Final Flashcards
Patho of Chron’s disease
Inflammation and ulceration occurring anywhere in GI tract from mouth to anus
Ulceration characteristics of Crohn’s disease
Patchy, “skip” lesions
May be full thickness
Path of ulcerative colitis
Inflammation of colon/large intestine ONLY
Direction and characteristics of ulceration in ulcerative colitis
start at rectum move up
Superficial
Risk associated with ulcerative colitis
Colon cancer
Patho of cirrhosis
Hepatocytes » fibrotic and scarred tissue
Permanent/irreversible
Early symptoms of liver disease
Malaise
Flatulence
RUQ heaviness
Late symptoms of liver disease
Portal hypertension
jaundice
Ascites
confusion/loc
peripheral edema
hepatorenal syndrome
caput medusae
bleeding risk
what causes jaundice
build up of bilirubin
What is ascites
distended abdomen
What is caput medusae
Dilated veins around belly button
Esophageal varices describe
swollen veins in esophagus
complications with esophageal vacicies
rupture leads to bleeding
upper GI - hematemesis
hypotension
low HCT/HGB
Signs and symptoms of GERD
Epigastric pain (heart burn), can get worse at night
Chronic cough
sore throat
Sour/bitter taste in the morning
What is cholelithiasis
Formation of gallstones
S/S and Duct blocked of cholelithiasis
none
S/S of biliary colic
Intermittent RUQ pain, N/V, resolves hours later
Duct and duration blocked in biliary colic
Cystic Duct
temporary
Describe Cholecystitis
Inflammation/infection due to pronlonged cystic duct blockage
S/S of Cholecystitis
RUQ pain, N/V, fever, Chills
Duct and duration blocked in cholecystitis
Cystic duct
permanent
S/S of Gallstone pancreatitis
Intense epigastric pain radiating to upper back and left shoulder
S/S of cholelithiasis
Ducts blocked in gallstone pancreatitis
Common bile duct
pancreatic duct
Describe Small bowel obstructions
Adhesion or strangulated hernia usually
Signs and symptoms of Small bowel obstruction
Central colicky pain/cramping
Frequent severe vomiting
severe fluid imbalances
metabolic alkalosis (vomiting)
Some stool passage initially then none
mild abdominal distention
Conditions causing Large bowel obstruction
Colon cancer and volvulus
Describe volvulus
Twisting of intestine around itself
S/S of large bowel obstruction
crampy, lower abdominal pain
Absolute constipation
minimal to no vomiting
massive abdominal distention
Hep A route
fecal oral
T/F there is a vaccine for hep a
true
T/F there is a cure for hep a
Self recovery, lifelong immunity
Route for hep b
Blood to blood
sexual contact
T/F there is a vaccine for hep b
true
T/F there is a cure for hep b
False
Hep C route
Blood to Blood
T/F there is a cure for Hep C
True
T/F there is a Vaccine for Hep C
No
Patho for celiac disease
Immune reaction to gluten leading to flattening of villi
Patho for diverticulitis
Inflammation/infection of outpouching within the colon, usually due to blockage
S/S of diverticulitis
Fever, nausea, leukocytosis (increased WBC), LLQ (lower left quadrant) pain
Patho for peritonitis
inflammation of peritoneal cavity surrounding the bowel (should be sterile)
Causes of peritonitis
blood borne pathogen
bowel perforation due to ruptured appendicitis, ulcer, or bowel
H. Pylori complications
peptic ulcer disease
Risk factors for abdominal hernias
Male, obesity, pregnancy, heavy lifting, age, chronic cough, constipation
Patho for pancreatitis
auto-digestion of pancreas due to activation of digestive enzymes within the pancreas
Risks for anaphylaxis
Extreme allergic response
invloves 2+ body systems
urticaria
respiratory compromis
HIV cause
retrovirus - attacks CD4 cells
Aids classification
CD4 < 200
AIDs defining illness
Where active natural immunity comes from
Infections
Where active artificial immunity comes from
vaccination
What is passive immunity
immunity that is given to you from someone
Where passive natural immunity comes from
Maternal antibodies
Where passive artificial immunity comes from
monoclonal antibodies
Signs of acute inflammation
redness
heat
swelling
pain
loss of function
patho of sepsis
Infection that results in severe inflammation, unstable vital signs, potential for multi-organ failure
Systemic inflammatory response (SIRS) definition
2 abnormal findings in
temperature
RR
HR
WBC
PCO2
Sepsis definition
2 SIRS + Confirmed or suspected infection
Sever sepsis definition
Sepsis + signs of end organ damage + hypotension + increasing lactate
Septic shock
persistent sepsis
Rheumatoid Arthritis pathophysiology
progressive autoimmune disorder where B cells create antibodies that attack joints
Common sites for Rheumatoid arthritis
Hands/wrists, feet, knees
can be in heart linings, lungs, eye, etc.
