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Pathophysiology Study Review Notes
Module 4 ▪ Clinical manifestations – appendicitis o Right, lower abdominal pain, nausea, occasional diarrhea ▪ Cause of pseudomembranous colitis and nonpharmacologic treatments- o (Often called antibiotic associated colitis) Acute inflammation and necrosis of the large intestine caused by Clostridium difficile. Exposure to antibiotics is the major factor predisposing to the development of this disorder. Stop the affecting antibiotic. Treat ischemia, fecal transplant, colectomy ▪ Clinical manifestations – cholecystitis- o Acute: Inflammation of the gallbladder wall. o Chronic- inflammation of the gallbladder wall attributed to persistent low- grade irritation from gallstones or recurrent attacks of acute cholecystitis. ▪ Cause of Helicobacter pylori (H. pylori)- o Transmission person to person, fecal-oral route, reservoir in water sources. H. pylori often causes peptic ulcer disease ▪ Clinical manifestations – gastric carcinoma o Early- none. o Advanced- anorexia, weight loss and GI bleed ▪ Causes of gastroenteritis due to Salmonella o Consumption of raw or undercooked chicken/eggs o Diarrhea, N/V, abdominal pain ▪ Complication of perforated gallbladder- o Sepsis. o Rare complication of acute cholecystitis ▪ Cause of jaundice and disease associated with jaundice- o Elevated levels of bilirubin o Caused by a buildup of bilirubin, which is a waste product in blood. An inflamed liver or obstructed bile duct can cause jaundice. Diseases
associated: infections of the liver from a virus (Hepatitis), overuse to Tylenol. ▪ Define the following terms: dysphagia; occult blood- o Dysphagia: difficult or painful swallowing o Occult blood (cause by polyps) blood you can’t see with the naked eye, FOBT (fecal occult blood test). Means there is usually bleeding somewhere in the digestive tract. ▪ What should patients with newly diagnosed pancreatitis avoid? o Alcohol ▪ What causes greenish-yellow emesis? o Bile, caused by vomiting on an empty stomach, or bile reflux. ▪ Most frequent location of peptic ulcers- o Proximal Duodenum ▪ What types of hepatitis increase the risk of hepatocellular carcinoma? o Hep B and C ▪ Clinical manifestations of chronic gastritis o Upper abdominal pain o Indigestion o Bloating o N/V o Weight loss/loss of appetite o Hematemesis may occur bc of damage to the gastric epithelial mucosa ▪ What types of things put a patient at risk for developing acute gastritis? o Ingesting irritating substances- alcohol, aspirin, NSAIDs, viral bacteria, autoimmune ▪ Clinical manifestations of acute gastritis- o Anorexia, nausea, vomiting, and postprandial (after meal) discomfort ▪ Causes of hiatal hernia- o Conditions where intraabdominal pressure increases: ascites, pregnancy, obesity, chronic straining or coughing o Loosening of the muscular band around esophageal and
o Enuresis- intermittent incontinence while asleep (usually in children but not always). o Micturition- the act of urinating o Overflow incontinence- when the bladder becomes so full it leaks urine ▪ A genetic defect in young children with cystitis o Vesicoureteral reflux ▪ How do kidney tubules maintain a normal pH in response to fever and respiratory infection? o They secrete more acids and reabsorb more bicarbonate ions. ▪ Bilateral kidney disease – why does metabolic acidosis occur? o Tubule exchanges are impaired. ▪ Serum marker ordered when screening for prostate cancer- o PSA- Prostate-Specific Antigen ▪ Causes of increased glomerular filtration rate (GFR)? o Kidney Disease/Failure o Diabetes o High BP o GFR raised by increased hydrostatic pressure in glomerular capillaries (from Kahoot) ▪ Complication of hydronephrosis- o Most common is development of UTI and pyelonephritis. o When the UTI is associated with a high fever, kidney infection is usually suspected. ▪ Most common cause of pyelonephritis- o An ascending infection of E.Coli. ▪ Risk factors for developing chronic renal failure- o Obesity, HTN, age, African American decent, low birth weight, smoking, Type 2 Diabetes. ▪ Functions of the kidney- o E.E.R ▪ Excretion, Elimination, Regulation
▪ Clinical manifestations of benign prostatic hypertrophy (BPH)- o urinary retention, obstruction to flow, decreased stream, hesitancy (difficulty initiating a stream), interruption of stream, infection caused by retention ▪ Substance that controls the reabsorption of water from the collecting ducts- o ADH, Antidiuretic Hormone Module 6 ▪ What is type 2 diabetes characterized as? o High Blood Glucose levels as a result from impaired insulin utilization, insulin resistance ▪ Clinical manifestations of Grave’s disease- o Common cause of hyper thyroidism, enlargement of thyroid- diffuse goiter, exophthalmos, heat intolerance, anxiety, bulging eyes o Dermopathy- thick, red skin on shin & top of feet ▪ What processes occur during fasting? o Glucose is produced by glycogenolysis, gluconeogenesis, and insulin falls to basal level o Glucagon is responsible for most glucose production in fasting state o Other counterregulatory hormones (corticosteroids, growth hormones, catecholamines) augment glucose production ▪ This type of tissue is accessed to promote energy production in type I diabetes- o Adipose Tissues ▪ Clinical manifestations of hyperthyroidism; hypothyroidism; hypoparathyroidism; hyperparathyroidism- o HYPERthyroidism - fatigue, weight loss, sensitivity to cold, depression, memory problems, goiter, hair loss, muscle pain, trembling hands, infertility. Hyper= grave’s disease. o HYPOthyroidism - decreased BMR, weakness, fatigue, cold intolerance, decreased appetite, weight gain, depression, menstrual irregularities, muscle weakness. o HYPOparathyroidism - tingling/burning in fingertips, toes, lips,
