Epidural - breakthrough 223. Pain modulators from damaged tissue, inflammation, cell death ( , prostaglandins, serotonin, bradykinin), or from nerve terminals ( ): - histamine - substance P 224. ’are a naturally released substance which helps prevent or modulate the release of substance P to mitigate pain: endorphins 225. Endorphins (e.g.,): peptides activate opiate receptors to reduce pain: enkephalin 226. motor division innervates the skeletal muscle; involve voluntary, reflexes, and rhythmic motor patterns: somatic 227. motor system sends involuntary commands to cardiac/smooth muscle, and glands: autonomic 228. Neurons that control the lower motor neurons as well as the 50 / 243. s/sx of respiratory disease; selective bulbous enlargement of distal seg- ment: clubbing 244. s/sx of respiratory disease; lack of oxygen: hypoxia 245. Gas exchange requires and matching: ventilation and perfusion 246. type of respiratory disease with no ventilation; mucus plug; pneumonia primary examples include - atelectasis, pulmonary edema, airway obstruction, bronchial constriction: Shunt 51 / 247. no perfusion; pulmonary embolism; pulmonary hypotension; anything that decreases perfusion; ALWAYS emphysema is classified as this type of respiratory disease: dead space 248. is the blockage of an artery in the lungs that has moved from elsewhere (embolism).: Pulmonary embolism (PE) 249. is common source of embolism (clots) in pulmonary em- bolism: Deep vein thrombosis (DVT) 250. Virchow's triad: 2 of 3 (or more) puts patient at risk of DVT.: - hypercoagu- lability - circulatory/venous stasis - vascular/endothelial injury 251. When diagnosing a pulmonary embolism, we know it is a clotting event if there is a positive test ; angiography; or scan, but this scan doesn't necessarily tell if it is a clotting based process: D- dimer V/Q 252. Tx of pulmonary embolism: anticoagulants (prevent clot: ) and thrombolytic (attack already formed clot: ): heparin tPA 253. Virchow's Triad for DVT: - ESTROGEN -INFLAMMATION -DEHYDRATION - major surgery/trauma 52 / - pregnancy - infection and sepsis - IBS: hypercoagulability 254. Virchow's Triad for DVT: -physical trauma, strain, or injury - microtrauma to vessel wall.: vascular damage 255. Virchow's Triad for DVT: - congenital abnormalities affecting venous anatomy - low heart rate (bradycardia) - low blood pressure (hypotension): circulatory/venous stasis 256. stretch of the lungs under pressure: compliance 257. tries to collapse alveoli; opposed by surfactant: surfactant 258. air in pleural space between lung and chest wall: pneumothorax 259. T ypes of Pneumothorax: no trauma: spontaneous 55 / 277. B est test for obstructive airway disorders: FEV1/FVC ratio being - or any airway flow, peak flow, etc: reduced 278. Restrictive. airway disorders - in compliance and lung volumes - FEV1/FVC ratio : - Decrease - increased 279. Long-term inflammatory disease that leads to airway obstruction; ob- structive: asthma 280. in asthma we see: forced expiratory volume in one second (FEV1), airway resistance (due to reduced ) leads to obstruction of airflow.: - decreased - radius 281. Tx of asthma: opens airways and reduces residual volume: bron- chodilation 282. Tx of asthma: = a non- specific beta adrenergic agonist that can relax airway smooth muscle, but activates the beta1 (cardiovascular, tachy- cardia) and beta2 (bronchial smooth muscle); activation of is more ideal: -epinephrine - beta 2 283. Tx of asthma: relax airways and can reduce mucus production- : anticholinergics 284. Tx of asthma: drugs help with 56 / inflammation that underpins asthma; such as glucocorticoids and corticosteroids: anti-inflammatory 285. Pulmonary Fibrosis Pulmonary Edema Pneumonia These are all considered airway disorders: restrictive 286. Other respiratory diseases: - (general term, any condition affecting the blood vessels in lung) - : blockage of one or more pulmonary arteries in lungs - : high blood pressure in the arteries in lungs - inability to maintain gas exchange - : fluid in alveoli; alveolar capillary destruction of the lungs; sepsis; inhalation of harmful substance; severe pneumonia; COVID-19; pancreatitis Lung cancer:: - pulmonary vascular - pulmonary embolism - pulmonary hypertension - acute respiratory failure - acute respiratory distress syndrome 287. Respiratory volumes are decreased in a person with pulmonary fibrosis, by increasing : thickness 288. In pulmonary fibrosis: Low PaO2 and O2 sat indicate compromise to ( X); low PaCO2 suggests easier to exchange ; greatest compromise is to getting oxy- gen across when the gas exchange time is reduced with increased blood pressure/flow during .: - gas exchange; 57 / increase - CO2 - exercise 289. Kidney Functions: = process whereby renal tubules return materials necessary to the body back