Rheumatoid arthritis presentation
symmetrical joint inflammation
Botulism patho
Clostridium botulinum bacteria causes food poisoning symptoms followed by DESCENDING paralysis by blocking ACH at junction
Causes for botulism
improper canning/preserving
honey risk for infants
Patho for tetanus
Clostridum tetani enters open wound
blocks inhibitory nerves in brain
Excitatory nerve take over
S/S of tetanus
stiff jaw/neck, arched back, fever
may cause seizures
Pre-renal injury definition
decreased blood flow
pre-renal injury causes
hemorrhage, dehydration, hypovolemia
intra-renal injury definition
damage to renal architecture
Intra-renal injury causes
drugs, disease
post renal injury definition
obstruction of urinary outflow
post renal injury causes
BPH
Phases of Acute kidney injury recovery
oliguric
diuretic
recovery
Definition of oliguric phase
<400 ml of urine/24hrs
urinalisis:
Fatigue malasie
Urinalisis of Oliguric AKI
casts, RBC, WBC,
hyperkalemia/hyponatremia
elevated BUN/creatinine
Definition of diuretic AKI
> 2-4 mL/day
hypovolemia, dehydration, hypotension
BUN/Creatinine levels are elevated but stabilized
Definition of recovery phase in AKI
GFR improves
BUN/Creatinine return to normal
Chronic kidney disease
Decreased GFR
Low urine output
Waste accumulation
Serum increases in Chronic kidney disease
Sodium
potassium
chloride
hydrogen ions
magnesium
phosphate
BUN
creatinine
PTH
Serum decreases in CKD
Calcium
erythropoietin
vitamin D
RBC’s
Nephrotic syndrom patho
Damage to glomerulus (not inflammatory)
Protein loss is not stopped
S/S of Nephrotic syndrome
Hypoalbuminemia » edema
hyperlipidemia » protein and fat creation
Proteinuria = foamy urine
Definition of acute nephritic syndrome
Glomerulonephritis (inflammation of glomeruli)
Causes of Nephritic syndrome
Antigen-antibody complex causing inflammation of glomerulus and basement membrane to leak
S/S of nephritic syndrome
Cola colored urine
hypertension
Acute cystitis
Lower UTI
Bladder infection
S/S of Acute cystitis
Dysuria, frequency, urgency, cloudy or bloody urine
No systemic symptoms (no fever)
Elderly clients - confusion
Acute Pyelonephritis and possibilities
Upper UTI
Bacteria in kidney
Urosepsis possible (bloodstream infection)
S/S of Acute pyelonephritis
Dysuria, frequency, urgency
Systemic symptoms » fever, flank pain, malaise, N/V
Stress incontinence and risk factors
Sphincter/valve malfunction
risk factors: multiple pregnancies, female, age 40+
Urge incontinence (OAB)
Over active bladder
detrusor muscle overactivity
sudden, frequent urges, females
Overflow incontinence and risk factors
Chronic bladder distension due to retention/obstruction
Risk factors: BPH, Incomplete emptying, males
Functional Incontinence and risk factors
Inability to hold urine due to underlying psychiatric or CNS causes
Risks: strokes, alzheimer’s
Nephrolitias and common
Kidney stones
Oxalate stones: too much oxalate/calcium and not enough fluid.
Cervical cancer cause and S/S
Cause: human papilloma virus (HPV)
S/S:
Early- asymptomatic
Advanced- vaginal discharge/bleeding
Pelvic inflammatory disease (PID) and complications
Infection of the female reproductive organs including uterus
Complication: permanent damage, infertility
PID risk factors
Multiple sex partners
unprotected sex
past history of PID
Testicular torsion and S/S
Twisting of blood supply cord.
unilateral pain, swelling, abdominal pain, N/V, heightened testicle, frequent urination, fever
Benign prostate hyperplasia (BPH)
Hyperplasia of prostatic tissue causes compression of urethra and urinary obstructions
S/S and risks of BPH
S/S: Obstructed urine flow, difficulty urinating, dribbling, increased frequency/urgency, nocturia, decreased flow strength
Risks: infection, post renal kidney injury
Hypoxia
1 cause of cell death
Decreased ATP, anerobic metabolism
Na/K pump failure
Calcium pump failure
ribosomal dysfunction
loss of plasma membrane
Hypertrophy
Increase in size
atrophy
decrease in size
Dysplasia
precancerous, abnormal cell shape
metaplasia
cells change to another cell shape
Hyperplasia
increase in the number of cells
Neoplasia
New abnormal growth
Benign
slow, non-invasive, no metastasis, well differentiated
Malignant
Autonomy, metastasize, anaplasia, angiogenesis
Early warning signs of cancer
anorexia, unintended weight loss, fatigue/weakness, bruising/bleeding, unexplained fevers, unexplained night sweats, new onset pain, cachexia
Grading
how cells have changed
Staging
Spread of cancer
Stage I
local confined
Stage II
invasion next to tissue
Stage III
Lymph nodes involved
Stage IV
Distant organ, metastatic
Non disjunction
Error is meiosis resulting in extra or missing genetic material
Autosomal dominant conditions
Polycystic kidney disease
Huntingtons disease
Marfans syndrome
Autosomal recessive conditions
Cystic fibrosis
sickle cell anemia
tay-sachs disease
PKU
X linked recessive disease
hemphilia
color blindness
Iron deficiency anemia and size and S/S
low HgB/HCT
Low ferritin
RBC - microcytic
S/S fatigue, SOB, Pale skin
Sickle cell anemia
Sickle cell change during stress
Aplastic anemia and S/S
Damage to stem cells, all lines affected.
