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Pathopharmacology > Final Exam > Flashcards

Final Exam Flashcards

1
Q

Atrophy

A

a decrease in the size of a tissue or organ due to cellular shrinkage; the decrease in cell size is caused by the loss of organelles, cytoplasm and proteins.
* caused by mutations, poor nourishment, poor circulation, loss of hormonal support, loss of nerve supply to the target organ, excessive amount of apoptosis of cells, and disuse or lack of exercise or disease intrinsic to the tissue itself

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2
Q

Dysplasia

A

the abnormal growth or development of a tissue or organ

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3
Q

Hyperplasia

A

an enlargement of an organ or tissue caused by an increase in the amount of organic tissue that results from cell proliferation
* refers to increase in number

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4
Q

Hypertrophy

A

an increase and growth/thickening of muscle cells
* refers to increase in size

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5
Q

Metaplasia

A

the replacement of a mature, differentiated cell type by another mature, differentiated cell type that does not typically occur in the tissue in which it is found
* occurs in tissues constantly exposed to environmental agents, which are often injurious in nature

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6
Q

Iron Deficiency Anemia

A

Patho
* The body lacks adequate RBCs (Red Blood Cells) to carry oxygen around the body to perfuse the tissues.

Causes
* Lack of iron, B12 & other building blocks
* Diet low in: meat, fish, & poultry
* Pregnancy: fetus stores iron
* Pica: * LOW hematocrit and hemoglobin levels
* Gastric Bipass Surgery

S/S
* tired, fatigued & pale skin, with shortness of breath and dizziness
* Stomatitis - inflammation of mouth & lips
* Glossitis - inflammation of the tongue

Treatment
* Meat, Fish, Poultry
* Spinach “green leafy, veg” & whole grains
* Foods high in Vit C

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7
Q

Hemolytic Anemia

A

Patho
* a disorder in which red blood cells are destroyed faster than they can be made

Causes
* inheriting genetic conditions that cause anemia
* certain infections
* certain medications

S/S
* Jaundice
* SOB
* Fatigue
* Tachycardia
* Hypotension

Treatment
* blood transfusions
* bone marrow stem cell transplant
* lifestyle changes

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8
Q

Aplastic Anemia

A

Patho
* a condition that occurs when your body stops producing enough new blood cells

Causes
* Bone Marrow damage - The damage may be present at birth or occur after exposure to radiation, chemotherapy, toxic chemicals, some drugs, or infection.

S/S
* Fatigue, frequent infections, rapid heart rate, and uncontrolled bleeding

Treatment
* medications, blood transfusions, and stem-cell transplants

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9
Q

Sickle Cell Anemia

A

Patho
* The RBCs have a distorted shape, transforming from a nice round plump shape to a skinny sucked in sickle shape. These misshapen RBCs die quicker than normal RBCs, carry less oxygen to the body & get clogged in tiny blood vessels - blocking or occluding the blood supply causing ischemia to the organs.
* A vaso-occlusive crisis or“sickle cell crisis” can occur, causing extreme pain from the lack of oxygen.

S/S
* Blood clot manifestations: One-sided arm weakness, Swelling of the feet and hands (Dactylitis), sudden inability to be aroused

Complication
* Splenic sequestration crisis: rapidly enlarging spleen, low BP

Treatment
* Hydration: IV fluids
* Bed rest
* Pt control analgesia pump

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10
Q

Pernicious Anemia

A

Patho
* The body cannot absorb B12, which is a vital building block to
create RBCs. Clients lack intrinsic factor in the GI tract, which
helps the body take in B12.

Cause
* An autoimmune condition in which the body’s immune system attacks the actual intrinsic factor protein or the cells in the lining of your stomach that make it.

S/S
* Glossitis: inflammed smooth red tongue
* extreme weakness
* Jaundice

Treatment
* B12 injections IV or IM

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11
Q

Cell Lines

A
  • A defined population of cells that can be maintained in culture for an extended period of time, retaining stability of certain phenotypes and functions.
  • Cell lines are usually clonal, meaning that the entire population originated from a single common ancestor cell.
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12
Q

Deep Vein Thrombosis

A

Patho
* clot in deep vein

Causes
* being sedentary
* OCP
* pregnancy
* age
* injury
* obesity

S/S
* Calf pain and cramping
* One sided swelling
* Warm and red from blood pooling
* SOB and chest pain - alert HCP

Treatment
* anticoagulants: heparin and warfarin
* compression socks

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13
Q

Leukemia

A

Patho
* A type of cancer that affects the blood cells & bone marrow. Bone marrow is responsible for making blood cells: WBCs, RBCs, platelets. In Leukemia there is an overproduction of white blood cells (WBCs) that crowd out the production of normal cells, leading to low RBCs & low platelets.

