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patho final exam with complete solution
1. what can cause constipation: --functional or mechanical condition- disorders of the pelvic floor
in females -rectocele --low residue diet- not enough fiber --sedentary lifestyle --excessive use of antacids--decrease motility --changes in general-can be due to aging, no access to toilets, pregnancy, IBS
2. what can cause diarrhea: -can be related to a bacteria or virus
-change to the mucosal lining -excessive secretion of fluid and electrolytes
3. effects of diarrhea: -dehydration
-fluid and electrolyte imbalance --> hyponatriema, hypokalemia -weight loss
4. upper GI bleeding: esophagus, stomach, or duodenum
5. lower GI bleeding: ileum, jejunum, colon, rectum
6. hematemesis: bloody emesis (vomit), varies from red to dark "coffee ground appearance
7. hematochezia: blood that is fresh and from the rectum
8. melena: black, tarry, foul smelling stool caused by blood in the intestinal tract
9. occult bleeding: trace amounts detectable with lab tests (guiac testing)
10. slow blood loss may result in...: decreased Hct and Hgb
11. GERD causes: -increase in abdominal pressure
-conditions that delay gastric emptying
12. manifestations of GERD: heartburn
regurgitation of chyme mid-epigastric pain within one hour of eating
13. in infants, GERD is related to...: the dilation of the esophagus and reflux of stomach
cotents -normal in newborns because neuromuscular control of the gastroesophageal sphincter is not fully developed
14. intestinal obstruction: any condition that prevents the flow of chyme through the intestinal
lumen or failure of normal intestinal motility in the absence of an obstructing lesion
15. ileus: obstruction of the intestines (large or small)
16. functional obstruction: -paralytic ileus
failure of intestinal motility often after abdominal surgery
17. simple obstruction: most common mechanical blockage-an object
18. chronic/partial obstruction: -usually associated with tumors or inflammatory disorders of the
intestine
19. manifestations of an obstruction: crampy/colicky pain followed by emesis and abdominal
distention; bowel sounds may be altered to be decreased or absent below the obstruction
20. peptic ulcer disease: A break or ulceration in the protective mucosal lining of the lower
esophagus, stomach, or duodenum
secreting mucosa of the body
28. gastric ulcers manifestations: -differ from duodenal ulcers is the pain
-its usually after eating!!!
29. gastric ulcers patho: - increased mucosal permeability to hydrogen ions --> increased
concentration of bile salts disrupting the gastric mucosa --> disrupted mucosa becomes edematous and loses plasma proteins --> destruction of small vessels cause bleeding --gastric secretion tends to be normal or less than normal
30. inflammatory bowel diseases: -Ulcerative colitis, Crohn disease, irritable bow- el syndrome
(IBS)
31. inflammatory bowel diseases causes/associations: -genetics, alterations of epithelial barrier
functions, immune reactions to intestinal flora, abnormal T cell responses
32. ulcerative colitis: - chronic inflammatory disease that causes ulceration of the colonic
mucosa --sigmoid colon and rectum --age of onset 20-40 years old
33. ulcerative colitis patho: - primary lesion in large intestinal/rectal area and ascends to the
colon --> mucosa is hyperemic --> small erosions form and ulcers/ab- scesses ensue --> necrosis of tissue --> edema and thickening of mucosae can narrow lumen of colon
34. ulcerative colitis symptoms: left lower quadrant pain with BLOODY diarrhea, left lower
quadrant since it affects the rectum... -bloody stools -cramping -diarrhea (10-20/day) usually watery
35. Crohn Disease: -inflammation anywhere from mouth to anus
-chronic inflammation of the intestinal tract usually affecting the ileum and colon --rectum is seldom involved --10-20% of those diagnosed have a family history
36. Crohn Disease patho: inflammatory process- cell mediated response --> inflammation begins
in intestinal submucosa and spreads --> neutrophils and macrophages promote inflammation
-hypothalamus: many hormones and neurotransmitters are involved (control ap- petite and weight, GI motility; leptin resistance happens then the person doesnt realize they are full) -proinflammatory state (proinflammatory cytokines are activated)
43. Cirrhosis: -irreversible inflammatory disease that disrupts liver function and even
structure -decreased hepatic function caused by nodular and fibrotic tissue synthesis (fibro- sis) --fibrosis alters or obstructs billiary channels and blood flow --regeneration no longer occurs and instead hypoxia, necrosis, atrophy and liver failure occurs --fibrosis yields a smaller or larger liver and hard to palpation
44. Cirrhosis manifestations: anorexia, nausea, jaundice, edema, pain, ascites, anemia