BMS, (petechiae
Vitamin B12 anemia S/S
Lack of intrinsic factor
unique S/S: neurological symptoms
Active compensatory mechanism
Sympathetic nervous system
ADH - reduce urinary output
RAAS - angiontensin II and vasoconstriction
Active compensatory mechanism physiology
increase HR, Vasoconstriction, ADH secretion, RAAs activation
Acute hemolytic reaction
ABO incompatibility (wrong blood)
Hemoglobinuria (broken down RBC) acute renal failure, DIC, death
Disseminated intravascular coagulation (DIC)
Excessive clotting uses up all clotting factors causing massive bleeding, low bp, and easy bruising
Cushings disease patho
excessive corticosteroid (crtisol)
Causes: chronic prednisone use, adrenal gland tumor
S/S of cushings
Obesity/Weight gain
purple striae
hyperglycemia, hypertension
protein breakdown
loss of collagen
insomnia
osteoporosis
acne
immune suppression
Hypothyroidism conditions and S/S
hashimoto’s thyroiditis (primary)
Myxedema coma
Low metabolism
Hashimoto’s thyroiditis
Auto immune inflammation of thyroid gland
atrophy or distruction of tissue
myxedema coma
sever hypothyroidism
hyperthyroidism conditions and S/S
Grav’es disease
thyrotoxic crisis
S/S: high metabolism
Graves disease
autoimmune that causes excessive production of thyroid hormone
thyrotoxic crisis (thyroid strom)
Too much thyroid hormone
Can be fatal from heart failure and pulmonary edema
Type I diabetes Mellitus
Insulin depndent
autoimmune destruction of beta cells in pancreas
Type II diabetes
Gradual onset
Cellular resistance
adipose tissues lead to resistance
Risk factors of Type II Diabetes
History of gestation diabetes, inactive lifestyle, obesity
Diabetic keto acidosis
Type I Dm
Blood sugar > 250
acetone
keatones
kusmau’s
Hyperosmolar hyperglycemic State (HHS)
Type II Dm
Blood sugar > 600
no smell/ ketones
shallow breaths
slow onset
LOC
Profound dehydration
Compartment syndrome and 6 P’s
Swelling/ other occlusion of artery
Pain, parethesia (loss of sensation) Pallor, paralysis, pulselessness, poikilothermia (cold in one extremety)
Fat embolism
Marrow leakage impacts lungs, brain, skin, w/n 24 hrs after fracture
Perfect triad (Fat embolism)
SOB, Petechia (neck/chest), Confusion
Rhabdomyolysis and effects
Muscle break down
Myoglobinemia, myoglobinuria
hyperkalemia
arrythimas
creatine kinase in blood
ABCDE for moles
Asymmetry
border
color
diamter (Larger than 6mm)
Evolving
Decubitus (pressure) ulcers and main factors
Ischemic lesion
impaired blood flow
Skin pressure
shearing force
friction
moisture
Burn complications
Infection/sepsis
hypovolemic shock (edema)
hypothermia
Respiratory dysfunction
Increased metabolic demand (O2, glucose, protein)
Cellulitis and S/S
Infection of hypodermis
S/S: redness, swelling, warm
Damage from hypertension
Brain- Ischemic or hemorrhagic
peripheral vascular disease
aneurysm
kidney injury/failure
retinal damage
Cardiac - angina heart attack/failure
left ventricular hypertrophy
Coronary syndrom W/O ischmia/elevated troponin
Stable and unstable angina
Coronary syndrome W/ elevated troponin and ischemia
NSTEMI and STEMI
Atherosclerosis Risk factors
Smoking, diabetes, hypertension, high cholesterol, high triglycerides, obesity
atrial fibrillation and causes
rhythm starts in atria
risk: ischemic stroke/clots
Right hear failure signs
peripheral edema, hepatomegaly, splenomegaly, abdominal pain, GI issues, JVD, ascites, wight gain
(Cor pulmonale)
Left heart failure signs
Pulmonary edema, SOB, paroxysmal nocturnal dyspnea/tachypnea, activity intolerance, confusion, tachycardia, hypoxia
Rheumatic heart disease
strep infection leads to immune response and damage to heart valves
Inefective endocarditis
Bacterial infection of heart impacting tricuspid valve
S/S of inefective endocarditis
fevers, chills, new heart
murmur, night sweats,
fatigue, SOB and chest pain.
splinter hemorrhages (under nails)
Roth spots (retina),
Osler nodes (feet/hands).
