Patho final exam (copy)
Terms
undefined, object
copy deck
- Where does the liver receive blood from?
- Hepatic artery and hepatic portal vein
- What are varices?
- dilated blood vessels
- What are the routes of transmission for Hepatitis?
-
A and D - fecal-oral, parental, sexual
B - parenteral sexual
C - parenteral
E - Fecal-oral - What are the incubation periods for Hepatitis?
-
A - 30 days
B - 60-180 days
D - 30-180 days
C - 35-60 days
E - 15-60 days - What are the varying levels of severity with hepatitis?
-
A - mild
B - severe, may be prolonged
D - severe
C - unknown
E - severe in pregnant women - What is alcoholic cirrhosis?
- Damage to the hepatocytes. Toxic effect of chronic and excessive alcohol intake is the cause.
- What is alcoholic hepatitis?
- inflammation of the liver due to alcohol intake.
- Explain the pathophysiology of alcoholi cirrhosis.
-
1. Long term ETOH use
2. Alcohol is transformed to acetaldehyde
3. Acetaldehyde causes liver call damage and death.
4. Cellular damage initiates an inflammatory response, necrosis, and excessive collagen formation.
5. Fibrotic tissue replaces liver cells. - A patient diagnosed with a neoplasm of the ascending colon would be expected to exhibit what?
- secretory diarrhea
- Achalasia results from...
- neurologic dysfunction
- Reflex esophagitis is defined as...
- an inflammatory response to GERD
- how does the liver play a role in intestinal digestion?
- It secretes bile which contains bile salts that have a digestive function.
- What are the four complications secondary to protal hypertension?
-
varices
splenomegaly
ascites
hepatic encephalopathy - The vomiting reflex can be stimulated by
- severe pain
- The nurse explains to the pt with GERD that this disorder...
- often involves relaxation of the lower esophageal sphincter, allowing stomach contents to back up into the esophagus
- What is the primary cause of duodenal ulcers?
- hypersecretion of pepsin by the stomach
- How does the pathology of stress ulcers differ from that of duodenal ulcers?
- The presence of ulcers in both the stomach and duodenum.
- The primary action of ranitidine (pepcid) is to:
- antagonize the action of histamine at its H2 receptor site
- Which of the following symptoms would help the nurse distinguish between ulcerative colitis and Crohn disease?
- malabsorption and steatorrhea
- The most potentially dangerous complication of diverticulitis is:
- perforation and peritonitis
- An adult has been diagnosed with colon cancer. What are the clinical manifestations the nurse would most likely see?
- alternating episodes of diarrhea and constipation
- Shock can develop with acute pancreatitis for which of the following reasons?
- vasoactive inflammatory mediators are released into the blood stream.
- Which of the following lab results are most specific to a diagnosis of acute pancreatitis?
- elevated white blood cell count
- Symptoms of cholelithiasis include all of following except?
- decreased serum bilirubin levels
- Hepatitis B is least likely to be transmitted via
- fecal-oral contamination
- What happens during vomiting?
- deep inspiration, airway closure, forceful diaphragm and abdominal muscle contractions, and esophageal sphincter relaxation.
- Which does not cause constipation?
- hyperthyroidism
- Osmotic diarrhea is caused by
- lactase deficiency
- How melana defined?
- black, tarry, stools
- Intestinal obstruction causes what?
- decreased intraluminal iension, hyperkalemia, and decreased nutrient absorption.
- Peptic ulcers may be located where?
- in the stomach, esophagus, duodenum
- Gastric ulcers may lead to what?
- malignancy
- Duodenal ulcers may be complicated by what?
- hemorrhage
- In malabsorption syndrome, what is flatulence and abdominal distension caused by?
- undigested lactose fermentation by bacteria
- The characteristic lesion of Chron disease is what?
- found in the ileum and granulomatous
- Low residue diets and chronig constipation play a role in the pathogenesis of what?
- diverticulitis
- The most common manifestation of portal hypertension is what?
- vomiting of blood from esophageal bleeding
- Hepatic encephalopathy is manifested by:
- cerebral dysfunction
- Which would be consistent with a diagnosis of viral hepatitis?
- Elevated AST serum enzymes, Decreased serum albumin levels, Prolonged coagulation times, Increased serum bilirubin levels
- Which viral hepatitis is not associated with a chronic state or a carrier state?