45. portal hypertension: abnormally high blood pressure in the poral venous sys- tem due to
resistance to blood flow --caused by disorders that obstruct or impede blood flow through any component of the portal venous system or vena cava
46. portal hypertension causes: -shunts, thrombosis, fibrosis, cirrhosis of the liver, hepatitis, right
heart failure
47. portal hypertension symptoms: hematemesis is the most common
48. portal hypertension consequences: varices, splenomegaly, ascites
49. ascites: accumulation of fluid in the peritoneal cavity- fluid is trapped
-cirrhosis is the most common cause but can also be from heart failure and other organ malfunction
50. ascites patho: -decreased synthesis of albumin by the liver and fluid retention
--> portal hypertension and decreased albumin --> capillary hydrostatic pressure to exceed capillary osmotic pressure --> imbalance pushes water into the peritoneal cavity and you also have decreased circulating blood volume --> sodium and water retention --> activates RAAs system --> possible bacteria and toxin release leads...-> to peritonitis and inflammatory response --> furthers capillary permeability and more fluid into the cavity
51. ascites manifestations: weight gain
increased abdominal girth dyspnea increased respiratory rate
52. jaundice (icterus): -yellow or greenish pigmentation of the skin caused by
hyperbilirubinemia -obstructive jaundice -hemolytic jaundice
53. obstructive jaundice: - extrahepatic obstruction: common bile duct occluded
- intrahepatic obstruction: alterations in hepatocyte function and obstruction of bile canaliculi
54. hemolytic jaundice: prehepatic jaundice: excessive hemolysis of red blood cells or
absorption of a hematoma
55. jaundice manifestations: •Light colored stools possible
- Fever, chills, pain may occur
- Yellow sclera then progress to skin
- Itching
Recovery phase
63. hep in children: bruh
64. skin functions: -protection
--activate vit D --micro-organisms, UV, body fluid loss, mechanical stress --regulate body temp -immune surveillance --touch and pressure receptors --commensal micro-organisms
65. keloid: type of scar overgrowth with scar extending BEYOND original site of injury
-usually dark skinned individuals -excessive fibroblast activity and collagen formation -grow within one year of skin damage -claw-like appearance on flat surfaces
66. eczema/dermatitis characterizations: itching, lesions, skin changes, crusting, oozing, and
chronic skin alteration
67. inflammatory disorders of skin: allergic contact dermatitis irritant
contact dermatitis stasis dermatitis
68. allergic contact dermatitis: -commonly T cell mediated hypersensitivity reac- tion (type IV)
-interaction of skin barrier function, reaction to irritants -genetic susceptibility examples: poison ivy, latex allergy
69. irritant contact dermatitis: -innate immunity activated by proinflammatory properties of
substances -irritating substances temporarily damage the epidermis examples: detergents, industrial cleaners
70. stasis dermatitis: - Lower leg involvement
- Due to chronic venous stasis and edema
- Pooling of blood traps neutrophils leading to erythema and itching followed by scales, hyperpigmentation and lesions
71. psoriasis (papulosquamous disorder): autoimmune skin disease involving scalp, skin, ears.
most common type of "plaque"... psoriasis vulgaris -diagnosis around age 20; hereditary -T helper cells secrete cytokines cause symptoms -epidermal shedding turnover 3-4 days instead of the usual 14-20 days -thickened epidermis and forms white-silver plaques of keratin
72. psoriasis (papulosquamous disorder) associations: IBS, Crohn's, Rheuma- toid Arthritis
73. Lichen Planus (papulosquamous disorder): benign autoimmune self limiting inflammatory
disease of skin and mucous membranes -T cell mediated immune response in which epithelial cells are identified as foreign, cytokine involvement -can last for months or years, recurrence possible, and pruritis is most distressing symptom
74. acne vulgaris (papulosquamous disorder): inflammatory disorder of pilose- baceous unit
82. role of a nurse with EM or SJS: 1. recognize target lesion
2.obtain medication history (penicillin, phenytoin, barbiturates, sulfonamides)
3.possible bugs (HSV, EBV, mycoplasma)
83. bacterial infections of skin: -folliculitis
-furuncles "boils" -carbuncles -impetigo -cellulitis
84. folliculitis: -infection of hair follicle where bacteria enter at skin hair opening
--usually staph aureus
85. furuncles "boils": -folliculitis where inflammation has spread post follicle and into dermis
(cellulitis) --usually staph aureus
86. furuncles "boils" symptoms: firm red painful nodule 1-5cm that could drain pus/necrotic
tissue
87. carbuncles: -collection of infected hair follicles
88. carbuncles symptoms: subcutaneous/deep dermis red painful swollen, drain- ing mass in