Primary Hypothyroid: (problem is with the thyroid gland) l ow T3, T (hyposecretion of t3 and t4), TSH high Primary Aldosteronism: Conn Syndrome usually caused by aldosterone- secreting tumors Secondary Aldosteronism: increased adrenal production of aldosterone in response to nonpituitary, extra adrenal stimuli (such as: hypoperfusion) – target hormone for aldosterone is kidney ▪ Define: myxedema- o This occurs in untreated hypothyroidism. Severely advanced hypothyroidism. Lack of thyroid hormone that contributes to NON-pitting edema. ▪ Causes of hypothyroidism- o May be congenital or acquired ▪ IF we are born with it = called cretinism o Majority are primary b/c thyroid is malfunctioning o Acquired hypothyroidism is hashimoto ▪ The 3 P’s in type I diabetes- o Polyuria (increased urination) o Polydipsia (increased thirst) o Polyphagia (increase hunger) ▪ Difference between primary and secondary endocrine disorders- o Primary= problem is with gland that produces hormone ▪ Example: type 1 diabetes is a primary disease o Secondary= problem with the pituitary ▪ Cause of Cushing’s syndrome: PRIMARY o Caused by the pituitary producing too much ACTH, which turns into increased cortisol, excess glucocorticoids from adrenal glands ▪ Cushing Disease: Secondary ▪ Cushing Syndrome: primary- problem with the adrenal cortex ▪ Tertiary- problem with the hypothalamus
- Patient presents with lower right abdominal pain, nausea, occasional diarrhea. They have appendicitis
- Growth hormone mainly targets the liver
- Type 2 Diabetes- peripheral tissue insulin resistance
- Acromegaly- deep voice, increased ring/shoe size, coarse facial features
- 2 stress hormones that increase glucose production in liver= corticosteroids and catecholamines
- Bleeding between periods= metrorrhagia
- Pheochromocytoma key sign= very high blood pressure
- Hirschsprung’s Disease= inadequate innervation of the colon
- Diabetes insipidus= too little ADH production
- Gall stones obstructing the cystic duct would cause severe upper right quadrant pain
- GFR raised by increased hydrostatic pressure in glomerular capillaries
- Difference between acute gastritis- and chronic o Resulting difference between the two: chronic gastritis causes lining erosion, atrophy, inflammation o Acute gastritis: Lactose intolerance: causes gastritis. they are gastritis symptoms. If they accidentally get lactose: n/v, diarrhea- anorexia
- If you get a hiatal hernia it is caused by- increased intraabdominal pressure
- Peritonitis symptoms: rigid abdomen, o Cause of rigid abdomen: inflamed peritoneum
- Crypto organism- hidden/undescended testes- cause infertility
- Amenorrhea- absence of a period o Metrorrhagia- bleeding in between periods o Dysmenorrhea-
- Painful prostate-prostitis
- When I tap your CVA- checking for flank pain, kidney tenderness
- Bad flank pain- the cause is usually kidney stones
- If a man has a hydroseal- what is this? o Fluid buildup in the scrotum- tunica vaginalis
- Hydronephrosis- what’s a complication of this? o Swelling and build up of fluid in the kidney- what happens in area where the swelling is? Ischemia and necrosis
- What hormone is responsible for reabsorption in kidneys? AHD o Where does the happen? Collecting ducts
- Prostatitis- symptoms o Hesitancy o Painful prostate
- Kidney pain: called CVA tenderness, we call the pain renal colic
- Syphilis- what causes bacteria o Anerobic spirochete o Main problem with syphilis- cardiovascular, aortic stenosis, inflamed aorta, brain, blindness, numbness and tingling, (get goofy…?)
- Function of kidney: o Filter, regulate BP, secretion, regulation of the fluid balance, removal nitrogenous waste, acidic waste
- What do the kidneys do with vit D? o Activate the Vit D
- GFR- this is a calculated number, what two values are used to make this calculation? o Serum urea goes up o Bicarb goes down o Creatinine goes up, GFR goes down
- What kind of people are at risk for chronic renal failure? o Diabetes (type 1) o Someone who takes a lot of nsaids o Hypertension o Chronic kidney disease patients are more at risk
- Things that cause women to quit having period in a NON menopausal woman: o HYPOthyroidism and adenomas and carcinomas
- Who can tell me about the RAS system? o When is the RAS system activated? ▪ LOW BP or when blood flow in the afferent arterial is decreased
- Herpes: o How do we treat? Antiviral drug- not antibiotics
- Glomerulonephritis about you have strep throat? Post streptococcal gloferrial nephritis- what does urine look like? o Dark urine
- Characteristics of Type 2 Diabetes: o Peripheral tissue insulin resistance
- What is acromegaly caused by? o Overproduction of adult growth hormone
- Goiter- we suspect: HYPERthyroidism- Grave’s disease
- Primary hypothyroidism and Secondary- know the T3, T4 and TSH
- Fasting- what happens in the alpha cells of the pancreas? o Glucagon
- Symptoms of Cushing’s: o Weight gain, low energy, increase in hair, depression, anxiety, fatigue, irritability, headaches
- Pt with type 2 diabetes: why do they need to control their blood sugar?
- Myxedema: occurs in hypothyroidism, you have non-pitting edema
- Kid who is bigger than all their peers: o They might have gigantism
- Type 1 diabetes and stress: o Blood sugar goes up b/c of release of glucocorticoids
- Diabetes insipidus: o Not enough ADH ▪ So, they drink and urinate A LOT!!!
- Type 1 diabetes: Not producing insulin- they can use fat for energy- ADIPOSE TISSUE
- Type 1 diabetes (absolute insulin deficiency)
- 3 P’s of diabetes: o Polydipsia o Polyuria o Polyphagia
