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Solution to Pathophysiology
Final Exam
What is allergic asthma associated with? - answer -Type 1 Hypersensitivity; IgE mediated What are the S&S of ARDS? - answer -SOB, Shallow Rapid Breathing, Atelectasis (aveoli close), Dyspnea, Inspiratory Crackles, Respiratory Alkalosis, Decreased Lung Compliance, Hypoxemia What are the S&S of tension pneumothorax? - answer -Pressure that builds up and pushes the trachea towards the unaffected side; Absent breath sounds over affected lung What is cystic fibrosis? - answer -Excessive mucous coating in the lungs and pancreas; Genetic Disorder (Autosomal Recessive) Changes with an asthma attack: - answer -Wheezing, SOB, Bronchoconstriction, Dyspnea, Tachypnea (rapid breathing) How do you interpret ABG's? - answer -1. Look at pH (acidosis - low or alkalosis - high)
- Check the CO2 (resp. indicator) - less than 35 (alkalosis) more than 45 (acidosis)
- Check the HCO3 (metabolic indicator) - less than 22 (acidosis) more than 26 (alkalosis)
- Determine primary disorder (matches the pH)
- Determine if its compensated (pH returns to normal or near normal) Respiratory Acidosis: What happens to the pH/CO2? - answer -Elevation (increase) of pCO2 -- Decreased pH (acidosis)
Respiratory Alkalosis: What happens to the pH/CO2? - answer -Depression (decrease) of pCO2 -- Increased pH (alkalosis) Metabolic Acidosis: What happens to the pH/HCO3? - answer -Depression (decrease) of HCO3 -- Decreased pH (acidosis) Metabolic Alkalosis: What happens to the pH/HCO3? - answer -Elevation (increase) of HCO3 -- Increased pH (alkalosis) What are signs of renal cancer? - answer -No pain! Hematuria (Blood in the Urine) How do you manage end stage renal disease? - answer -Dialysis, Fluid Restriction, Low Protein Diet, Decrease Medication Doses, Anti-hypertensive, Give Ca Supplements, Give Erythropoietin Shot, Give Iron Supplements/Blood Transfusion (anemic) What do you call kidney pain? - answer -Nephralgia What is the most helpful test to determine renal function? - answer -Creatinine What bacteria is associated with acute pyelonephritis? - answer -E. coli What is the treatment for pre-renal kidney failure? - answer -Hypovolemia - Give Fluids What causes acute intrarenal failure? - answer -Kidney Stones (renal calculi), Renal Ischemia What do we see associated with SIADH? - answer -Fluid Retention (edema), Crackles in Lungs, Hypertension, Decreased Sodium (diluted) What causes myxedema coma? - answer -Hypothyroidism What is the main underlying condition for Type I and Type II Diabetes? - answer - Impaired Glucose Transport What is the difference between Type I and Type II Diabetes? - answer -Type I - Complete lack of insulin (Hyperglycemia) Type II - Insulin resistance on the cells What would we see with hypoparathyroidism? - answer -Decrease of Calcium (softer bones), Positive Chvostek's Sign, Tetany/Hyperactivity of Muscles/Tremors What is the therapy for Type I Diabetes? - answer -Give Insulin What is the therapy for Type II Diabetes? - answer -Diet, Exercise, Oral Antihyperglycemic Medicine (sensitizes cells to take up insulin)
What is a tonic-clonic seizure? - answer -"Grand Mal" (aka: Generalized Seizure) Unconsciousness, Convulsions, Muscle Rigidity What stage of sleep do most dreams occur in? - answer -REM (Stage V) What are the poorest neurological symptoms we can see in an unconscious patient? - answer -Hyperactive/Hypoactive Reflexes, Pupil Restriction/No Response, Decorticate/Decerebrate Posturing What are the 3 parts of the Glaucoma scale? - answer -Verbal, Motor, Eye Movement Score of 3(least) - 15(best) What kind of hemorrhage do cerebral aneurisms cause? - answer -Subarachnoid What causes a cerebral aneurism? - answer -Ballooning out of a blood vessel - Atherosclerosis, Trauma, Hypertension, Infection What is the difference between focal and generalized seizure? - answer -Focal Seizure