Pericardial tamponade, S/S and becks triad
Fluid compression of right heart
S/S: weakness, syncope, dizziness
Becks triad: muffled heart sounds, hypotension, JVD
Transient ischemic attack
(TIA) temporarry occlusion with resolve, no permanent damage
Ischemic stroke
Blocked blood flow to brain from thrombus or embolus
Hemorrhagic stroke and S/S
Rupture in vessel of brain
S/S: sudden onset of severe headche, confusion, LOC
S/S of ICP
Headache/ changes
N/V
Fixed/Dilated pupils
Posturing
Cushings triad
Cushing’s triad
Increased BP
Bradycardia
bradypnea
Status epilepticus
Seizure > 5 minutes or 2 w/n 5 minutes
Epidural hematoma
Arterial bleed b/n skull and dura mater
Subdural hematoma
Venous bleed b/n dura and arachnoid mater
Autonomic dysreflexia
Sympathetic overdrive from irritant in paralysis
Meningitis and S/S
inflammation of meninges
Inflammation – Swelling – Increase ICP - Death
S/S: Fever
* Neck Pain/Nuchal Rigidity
* Photophobia
* Sleepiness
* Vomiting
* Seizures
* Headaches
Somatic pain
Skin/tissue/bone pain
Visceral pain
organs, referred pain present
Alzheimer’s patho
Amyloid plaque in brain
progressive and incurable
Parkinson’s disease patho
loss of dopamine producing cells in substantia nigra
causes motor issues
Multiple sclerosis Patho and S/S
Destruction of myelin sheath
fatigue, blurry/loss of vision, incontinence, balance/gait issues, AMS
Atelectasis
Collapse of a section of alveoli
Asthma and S/s
broncochonstriction, inflammation, and mucous production
SOB, Expiratory wheezing, cough, tachypnea
Cystic fibrosis
Autosomal recessive
respiratory, pancreas, and reproductive mucous issues
COPD and S/s
emphysema (Scarring/dmage alveoli) and Chronic bronchitis (mucus production)
chronic cough, hypercapnia, hypoxemia, barrel chest
Tension pneumothorax and S/S
lung collapse and R. heart failure from pressure
Hypotension, tachycardia, tracheal deviation to unaffected side,
No breath sounds on impacted side
Tuberculosis and S/S
Bacterial infection of lungs
S/S: cough > 3 weeks, hemoptysis, wight loss, fatigue, fever
Influenza and S/S
Viral infection
high fever, runny nose/sore throat/ cough
myalgia,
N/V/D
Pneumonia and impact
Lower respiratory infection
diffusion issue
Pulmonary embolism/ DVT and risks
Pe- blocked pulmonary artery
risks Fractures
* Immobility
* Cancer
* Birth control pills, estrogen therapy
* Pregnancy
* Smoking
* Obesity
Raas system activation
Low blood volume
low blood pressure
Albumin and impacting diseases and S/S
Osmoti pressure (oncotic pressure)
Liver disease and kidney disease (low albumin)
S/S peripheral edema
Hypernatremia S/S
Thirst, muscle twitching, decrease in deep tendon reflexes
* Both will present with confusion, coma, and seizure
Hyponatremia S/S
tachycardia, hypotension, muscle weakness, respiratory arrest
Hyperkalemia S/S
Cardiac arrhythmia, weakness, confusion, tall T wave
Hypokalemia S/S
Cardiac arrhythmia, weak pulse, ST depression/inverted T wave
hypercalcemia S/S
N/V, bone pain, kidney stones, low phosphate
”moans, bones, stones, and thrones”
hypocalcemia S/S
Numbness, tingling, muscle spasms in face/hands/feet/mouth,
weak bones, high phosphate
Chvostek’s sign, Trousseau’s sign
causes of metabolic acidosis
DKA, liver failure, kidney disease
Causes of respiratory acidosis
hypoventilation (pneumonia, copd)
Sedation
= hypercapnia and hyperkalemia
Causes of metabolic alkalosis
Loss of acid, addition of base
Severe vomiting, NG tube suction
= hypokalemia
Causes of respiratory alkalosis
Hyperventilation
= hypocapnia nad hyopkalemia
