Pathophysiology Final Exam Review with Correct Answers, Exams of Advanced Education

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2024 NR 283 PATHOPHYSIOLOGY

FINAL EXAM REVIEW WITH

CORRECT ANSWERS

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UTI or Acute Cystitis - CORRECT-ANSWERS- cloudy urine

• caused by E. coli Pancreatitis - CORRECT-ANSWERSis caused by:
• gallstones (bile duct disorder)
• alcohol Rickets - CORRECT-ANSWERS- a term used for osteomalacia in CHILDREN
• usually due to inadequate or lack of Vitamin D Appendicitis - CORRECT-ANSWERS- pain in the lower right quadrant (LRQ) What is the difference between Angina and Myocardial Infarction (MI)? - CORRECT-ANSWERS- a myocardial infarction is a serious condition where there is complete blockage of blood supply to the heart
• in contrast, stable angina is chest pain or discomfort that usually occurs with activity or stress resulting from poor blood flow through the blood vessels in the heart Congestive Heart Failure (CHF) - CORRECT-ANSWERS- occurs when the heart is unable to pump sufficient blood to meet the metabolic needs of the body
• left side: leads to pulmonary congestion (Left is for Lungs)
• right side: systemic circulation Crohn's Disease - CORRECT-ANSWERS- nonbloody diarrhea
• usually in small intestine
• soft semiform stool Thrombophlebitis (Thromboembolism) - CORRECT-ANSWERS- starts in legs
• refers to the development of a thrombus in a vein in which inflammation is present

• may lead to pulmonary embolism
• a condition in which a blood clot in a vein causes inflammation and pain Symptoms:
• redness
• swelling
• pain Ulcerative Colitis - CORRECT-ANSWERS- blood and mucus diarrhea
• inflammation starts in the rectum, progresses through the colon
• up to 12 stools per day or it's excessive Epidural (Extradural) Hematoma - CORRECT-ANSWERS- hematoma above the skull
• results from bleeding between the dura and the skull, usually caused by tearing of the middle meningeal artery in the temporal region
• signs of trouble usually arise within a few hours of injury, when the person loses consciousness after a brief period of responsiveness Labs of Renal Failure - CORRECT-ANSWERS- high BUN (blood urea nitrogen)
• high creatinine
• high potassium
• high phosphate
• low calcium
• low hematocrit
• low hemoglobin
• low sodium Shock - CORRECT-ANSWERS- low blood pressure
• cool extremities
• tachycardia Cirrhosis - CORRECT-ANSWERS- is a complication of hepatic encephalopathy Esophageal Varices - CORRECT-ANSWERS- caused by cirrhosis
• the most serious complication of esophageal varices is bleeding Down Syndrome - CORRECT-ANSWERS- a chromosomal issue
• trisomy 21

Hypoxemia - CORRECT-ANSWERS- low oxygen in the blood Deep Vein Thrombosis or Venous Thrombus - CORRECT-ANSWERS- red hot swollen legs Peritonitis - CORRECT-ANSWERS- serious complication of appendicitis Meningitis/Meningeal Irritation (Signs/Symptoms) - CORRECT-ANSWERS- nuchal rigidity (impaired neck flexion resulting from muscle spasm)

• Brudzinski's sign (neck flexion causes flexion of hip and knee)
• Kernig's sign (resistance to leg extension when lying with the hip flexed)
• photophobia First Sign of Amyotrophic Lateral Sclerosis (Lou Gehrig's Disease) - CORRECT- ANSWERS- Amyotrophic Lateral Sclerosis (ALS)
• is muscle weakness which eventually leads to muscle atrophy Transient Ischemic Attack (TIA) - CORRECT-ANSWERS- is a precursor to stroke Agnosia - CORRECT-ANSWERS- identification by sense of touch
• if a person looks at a pen and can't identify it but can identify the pen by touching it, they have agnosia Encephalitis - CORRECT-ANSWERS- caused by a virus Multiple Sclerosis - CORRECT-ANSWERS- demyelination of the axon sheath Congestive Heart Failure (CHF) - CORRECT-ANSWERS- occurs because the cardiac muscle is too weak to meet metabolic demands Hemoptysis - CORRECT-ANSWERS- bloody sputum Stenosis - CORRECT-ANSWERS- hardening, restricting blood flow Regurgitation - CORRECT-ANSWERS- leaky valve If a patient comes in with a blood sugar that is 45 the first thing you should do is? - CORRECT-ANSWERS- recheck the blood sugar level Dilation - CORRECT-ANSWERS- the heart is very stretched out and can't go back

