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Patho - Megan/Shay’s Study Guide Review
1. What is the primary determinant of oncotic pressure?: Albumin
2. Form of osmotic pressure exerted by proteins: Oncotic Pressure
3. What is the difference between adult and child immunity?: Naive T Cells
4. Fluid and electrolyte levels are regulated by , which
regulates actions such as thirst, ADH, the kidneys, and RAAS.: Osmoreceptors
5. What are the causes of dehydration?: #Excessive loss #Inadequate
intake #Both
6. What s/sx are associated with dehydration?: #Dry mucous membranes #Decreased skin
turgor #Decreased urine output #Low blood pressure #Tachycardia #Weak heart rate #Confusion
7. A patient with a viral illness and severe vomiting has an elevated CO2 level and pH of 7.53. She is
breathing slowly. What condition does she have?: Meta- bolic alkalosis The patient's pH and CO2 levels are both elevated (moving in the same direction). This indicates metabolic alkalosis. The CO2 level is high because her respiratory system is attempting to compensate for the high pH by exhaling less and retaining more CO2.
8. Normal CO2 level: 35- 45
9. Normal pH level: 7.35-7.
10. Normal HCO3 level: 22- 26
11. Michael's pulmonary edema leads to respiratory acidosis. How does pH impact Michael's basal
metabolic panel? Choose 3 answers. His CO2 level is increased because his lungs have difficulty removing it from the bloodstream. His calcium level is reduced because the elevated concentration of H+ makes it easier for Ca+ to bind to albumin.
2 / 60 His CO2 level is decreased because his lungs have difficulty adding it into the bloodstream. His sodium level is decreased due to hypervolemia.
4 / 60 Confusion
5 / 60 Muscle twitching or spasms Restlessness Seizures
16. Normal potassium level: 3.5-5.
17. Hypokalemia is indicated by what lab result? S/Sx: K < 3.
#Muscle fatigue/cramping #Nausea, vomiting, constipation #Cardiac dysrhythmias #Paresthesia (numbness/tingling)
18. Hyperkalemia is indicated by what lab result? S/Sx?: K > 5.
Muscle weakness/paralysis Paresthesia (numbness/tingling) Cardiac dysrhythmias Cardiac arrest/MI
19. Normal calcium level: 8.5-10.
20. Hypocalcemia is indicated by what lab result? S/Sx?: Calcium < 8.
Overexcitability of the muscles Muscle twitching Paresthesia (numbness/tingling) Chvostek and Trousseau sign (twitching on the cheek when touched) Cardiac dysrhythmias
21. Hypercalcemia is indicated by what lab result? S/Sx?: Calcium > 10.
Muscle weakness Loss of muscle tone Spontaneous fractures Kidney stones Cardiac dysrhythmias
7 / 60 stature (under 4' 7") Amenorrhea Webbing of the neck Edema Underdeveloped breasts/wide nipples
28. Respiratory rate increases during exercise. How does this increased respi- ratory rate allow the
body to maintain a homeostatic pH level?: The increased exhalation of CO2 helps to increase pH. (The increased respiratory rate allows more CO2 to be exhaled. Since CO2 reacts with water to form carbonic acid, getting rid of more CO2 through increased respi- ration will raise pH)
29. An ICU patient's arterial blood gas results show low pH and low CO2 levels. The patient's
respiratory rate is increased. What is the name of this condition?: Metabolic acidosis (Since the pH is low, and the pH and CO2 are trending in the same direction, the condition is metabolic acidosis. The low CO2 indicates that CO2 is not causing the acidosis. The increased respiratory rate lowers blood CO2 in an attempt to compensate for the metabolic acidosis.)
30. Your patient has pulmonary edema, which raises levels of CO2 in the blood. What helps the
patient's body to compensate for this increase? The kidneys conserve H+ and conserve HCO3- The kidneys excrete more H+ and conserve HCO3- The kidneys conserve H+ and excrete more HCO3- The kidneys excrete more H+ and excrete more HCO3-: The kidneys excrete more H+ and conserve HCO3- (The increased CO2 level will generate more carbonic acid. The body must compen- sate for the decreased pH. Excreting more H+ and conserving HCO3- will both help to increase pH.)
31. Heberden and Bouchard's nodes are indicative of what disease process?-
: Osteoarthritis
32. You receive a patient who has experienced a burn on the right leg. The burn has small blisters, is
markedly pinkish red, and has a shiny and moist appearance. When the patient is asked about pain
8 / 60 level, the patient describes it as severe. What level of burn does this patient present? Superficial thickness / Partial or intermediate thickness / Full Thickness / Fourth Degree: Second Degree (partial thickness) Second degree: Partial thickness burns can be either superficial partial thickness or deep partial thickness, depending on the degree of tissue necrosis of the dermal
10 / 60 What is the most likely classification of this burn? Superficial Thickness / Partial or Intermediate Thickness / Full Thickness /
11 / 60 Fourth Degree: Superficial / First Degree Burn Superficial burns are reddened and painful.