- Hepatitis A
- Which type of jaundice is due to increased destruction of erythrocytes?
- hemolytic
- Which most often causes biliary cirrhosis?
- biliary obstruction
- Symptoms of cholelithiasis include what?
- nausea, vomiting, right upper quadrant tenderness, jaundice, abdominal distress
- What does teh tissue damage a result of in pancreatitis?
- release of pancreatic enzymes
- Predisposing factors in the development of colon cancer inlcude what?
- familial polyposis, ulcerative colitis, low-fiber/high-fiber diet, high refined CHO diet
- The functional unit of the human kidney is what?
- nephron
- Which sequence of structures does urine pass through as it leaves the body?
- minor calyx, major calyx, renal pelvis, ureter, urinary bladder, urethra
- One feature of renal blood circulation that makes it unique is that...
- there are two sets of capillaries
- The glomerular filtration rate is regulated by what?
- the autonomic nervous system, the renin-angiotensin system, and atrial natriuretic factor
- The capillaries of the glomerulus differ from other capillary networks in the body because they
- branch from and drain into arterioles
- What are the functions of the kidney?
- water volume control, blood pressure control, converts vitamin D to an active form. It does not store urine.
- Potassium is secreted by the ______ and reabsorbed by the ______.
- collecting ducts, loop of Henle
- ADH causes water to do what?
- diffuse into the ascending limb of the vasa recta and return to systemic circulation
- Water reabsorbed from the glomerular filtrate initially enters what?
- vasa recta
- Plasma contains a much greater concentration of _______ then the glomerular filtrate.
- protein
- An increase in water permeability of the distal convoluted tubules and collection duct is due to what?
- an increase in ADH
- The decending loop of the nephron allows what?
- water reabsorption
- Which most accurately describes the pressures affecting net glomerular filtration?
- blodo hydrostatic opposes capsular hydrostatic and blood oncotic
- Tubular secretion of urea is accomplished where?
- in the distal convoluted tubule
- What do the kidneys conserve and eliminate?
- eliminate H+, eliminate NH4+, conserve HCO-3
- What should not appear in the glomerular filtrate just after the process of glomerular filtration has been accomplished?
- protein
- Atrial natriuretic factor does what?
- increased urine output
- What is urea?
- a waste product of protein metabolism.
- What substance is an abnormal component of urine?
- glucose
- The presence of albumin in the urine would indicate probable damage to what?
- glomeruli
- What is true about urinary tract infections?
- They are usually due to coliforms, especially E coli, organisms probably ender the bladder by way of the urethra, the patient may be asymptomatic.
- Renal calculi may be composed of what?
- calcium oxalate or uric acid
- What is characteristic of urethral stones?
- severe pain in back, severe pain in abdomen, nausea and vomiting
- Which are predisposing factors for acute urinary tract infections?
- the gender of the pt, congenital deformities of urinary tract, decreased urine flow.
- A common cause of both pyelonephritis and cystitis is what?
- invading microorganisms such as E. coli
- uremia exhibits
- retention of metabolic acids
- What is pyelonephritis?
- inflammation in kidney characterized by fever, chills, and flank pain. Characterized by pyuria, bacteriuria and hematuria. More common in young women than in young men
- Which renal condition usually has a history of recent infection with beta-hemolytic streptococci?
- glomerulonephritis
- Which statements are true of glomerulonephritis?
- significant damage to kidneys occurs, fever and flank pain occur, complement activation attracts neurtrophils, it is characterized by hematuria, proteinuria, and the presence of casts
- Nephrotic syndrome is associated with ____ to plasma _____.
- increased glomerular permeability; proteins
- Causes of acute renal failure include the following
- stones and strictures in kidney or ureters and heart failure leading to poor renal perfusion
- Describe the labs/symptoms of a patient in acute renal failure.
- elevated serum creatinine, high BUN, oliguria
- What are some characteristics of chronic renal failure?
- hyperkalemia, anemia, pruritis, acidosis
- How is chronic renal failure treated?
- with dialysis or transplants
- What may chronic renal failure result from what?
- hypertension
- Chronic renal failure is usually the result of what?
- chronic inflammation of the kidney
- An individual has an elevated blood level of urea and creatinine because of complete calculi blockage of one ureter. This is referred to as what?