If you remove the thyroid, what should you do after? - CORRECT-ANSWERS- you have to immediately check calcium levels because parathyroid are connected to thyroid Portal Hypertension - CORRECT-ANSWERS- causes vomiting and blood Chronic Renal Failure - CORRECT-ANSWERS- fatigue

• fluid retention
• edema
• severe pruritus
• altered mental status Diabetes Insipidus - CORRECT-ANSWERS- low ADH Hypoglycemia - CORRECT-ANSWERS- not tired
• emotional instability
• decreased level of consciousness How do you stop angina? - CORRECT-ANSWERS- by rest
• exercise makes it worse Sickle Cell Anemia - CORRECT-ANSWERS- genetic Diabetes Type I - CORRECT-ANSWERS- autoimmune destroys pancreatic beta cells Apoptosis - CORRECT-ANSWERS- scheduled for cell death Prognosis - CORRECT-ANSWERS- outcome of a disease First Sign/Symptom of Increased Pressure - CORRECT-ANSWERS- decrease level of consciousness
• confusion Peptic Ulcer (Gastric) - CORRECT-ANSWERS- occult blood in stool
• coffee-ground vomitus (coffee grains in the vomit) Sprain - CORRECT-ANSWERS- a torn ligament Azotemia - CORRECT-ANSWERS- nitrogen in the blood caused by kidney damage
• excess urea and other nitrogen wastes in the blood, as in renal failure Dislocation - CORRECT-ANSWERS- distortion of joint, usually evident
• bone separated from/deformed at joint

What group is at high-risk for Gout? - CORRECT-ANSWERS- males between 40-50 years of age What group is at high-risk for Osteoporosis? - CORRECT-ANSWERS- postmenopausal women due to low estrogen levels Gastritis - CORRECT-ANSWERS- is an inflammation of the stomach that may occur in many forms such as acute and chronic

• inflammatory disorder of gastric mucosa
• Increases risk of cancer Acute Gastritis - CORRECT-ANSWERS- gastric mucosa is inflamed
• may be ulcerated and bleeding
• is usually self-limiting
• may result from infection by microorganisms, allergies to foods, spicy or irritating foods, excessive alcohol intake, ingestion of aspirin or other NSAIDs, ingestion of corrosive or toxic substances, radiation or chemotherapy
• signs and symtpoms include:
• anorexia, nausea, vomiting may develop
• hematemesis caused by bleeding
• epigastric pain, cramps or general discomfort
• with infection, diarrhea may develop Chronic Gastritis - CORRECT-ANSWERS- characterized by atrophy of stomach mucosa
• loss of secretory glands
• reduced production of intrinsic factor
• Helicobacter pylori infection is often present
• signs may be vague
• mild epigastric discomfort, anorexia, intolerance for certain foods
• increased risk of peptic ulcers and gastric carcinoma
• certain autoimmune disorders are associated with one type of chronic gastric atrophy Signs and Symptoms of Renal Calculi (Kidney Stones) - CORRECT-ANSWERS- stones in the kidney or bladder are frequently asymptomatic