- affects 1 spot Generalized Seizure - all over the brain What are night terrors? - answer -Affects children, causes fear that is difficult to wake them up from. Fear is still persistent when awoken How do you determine how to treat a stroke? - answer -Determine if its a Hemorrhagic or Ischemic Stroke What are the S&S of Parkinson's disease? - answer -Pill Rolling, Shuffling Gait, Unintentional Tremors at Rest, Drooling What are the S&S of a right sided cerebral stroke? - answer -Life Sided Weakness What causes Encephalitis? - answer -West Nile Virus What are risk factors for hemorrhagic strokes? - answer -Hypertension What kind of things will you see with fibro myalgia? - answer -(18) Tender Spots, Pain w/o Inflammation, Fatigue What would you expect when a student comes in with S&S of a fever of 102, headache, and confusion? - answer -Meningitis - very contagious! Do children have higher or lower thresholds for pain than adults? - answer -Lower What happens to the brain signals in multiple sclerosis? - answer -Slow Down
What is one of the main complications with spinal cord injury patients, even years later after the injury? - answer -Autonomic Dysreflexia What is a normal intracranial pressure? - answer -5 - 15 mmHg What will happen if a person has a intracranial pressure of 36? - answer -Cranium Herniation What are S&S of spinal shock? - answer -Loss of Reflexes Below Level of Injury, Disturbances of the Bowel and Bladder Function Somatic Pain - answer -On the body - superficial, arising from the skin described as sharp, dull, aching, or throbbing Visceral Pain - answer -Pain in the internal organs and lining of body cavities described as aching, gnawing, throbbing, intermittent A patient complains of pain, inflammation, pattern of detmatome? - answer -Herpes Zoster (Shingles) What is gouty arthritis caused by? - answer -Uric Acid What are the complications of fractures? - answer -Infection, Improper Healing, Too Much Protein in the Blood, Ischemia, Compartment Syndrome What are the complications of compound (open) fractures? - answer -Infection (open wound), Increased Bleeding, Muscle Damage, Emboli - Compartment Syndrome is NOT a problem with this!!! Why are women at an increased risk for osteoporosis? - answer -Decreased Estrogen Levels (Menopause) What is the difference between Rheumatoid arthritis and Osteoarthritis? - answer - Rheumatoid: Autoimmuned, Pain Decreases Throughout the Day, Chronic Inflammation, Affects Tissues & Joints Osteoarthritis: Pain Increases Throughout the Day, Inflammation in the Joints When is a bone completely healed? - answer -Once the Callus is Reabsorbed What is Osteomalacia due to? - answer -Vitamin D Deficiency What do you do for a patient who has a casted broken arm with no capillary refill and the fingers turned white? - answer -Cut the Cast Off
How are eyes damaged in Diabetes? - answer -Hypertension causes hemorrhage in the weak blood vessels What are the s&s of compartment syndrome? - answer -Pallor, Pain, No Pulse, Paresthesia, Paresis (slight/partial paralysis) How do you treat compartment syndrome? - answer -Make cuts to relieve the pressure What are the different types of skin cancer? - answer -Basal cell carcinoma, squamous cell carcinoma, cutaneous melanoma, kaposi sarcome What are the s&s of scleroderma? - answer -Decreased skin turgour, hard skin, hypopigmented skin, taut, shiny, difficulty moving fingers/joints What is the main difference between viral pneumonia and bacterial pneumonia? - answer -Viral- Dry Cough Bacterial - Cough up Mucous/Phlegm What happens to the lungs in ARDS? - answer -Pulmonary Hypertension, Oxygen has no effect on increasing the pulse-ox (hypoxemia), Atelectasis, Decreased Tidal Volume, Vasoconstriction, Fibrosis of Aveoli What are the s&s of COPD? - answer -Fatigue, Dyspnea, Cough, Hypoxemia, Hypercapnia (increased CO2), Cor pulmonale (right side heart failure), SOB What causes esophageal varices? - answer -Portal Hypertension, Gastric Acid Erosion What are the s&s of Cushing's disease? - answer -Increased ACTH (adrenocorticotropic hormone), Wt. Gain, Moon Face, Buffalo Hump, Hypertension, Hyperglycemia, Decreased Potassium, Decreased Immune Function, Increased Sodium Why can prolonged seizure activity cause brain damage? - answer -Tissue Ischemia, Damage to the Neurons What happens in a myoclonic, absence, and a partial stroke? - answer -Myoclonic - sporadic (isolated), jerking movements Absence - brief loss of consciousness Partial - abnormal electrical activity is restricted to one brain hemisphere What is the classic sign of emphysema? - answer -Barrel Chest What is the classic sign of bronchitis? - answer -Productive Cough (Phlegm/Mucous/Sputum)