- postrenal disease
- Nephrotoxins, such as antibiotics, may be reponsible for:
- acute tubular necrosis
- Uremia as seen in chronic renal failure would include what?
- metabolic acidosis, elevated BUN and creatinine, and cardiovascular disturbances.
- What is the earliest symptom of chronic renal failure?
- polyuria
- prerenal failure may be associated with what?
- hypovolemia
- Uremia may have the side effect of what?
- pruritis
- Nephrotic syndrome in children manifests as what?
- proteinuria, hyperlipidemia, lipiduria
- Secondary amenorrhea is...
- the absence of menstruation following menarch
- What is likely pathophysiology of PMS?
- An abnormal nervous, immunologic, vascular, and gastrointestinal response to hormone flactulations of the menstrual cycle ikely occurs
- Endometriosis occurs when:
- has the ectopic endometrium resonding to hormonal fluctuations of the menstrual cycle.
- Fibrostatic disease is associated with :
- fluctuating lesion size
- Breast cancer is associated with:
- palpable axillary lymph node and mutated gene on chromosome 13 or 17
- Gonorrhea is caused by:
- neisseria gonorrhoeae
- Syphilis is caused by:
- Treponema pallidum
- In blunt head trauma:
- the dura remains intact
- In an automobile accident, an individual's forehead struck the windshiled. The coup/contracoup injury would be in what area
- the frontal/occipital
- in moderate diffuse axonal injury:
- coma lasts more than 24 hours and tearing of axons in the crebral hemisphere occurs
- What is a concussion:
- violent displacement of brain tissue due to acceleration or decelaration
- What is a contusion?
- bruising of part of the brain
- What is an extradural hematoma?
- arterial hematoma
- What is an subdural hematoma?
- venous bleeding
- What is intracerebral hematoma
- bleeding into the brain's parenchyma
- Most spinal cord injuries occur in the:
- cervial and lumbar regions
- Injury of the cervical cord may be lifethreatening because of:
- diaphragmatic impairment
- Autohyperreflexia is characterized by all of the following:
- slower heart rate, stimulation of sensory receptors below the level of the cord lesion, precipitation because of a distended bladder or rectum
- TIAs are
- focal neurologic deficits that develop suddenly last for several minutes and clear in 24 hours
- What is a risk factor for the development of CVAs?
- polycythemia vera, hypertension, DM, elevated blood cholesterol.
- What typically characterizes the victims of a cerbral embolic stroke?
- middle-aged individuals with a history of heart disease
- In bacterial meningitis, the CSF has:
- neutophilic infiltration
- Manifestations of Parkinson's disease include which of the following?
- resting tremor, akinesia
- parkinson's disease is a result of a dysfunction in
- basal ganglia
- myasthenia gravis is a result of a dysfunction in
- neuromuscular junction
- MS is a result of dysfunction in
- CNS myelin
- Guillain Barre syndrome is a result of dysfunction of
- peripheral nerve myelin
- Amyotrophic lateral sclerosis is a result of the dysfunction of
- corticospinal tracts and anterior roots
- one function of the somatic nervous system that is not performed by the autonomic nervouc system is:
- conduction of impulses to skeletal muscles
- Neurons that carry impulses away from the CNS are called
- efferent neurons
- neurons are specialized for the conduction of impulses, whereas neuroganglia:
- support nerve tissue
- Which contains the thalamus and hypothalamus?
- diencephalon
- The reticular activating system does what?
- maintains wakefulness
- Sensory neurons do what?
- carries impulses to the CNS
- effectors do what:
- responds to motor impulse
- What are protective coverings of the CNS?
- dura mater, arachnoid, cranial bone
- What is the composition of CSF?
- a plasma-like liquid with glucose, salts, and proteins
- What is characteristic of confusion?
- inability to think clearly
- An individual shows flexion in upper extremities and extension in lower extremities.
- This is decorticate posturing
- Cerebral death permits what?
- Normal internal homeostasis.
- Precipitating causes of seizure inlude:
- meningitis, stroke, hyperthermia
- Which epileptic weizure is characterized by temporal lobe spikes in EEG?
- psychomotor
- What is agnosia?
- inability to recognize sound
- An individual with increased ICP from a head injury shows dilated and sluggish pupils, widened pulse pressure and bradycardia. Which stage ICP exists?