36. Burn that requires surgery, forms more scars and are less painful?
Superficial thickness / Partial or Intermediate Thickness / Full Thickness / 4th Degree: Deep partial thickness / Second Degree Burn
- Blisters/weeps -Risk of infection/scarring increase with depth of burn
37. Describe an intracranial bleed in the epidural space: Typically caused by a head injury and
usually with a skull fracture. Occurs between the skull bone and the outmost membrane layer, the dura mater. High pressure bleeding is a prominent feature. You may briefly lose consciousness.
38. Describe an intracranial bleed in the subdural space: Collection of blood on the surface of your
brain. Typically caused by your head moving rapidly forward and stopping, such as a car accident or shaken baby syndrome. More common in older people and people with a history of heavy alcohol use.
39. Describe an intracranial bleed in the subarachnoid space: Occurs between the brain and the
thin tissues that cover the brain. The most common cause is trauma but it can also be d/t the rupture of a major blood vessel in the brain (intracerebral aneurysm). A sudden, sharp headache usually comes before a subarachnoid hemorrhage. Typical symptoms also include loss of consciousness and vomiting.
40. Describe an intracranial bleed in the intracerebral space: Occurs inside the brain.
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Nausea or vomiting
Dizziness
Irregular breathing
Vision loss or changes
Memory loss
Inability to walk
Difficulty speaking
Stupor
Seizures
Loss of consciousness
45. What neuro conditions cause flat emotions and sleep disturbances?: -
#Alzheimer's #Schizophrenia #Parkinson's disease
46. What are the s/sx of Parkinson's?: #Gait changes #Resting
tremor #Increased muscle tone (rigidity) #Slow gait/movements (bradykinesia)
47. What are the s/sx of Amyotrophic Lateral Sclerosis (Lou Gehrig's dis- ease)?: Upper motor
neurons become sclerotic and die Weakness in upper and lower extremities, head drop, speech changes, dysphagia. Treatment: Riluzole (Rilutek) - works by changing the activity of certain natural substances in the body that affect nerves and muscles.
48. What are the s/sx of Multiple Sclerosis?: #Episodes of muscle weakness #Numbness
#Blurred vision #Fatigue
49. What is Huntington's and what are s/sx?: Autosomal dominant inherited disorder.
14 / 60 S/Sx do not develop until adulthood and include movement (spasticity); chorea (lack of control), cognitive function, depression, psychosis, dementia, degeneration of neurons.
50. A provider is providing care for a patient following a hemorrhagic cere- brovascular accident
(CVA). The patient asks the provider to explain what happened during the CVA. Which response by the provider is best?: "A blood vessel in your brain broke open, causing bleeding in your brain and a lack of blood flow to an area."
51. An older adult patient presents to the emergency department after drop- ping a pot of boiling
water onto their feet. The skin on the patient's left foot is white with profound swelling of the ankle. The patient denies any significant pain. What is the most likely classification of this burn? Superficial thickness / Partial or Intermediate Thickness / Full Thickness / Fourth Degree: Full thickness/Third Degree Burn Full thickness burns may be white and the surrounding area is edematous. Due to the damage the nerve endings, pain is minimal or absent.
52. Riluzole (Rilutek) used for what?: Medication used to treat amyotrophic lateral sclerosis (ALS;
Lou Gehrig's disease). Class of medications called benzothiazoles. It works by changing the activity of certain natural substances in the body that affect nerves and muscles.
53. A provider is working with a patient who is recovering from a subarachnoid hemorrhage caused
by a cerebral aneurysm. The patient asks the provider to explain what happened. What is the best response by the provider? "You experienced a spasm of the arteries in your brain, which prevented blood flow to an area." "When you fell and hit your head, a blood vessel broke and you experienced bleeding into your brain." "A clot developed in an artery of your brain, which increased the blood pressure and caused the artery to rupture." "An artery in your brain had a weakened area, which ruptured, causing bleed- ing into your brain.": "An artery in your brain had a weakened area, which ruptured, causing bleeding into your brain."
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62. What are the compensatory mechanisms of heart failure?: #Renin and aldosterone
secretion (vasoconstriction and blood volume is increased) #SNS response (increases heart rate/vasoconstriction - epinephrine and norepi- nephrine) #Cardiac hypertrophy (increased size of the heart)
63. What are complications of heart failure?: #Cardiogenic shock #Acute
pulmonary edema #Organ failure
64. What lab test is an indication of heart failure?: B-Type Natriuretic Peptide (BNP) - a hormone
produced by the heart. BNP > 500 are considered indicative of heart failure.