• flank pain (back pain or area below the ribs) due to distention of the renal capsule
• renal colic caused by obstruction of the ureter
• intense spasms of pain in flank area
• radiating into groin area
• lasts until stone passes or is removed
• possible nausea and vomiting, cool moist skin, rapid pulse
• radiological examination confirms location of calculi Gastroesophageal Reflux Disease (GERD) - CORRECT-ANSWERS- food goes down and mixes with acid and goes back up
• involves the periodic flow of gastric contents into the esophagus which causes erosion and inflammation
• often seen in conjunction with hiatal hernia
• causes heartburn frequently occur 30 to 60 minutes after eating or at night Hepatic Encephalopathy - CORRECT-ANSWERS- increases ammonia (excessive levels)
• serum ammonia levels
• abnormal levels of electrolytes or amino acids, and excessive ammonia or other toxic chemicals which affect the central nervous system Cirrhosis - CORRECT-ANSWERS- causes liver blockage
• progressive destruction of the liver
  • causes the following:
• alcoholic liver disease (portal cirrhosis)
• biliary cirrhosis (associated with immune disorders)
• postnecrotic cirrhosis (linked with chronic hepatitis or long-term exposure to toxic materials)
• metabolic (usually caused by genetic metabolic storage disorders) Bladder Cancer - CORRECT-ANSWERS- main predisposing factor: SMOKING

• other predisposing factors include working with chemicals in laboratories and industry (particularly aniline dyes, rubber, aluminum), recurrent infections, heavy intake of analgesics
• most bladder tumors are malignant and commonly arise from transitional epithelium of the bladder
• develops as multiple tumors and tends to recur
• diagnosed by urine cytology and biopsy
• early signs include hematuria and dysuria Locked-in Syndrome - CORRECT-ANSWERS- aware and thinking but paralyzed
• refers to a condition in which an individual with brain damage is aware and capable of thinking but is paralyzed and cannot communicate
• some individuals can move their eyes in a "yes" or "no" response Comminuted Fracture - CORRECT-ANSWERS- multiple fractures of the bone
• a number of fracture lines in which there are multiple fracture lines and bone fragments Disuse Atrophy - CORRECT-ANSWERS- taking cast off and causes smaller/weaker muscle
• also called muscle wasting
• when muscles are no longer in use, they slowly become weaker
• causative factor: often occurs after a period of bed rest after a major surgical procedure, to people with limbs in casts or from becoming bedridden due to illness or age Open (Compound) Fracture - CORRECT-ANSWERS- is when bone is exposed
• results when the skin is broken
• the bone fragments may be angled and protrude through the skin
• in open fractures, there is more damage to soft tissue, including the blood vessels and nerves, and
• there is also a much higher risk of infection Graves' Disease/Hyperthyroidism (Signs/Symptoms) - CORRECT-ANSWERS- BULGY EYES (exophthalmos)

• exophthalmos is evident by the presence of protruding, staring eyes and decreased blink and eye movements
• it results from increased tissue mass in the orbit PUSHING THE EYEBALL FORWARD and from increased sympathetic stimulation affecting the eyelids
• occurs more frequently in women over 30 years of age and is related to an autoimmune factor Cushing's Syndrome (Signs/Symptoms) - CORRECT-ANSWERSSigns/Symptoms include:
• moon face (round and puffy)
• buffalo hump (a heavy trunk with fat at the back of the neck)
• paper thin skin (fragile skin)
• red streaks
• trunket obesity
• wasting of the muscle in the limbs
• is caused by an excessive amount of glucocorticoids (e.g., hydrocortisone or cortisol
• high in cortisol and high in ADH levels Pheochromocytoma (Signs/Symptoms) - CORRECT-ANSWERSSigns/Symptoms:
• high blood pressure
• headache
• heart palpitations
• constant anxiety
• is a benign tumor of the adrenal medulla that secretes epinephrine, norepinephrine, and sometimes other substances Meningitis - CORRECT-ANSWERS- a virus that causes swelling in the brain
• is an infection, usually of bacterial origin, in the meninges of the CNS
• any form of head trauma or surgery can result in meningitis from a variety of microorganisms
• aseptic or viral meningitis results from an infection, such as mumps or measles Hepatitis A (Transmission) - CORRECT-ANSWERS- transmitted by fecal-oral route

Hiatal Hernia - CORRECT-ANSWERS- increases abdominal pressure Intracranial Pressure (Signs/Symptoms/Complications) - CORRECT-ANSWERS- confusion, anxiety, stroke, pupillary responses

