This site is 100% ad supported. Please add an exception to adblock for this site.

Patho final exam (copy)


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?
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?
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?
Duodenal ulcers may be complicated by what?
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?
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?
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?
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.
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?
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?
The presence of albumin in the urine would indicate probable damage to what?
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?
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?
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?
prerenal failure may be associated with what?
Uremia may have the side effect of what?
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?
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?
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
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
A manifestation shared by both DM and DI is:
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
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
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?
Hypersecretion of aldosterone results in
hypersecretion of glucocorticoids results in
A hormone having an antidiuretic effect similar to ADH is...
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?
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

Deck Info