65. What are causes of left sided heart failure?: #MI #Valve
stenosis #HTN (has to push after the afterload)
66. What is the RAAS system?: Renin-angiotensin-aldosterone system - a ma- jor mechanism in
the regulation of arterial blood pressure. It is a compensatory mechanism that raises blood pressure and increases blood volume in response to decreased renal perfusion.
67. What is the patho of left sided heart failure?: Decreased cardiac output and pulmonary
congestion
68. What are the manifestations of left sided heart failure?: Forward Effects (in the body - not
getting oxygenated blood) #Fatigue and weakness #Exercise intolerance Backward Effects (in the lungs - blood backing up to the lungs) #Dyspnea #Orthopnea #Pink-frothy sputum #SOB #Rales/Crackles
69. What does the body do to compensate for left sided heart failure?: #Tachy- cardia
#Pallor #Daytime oliguria (low urine output)
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70. What are the causes of right sided heart failure?: #MI (R Ventricle) #Valve stenosis
#Pulmonary disease/hypertension (has to push through the lungs)
71. What is the patho of right sided heart failure?: Decreased cardiac output and systemic
congestion
72. What are the manifestations of right sided heart failure?: Forward Effects (to the lungs)
#Dyspnea #Fatigue and weakness #Exercise intolerance Backward Effects (systemic congestion/fluid back up - cannot maintain venous return) #Edema (feet, legs, buttocks, ascites, hepato and splenomegaly) #JVD (jugular vein distention)
73. Right sided heart failure compensation?: #Tachycardia #Pallor
#Daytime oliguria (low urine output)
19 / 60 **Can lead to endocarditis.
82. What is endocarditis?: A life-threatening inflammation of the inner lining of the heart's
chambers and valves (endocardium).
83. A patient asks the provider about a new diagnosis of aortic stenosis. What does the provider
explain about stenosis? It is caused by calcium deposits forming around the rim of the valve, which reduces the flexibility of the valve. It describes the valve leaflets shifting into the atrium with contraction, due to thickening of the valve leaflets. It is a thickening and narrowing of the valve that decreases the ability of blood to move through the valve. It is a failure of the valve to close properly, due to damage to the chordae tendineae that anchor the valve leaflets.: It is a thickening and narrowing of the valve that decreases the ability of blood to move through the valve. **A narrowing or stricture to the blood flow from the left ventricle to the aorta and may also affect the pressure in the left atrium.
84. Which type of valve defect leads to a diastolic murmur?: #Narrowing (steno- sis) of the mitral or
tricuspid valves #Regurgitation of the aortic or pulmonary valves
85. Which type of valve defect leads to a systolic murmur?: Many variations of mitral and tricuspid
valve regurgitation and ventricular septal defect.
86. What is a thrombus?: An aggregation of platelets and red blood cells (clot) found in the
location where it formed.
87. What is an embolus?: Can be a thrombus (blood clot), gas bubble, fat globule, mass of
bacteria, or other foreign body that has traveled through the bloodstream until becoming lodged in a blood vessel that is too small for it to pass though, blocking the blood flow.
20 / 60 **When an embolus occludes a blood vessel, it is called an embolism or embolic event.
88. What are 2 contributing factors to developing an aneurysm?: #A weakening of an artery wall
that results in bulging or dilation of the artery #Can be caused by arteriosclerosis, degenerative vascular disease, or other causes.
89. What are distinguishing characteristics of endocarditis?: #Prosthetic valves and pacemakers
are risk factors #Often caused by infection of the endocardium of the heart
90. What are distinguishing characteristics of pericarditis?: #Caused by inflam- mation of the
pericardium (thin membrane around the heart), often due to MI #Can result in cardiac tamponade if high levels of fluid accumulate and compress the heart **Sharp/stabbing pain worsens with deep breathing or cough.
91. How does malignant hypertension differ from benign hypertension?: Ma- lignant hypertension
is high blood pressure that has resulted in multiple complica- tions. Benign hypertension is high blood pressure without evidence of end target organ damage. HTN is never truly benign in that it causes damage to the endothelium that may not be evident for years.
92. A patient presents with a blood pressure of 204/102. The patient complains of chest palpitations,
a headache and blurred vision. What is the patient experiencing?: Hypertensive crisis The patient's systolic BP > 180 combined with symptoms of organ damage indicates hypertensive crisis.
93. A patient who recently underwent a knee replacement suddenly complains of severe SOB and
anxiety. What disorder is the most likely cause of the patient's symptoms?: Pulmonary embolism Patients are at risk for thrombosis and embolism following a major orthopedic surgery like knee replacement. The patient's sudden onset of symptoms suggests pulmonary embolism.
94. A patient asks the provider about a new diagnosis of aortic stenosis. What does the