• late sign = dilated pupils (affecting vision) Complications:
• increasing blood pressure with increasing pulse pressure
• slow heart rate
• papilledema (affecting vision)
• because the brain is encased in the rigid, nonexpandable skull, any increase in fluid, such as blood or inflammatory exudate, or any additional mass, such as a tumor, causes an increase in pressure in the brain Cerebral Edema - CORRECT-ANSWERS- problem associated with closed head injuries
• swelling of the brain
• leading to increased intracranial pressure Intracerebral Hemorrhage (Stroke) - CORRECT-ANSWERS- the third class of stroke
• has the worst prognosis
• hemorrhagic strokes are frequently MORE SEVERE and DESTRUCTIVE than other CVAs, because they affect large portions of the brain
• usually caused by rupture of a cerebral artery in a patient with severe hypertension
• because of the greater increase in ICP with hemorrhage, the effects are evident in both hemispheres and are complicated by the secondary effects of bleeding, in addition to the disrupted blood supply
• the presence of free blood in interstitial areas affects the cell membranes and can lead to significant secondary damage as vasospasm, electrolyte imbalances, acidosis, and cellular edema develop Transient Ischemic Attack (TIA) - CORRECT-ANSWERS- stroke symptoms for a short time
• the clinical manifestations (S/S) of TIA are similar to a stroke

• results from a temporary localized reduction of blood flow in the brain
• recovery occurs within 24 hours
• TIAs may occur singly or in a series
• repeated attacks are frequently a warning of the development of obstruction related to atherosclerosis
• intermittent short episodes of impaired function, such as muscle weakness in an arm or leg, visual disturbances, or numbness and paresthesia in the face, may occur Herniation - CORRECT-ANSWERS- when the cerebrospinal fluid (CSF) goes down the spine
• when a mass, such as a blood clot or tumor, becomes large enough, it may displace brain tissue, leading to this Stroke Volume - CORRECT-ANSWERS- varies with sympathetic stimulation and venous return
• when an increased amount of blood returns to the heart, as during exercise, the heart is stretched more and the force of the contraction normally increases proportionately
• during exercise, stress, or infection, cardiac output increases considerably
• is the volume of blood pumped from the left ventricle per beat Basilar Fractures - CORRECT-ANSWERS- fractures that occur at the BASE of the skull and are often accompanied by leaking of CSF through the ears or nose
• these fractures may occur when the forehead hits a car windshield with considerable force
• cranial nerve damage and dark discoloration around the eyes are common Contrecoup Injury - CORRECT-ANSWERS- head goes back and forth, affects front and back
• occurs when an area of the brain contralateral to the site of direct damage is injured as the brain bounces off the skull

• this injury may be secondary to acceleration or deceleration injuries, in which the skull and brain hit a solid object, which causes the brain to rebound against the opposite side of the skull, usually causing minor damage Iatrogenic - CORRECT-ANSWERS- a disease caused by a treatment, procedure, or error Examples of Iatrogenic Diseases:
• bladder infection following catheterization
• bone marrow damage caused by a prescribed drug Nosocomial Infections - CORRECT-ANSWERS- an infection acquired while hospitalized
• infections that occur in health care facilities, including hospitals, nursing homes, doctors' offices, and dental offices Orthopnea - CORRECT-ANSWERS- difficult or labored breathing when recumbent that is usually relieved by an upright position Modifiable Risk Factors for Atherosclerosis - CORRECT-ANSWERS- obesity
• cigarette smoking combined with oral contraceptives
• sedentary lifestyle
• diabetes mellitus
• poorly controlled hypertension
• high blood pressure combined with high blood cholesterol Pulmonary Edema - CORRECT-ANSWERS- refers to fluid collecting in the alveoli and interstitial area Main Sign and Symptom:
• frothy, blood-tinged sputum Tonic (Phase of Seizure) - CORRECT-ANSWERS- conTraction phase cLonic (Phase of Seizure) - CORRECT-ANSWERS- reLaxation phase Homeostasis - CORRECT-ANSWERS- a relatively stable or constant environment in the body, including blood pressure, temperature, and pH, maintained by the various control mechanisms
• is the maintenance of a relatively stable internal environment regardless of external changes
• disease develops when significant changes occur in the body, leading to a state in which homeostasis cannot be maintained without intervention