posterior neck, upper back, lateral thighs
89. -impetigo: superimposed infection of any skin lesion
-(staph aureus or beta-hemolytic strep)
90. cellulitis: infection of the dermis and subcutaneous tissue
-can follow any skin lesion
91. cellulitis symptoms: area of infection is darker than skin, hot to touch, swollen
92. viral infections (skin): -Herpes simplex virus (HSV)
-herpes zoster/varicella zoster=shingles/chicken pox -human papillomavirus (HPV)
93. Herpes simplex virus (HSV): HSV1- lips, mouth, eye, transmitted by saliva; lives in dorsal
root ganglion latently and can reactivate through sensory nerve endings HSV2- usually genital; transmitted by mucous membrane contact during shedding; vertical transmission
94. herpes zoster/varicella zoster=shingles/chicken pox: -lives latent in trigemi- nal and dorsal
root ganglion -20% pts postherapetic pain and reactivation -vaccines are usually given to reduce incidence
95. human papillomavirus (HPV): -skin wart (verruca vulgaris): transmission by touch
-genital wart (condyloma acuminata): highly contagious; can develop into cancer
96. fungal infections of skin: -tinea
-candida albicans
97. tinea: dermatophyte fungus; also called mycoses, a superficial skin infection
98. candida albicans: most common; overgrows in home sites like mouth, esoph- agus, vagina,
penis, skin folds
105. melanoma (malignant tumors) factors: family, steroid hormone, fair w sun- burns as
child, tanning bed before 30 yo, males, geography, 3 or more atypical nevi
106. first degree burn: self limiting, no scarring, damage to epidermis only
--sunburn
107. second degree burn: superficial partial thickness
--superficial: moist surface involving SUPERFICIAL DERMIS, blisters in minutes, intact pain sensors
108. third degree burn: -deep partial thickness and full thickness
109. third degree burn- deep partial thickness: waxy white surface involving entire
dermis, +/- blisters, diminished pain sensation
110. third degree burn- full thickness: involves entire epidermis/dermis/underly- ing
subcutaneous tissue -dry leathery lift off paper like layer with visible veins and white/cherry/red/black apperance, no pain sensation ***will not heal; scar
111. forth degree burn: full thickness + deeper tissue
-involves skin/subcutaneous tissue/tendon/muscle/bone
112. urethrocele: hernia or prolapse of the urethra into the vagina
113. urethrocele possible symptom:: incontinence
114. cystocele: prolapse of bladder into vaginal canal
115. cystocele possible symptoms:: "laugh too much" "when i run..."
-urinary leakage, incontinence, increased chance for UTIs
116. rectocele: rectum protrudes into vagina
-some stool moves forward, rest moves outward =floor is coming up, push for stool and so floor comes up higher, making it harder to pass stool
117. rectocele symptoms: higher risk for constipation
118. uterine prolapse: downward displacement of the uterus into the vagina
119. uterine prolapse symptoms: -heaviness in pelvis
125. endometriosis: -presence of functioning endometrial tissue or implants out- side the
uterus -responds to hormone fluctuations of the menstral cycle -creates painful and heavy menestruation -possible causes: retrograde menstruation, spread through vascular or lymphatic system, genetic predisposition -looks like coffee grounds
126. endometriosis symptoms: painful ovulation, pain during or after sex, abnor- mal
bleeding, chronic pelvic pain and fatigue, painful sex, difficulty getting pregnant, infertility, bleeding between periods, pelvic pain, painful or heavy irregular periods, constant fatigue, urination and bowel pain
127. urethritis: -inflammation of the urethra usually, but not always, caused by a
sexually transmitted disease (gonirrhea and chlymedia) -nonsexual origins can be caused by urologic procedures, insertion of foreign objects, anatomic abnormalities, or trauma
128. urethral strictures: -fibrotic narrowing of the urethra caused by scarring
-commonly a result of trauma or untreated or severe urethral infections -trauma --> creates scar tissue --> creates urethral stricture
129. urethral strictures symptoms:: complaint of urinary retention, slow dribbly flow,
trouble getting flow started
130. penile cancer: -carcinoma of the penis
-requires surgery, radiation, or chemo
131. penile cancer risk factors: smoking, HPV, age, AIDS
-all related to cellular health
132. penile cancer symptoms: growths, soreness of penis, bleeding from growths, lesions
133. variocele (scrotum): -inflammation/dilation of veins in the spermatic cord
-caused by inadequate or absent valves in the spematic veins -varicose veins in scrotal sac
134. hydrocele (scrotum): -scrotal sweeling caused by collection of fluid within the tunica
vaginalis -imbalance between fluid secretion and reabsorption -fluid where it shouldnt be -swelling after surgery will die down...