- Stage 3
- Infratentorial herniation occurs with:
- shifting of the cerebellum
- In cerebral vasogenic edema:
- cerebrospinal fluid leaves the ventricles
- Which statements are true regarding increasing ICP
- the brain volume increases, the blood volume in the vessels increases, brain tissue shifts from teh compartment of greater pressure to the one of lesser pressure.
- What is rigidity?
- tonic reflex activity
- What is hemiparesis
- upper and lower extremity paralysis on the same side
- What is akinesia
- difficult initiation of spontaneous and voluntary movements
- Basic perception of pain is from the
- postcentral gyrus
- initiation of pain stimulus comes from the
- nociceptive receptors
- discrimination and precision given to painful stimulus comes from the
- cortex
- In the gate control theory of pain simtulation of large A fibers
- "closes the gate"
- What is teh function of interleukin-1:
- it raises the hypothalamic set-point, its an endogenous pyrogen, and it is stimulated by exogenous pyrogens
- What type of pain is acute pain
- somatic, visceral or referred pain
- What is chronic pain?
- prolongues pain lastin gloner than 6 months that is either persistant or intermittent
- what is transduction?
- conversion of a mechanical, thermal, or chemical stimulus into a neuronal action potential.
- What is transmission?
- movement of pain impulses
- What is perception?
- pain is recongized by person, defined, and responded to
- What is modulation?
- changing or inhibiting pain impulses
- What are the three major neurotransmitters involved in the pain mechanism?
- endorphins, serotonin, and norepinephrine
- What is a narcotic agonist?
- (morphine) fully activates all receptor sites
- what is a narcotic agonist-antagonist?
- agonist at some sites and antagonist at others (stadol)
- What is a narcotic antagonist?
- Narcan, works against morphine to knock it off pain receptor site
- ICP is controlled by what three things?
- brain tissue, CSF, and blood
- What are barbiturates used for?
- inducing comatose state to help brain heal
- mannitol is used to do what?
- decrease ICP by plasma expansion and an osmotic effect.
- Stoke patients will use what drug therapy?
- apirin, plavix, heparin, etc
- patient with seizures will receive what therapy?
- tegretol (partial), neurotin (partial), lamictal (partial), ativan (status epilepticus)
- Which lab value would be expected in a pt with SIADH?
- serum sodium of 120 mEqL and urine hypoosmolality (low because of excessive urine output)
- Hypopituitarism in an adult male likely includes what:
- impotence, muscular mass decrease, skin pallor.
- Excessive secretion of GH in an adult may cause
- acromegaly
- A manifestation shared by both DM and DI is:
- polyuria
- the manifestaiont of hyperthyroidism include
- diarrhea, heat intolerance, weigth loss, and wakefulness
- Hypothyroidism crisis is
- myxedema coma
- Graves disease is
- hyperthyroidism, associated with autoimmunity and manifested by ophtalmopathy
- Inadequate levels of thyroid hormones at birth may cause
- mental retardation
- Hyperparathyroidism causes
- increased osteoclastic activity
- A manifestaion of hypocalcemia is
- tetany
- What is the most common cause of acromegaly?
- anterior pituitary adenoma
- If a 19 year old woman were suffering from SOB, weight loss, excessive sweating, and irritability, which hormone would you expect elevated in her serum
- thyroxine
- Oral insulin is used for peopel with
- type 2 DM
- Common symptoms of DM include
- hyperglycemia, blurred vision, persistent infection and polyuria
- Long-term corticosteroid therapy may cause
- delayed wound healing, osteoporosis, and peptic ulcers
- Which electrolyte alteration occurs in Addison's disease?
- hyponatremia
- Hypersecretion of aldosterone results in
- hypernatremia
- hypersecretion of glucocorticoids results in
- hyperglycemia
- A hormone having an antidiuretic effect similar to ADH is...
- insulin
- What is used to treat DI?
- desmopressin, vasopressin, diabinese, thiazide diuretics,
- What do t3 and t4 levels look like in hypothyroidism
- they are decreased
- What drugs are used for hypothyroidism?
- Synthroid
- What drugs are used for hyperthyroidism?
- Thiamides or iodine solutions
- What hormones are released by the anterior pituitary?
- ACTH, MSH, GH, prolactin, FSH, LH, and TSH
- What hormones are released by the posterior pituitary?
- ADH and oxytocin
- What is pheochromocytoma?
- an adrenal medullary tumor
- what is your name
- fill in the blank