into the bloodstream = blood pressure forces water, small solutes (not large ones) across filtration membrane; efficient and passive, but nonspecific - useful nutrients also pass through = active, selective uptake of molecules that did not get filtered into Bowman's capsule; occurs in tubules of nephron = release from the body: reabsorption filtration secretio n excretio n 290. is working to facilitate sodium reabsorption and potassium excretion: Aldosterone 291. diuretics ex. hydrochlorothiazide for nephrogenic DI; de- crease potassium and magnesium, absorb calcium; work by inhibiting the Na+/Cl- transporter in the distal convoluted tubule (DCT): Thiazide 292. diuretics;ex.mannitol; works by shifting the osmotic balance at the. capillary beds: osmotic 60 / 306. ATN: - anything that reduces blood flow - Shock, hypoperfusion, renal artery stenosis: ischemic 307. In our patient, we saw evidence of both types of ATN: toxic ( and ); ischemic ( ): - hemolysis + crush injury (rhabdo) - hypoperfusion 308. ATN is reversible if you can manage the : underlying issues 309. ATN leads to AKI: urinary sodium BUN, Cr renal blood flow GFR decreased urine output ( ): - increased - elevated - decreased -decreased -oliguria 310. Why do we get high BP (hypertension) related to renal dysfunction (ATN)? (2): - decreased blood volume - RAAS to increase kidney perfusion 311. In renal disorders: reduced perfusion 61 / shock: pre 312. In renal disorders: Obstructive Uropathy Renal Calculi Enlarged Prostate Urethral Stricture: post 313. In renal disorders: intrinsic; within the kidney Direct Damage Inflammation Infection ATN Polycystic Kidney Disease: renal (intrarenal) 314. Polycystic Kidney Disease: adult (ADPKD) fairly common leads to autosomal : - end stage renal disease (ESRD) - dominant 315. polycystic kidney disease: - infantile (ARPKD) - rare - high mortality 62 / - autosomal : recessive 316. Renal Calculi Types: (80%; most common) (10 - 15%: UTI) (5- 10%: gout) (rare, genetic mutations): - calcium - struvite - uric acid -cystine 317. : infection of any part of urinary tract cystitis ( ) pyelonephritis ( ) - major C.A. = E. coli urethritis ( ): UTI bladder kidne y urethr a 318. Risk Factors of UTI: - no associated - Female anatomy ( ) - sexual intercourse (connection to urinary system) - - - (instrumentation risk): - genetic 65 / ADH dDAVP 328. Nephrogenic DI is treated with (diuretic): removes fluids earlier so that there is less fluid to be lost due to lack of ADH response.: hydrochloroth- iazide 329. sudden decline in GFR; elevation in SCr, BUN, electrolytes; clinical spec- trum that requires prompt identification of underlying cause and rectification- : acute kidney injury (AKI) 330. kidney damage or decreased GFR > 3 months; albuminuria, urine casts, abnormal biopsy: chronic kidney disease (CKD) 331. long-term diseases associated with CKD: , ; de- creasing GFR for staging.: diabetes; hypertension 332. In end stage renal disease (ESRD), person will not survive without (2): - dialysis or transplant 333. spastic neurogenic bladder: failure to ; motor neuron dysfunction; hyperreflexive; IC: store; upper; urge 334. flaccid neurogenic bladder: failure to ; motor neuron dysfunction; hypotonic; IC: empty; lower; overflow 335. Incontinence: : overactive bladder : increased abdominal pressure; obesity; pregnancy; poor 66 / sphinc- ter/hypermobility of bladder neck or urethra : poor bladder contraction/urethral blockage Mixed: urge stress overflo w 336. Key goal of incontinence for pregnant women: exercises to try to restrengthen the to make sure to maintain retention of urine so that continence comes back after pregnancy: stress; pelvic floor 337. Cancers that cause kidney injury: '; cell carcinoma; cancer: Wilms'; renal; bladder 338. = decreased sodium in the blood = increased potassium in the blood RAAS ’ increases sodium reabsorption and increases potassium se- cretion loss of protein = loss of oncotic osmotic pressure = : hyponatremia hyperkalemia aldosterone edema 339. Systemic manifestations of renal failure might include congestive heart failure (CHF) and pulmonary edema (PE). How could these occur as a result of renal failure? CHF= PE = : increased HTN increased hydrostatic 67 / pressure 340. Would a protein restricted diet be beneficial in someone with acute kidney injury? - controversial: need to have sufficient protein, but may limit excess protein since protein is source of .: BUN 341. Why do patients with chronic renal failure often have anemia? What would you give to such a patient?: erythropoietin loss recombinant EPO 342. In persons with renal failure, there is often a decreased activation of vitamin D3. How might this alter calcium homeostasis? - Calcium Balance: decreased vitamin D3 activation = cal- cium absorption: - negative -decreased