S/S
* Frequent infections
* Fatigue, Unsteady Gait, Pale “Pallor”
* Bruising, Petechiae, & Easy Bleeding
* Weight Loss & Anorexia
* Bone pain

Diagnostic
* Bone marrow biopsy from posterior iliac crest

Treatment
* Radiation & Chemotherapy to kill the cancer.

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14
Q

Lymphoma

A

Patho
* Lymphoma is cancer within the lymphatic system, the body’s disease fighting
network including:
* Lymph nodes - the drainage tubes that help to empty the waste
* Spleen - houses the white blood cells (WBCs), which help to defend the body
against infection
* Thymus gland & bone marrow

Diagnostics
* Hodgkin’s = Reed-Sternberg
* Non-Hodgkin = NOT Reed-Sternberg

Cause
* Epstein-Barr Virus

S/S
* Painless Bumps & “Lumps under arm”
* Enlarged lymph glands
* Fever (no chills or feeling bad)
* Weight Loss
* Infections
* Night sweats (changing sheets)

Treatment
* chemotherapy or radiation

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15
Q

Multiple Myeloma

A

Patho
* Cancer of plasma cells
* The disease can damage the bones, immune system, kidneys, and red blood cell count.

S/S
* Fatigue and weakness due to anemia
* Easy bruising or bleeding
* Paleness
* Tingling or numbness in the fingers or toes
* Frequent infections and poor healing from infection
* Bone pain, usually in the back and ribs
* Broken bones, often in the spine
* Feeling very thirsty
* Weight loss
* Nausea or constipation
* Frequent urination, or no urination at all over a longer period of time

Treament
* chemo
* stem cell or bone marrow transplant

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16
Q

Neutropenia

A

Patho
* An abnormally low count of a type of white blood cell (neutrophils)

Cause
* It can be caused by diseases that damage the bone marrow, infections, or certain medications.

S/S
* fever, mouth ulcer, sore throat, or susceptibility to infection

Treatment
* avoid those with infections
* bone marrow stimulants

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17
Q

Anaphylaxis

A

Patho
* Severe allergic reaction

S/S
* Tachycardia
* Palpitations
* Dizziness
* Hives

Treatment
* Epi-Pen

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18
Q

Candidiasis

A

Patho
* a fungal infection caused by a yeast (a type of fungus) called Candida

Causes
* antibiotics
* pregnancy
* uncontrolled diabetes
* impared immune system

S/S
* itching
* rash

Treatment
* anti-fungal medications

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19
Q

Fever Treatment

A
  • rest
  • fluids
  • antipyretic - acetaminophen
20
Q

Histamine Release and Side Effects

A
  • Released from cells in response to an antibody called immunoglobulin E (IgE). This antibody may be secreted in response to an invading pathogen such as a virus, bacteria, or an allergenic substance such as pollen.
  • Histamine can also be released in response to injury caused by toxins.
  • Side Effects: itching, throat closing, NVD, anaphylaxis
21
Q

Inflammatory Response

A

The inflammatory process, or simply inflammation, is a defensive mechanism that helps protect the body against infections and injuries. It can be caused by external triggers, such as pathogens and environmental substances; and internal triggers, like cellular injury. The vascular response includes transient vasoconstriction, followed by and vasodilation; while the cellular response includes the mobilization of immune cells and an outpouring of chemical mediators. During the inflammatory process, fluid that leaks from blood vessels and accumulates in the tissue, which is called an inflammatory exudate. Finally, local signs of inflammation include heat, pain, redness, swelling, and loss of function; while systemic signs include fever, malaise, nausea, anorexia, tachycardia, and tachypnea.
https://www.osmosis.org/learn/Inflammatory_process:_Nursing

22
Q

MRSA

A

Patho
Methicillin-resistant Staphylococcus aureus
* A staph infection that is difficult to treat because of resistance to some antibiotics. Staph infections—including those caused by MRSA—can spread in hospitals, other healthcare facilities, and in the community where you live, work, and go to school.

S/S
* Swollen, painful red bumps
* Full of pus or other drainage
* Accompanied by a fever

Treatment
* antibiotics

23
Q

Parasympathetic Response to Infection

A

modulates inflammation by acting as an anti-inflammatory neural circuit

24
Q

Sympathetic Response to Infection

A

Protection of body tissues against challenges arising from the environment as well as from within the body. This function includes the modulation of inflammation, nociceptors and above all the immune system

25
Q

Type 1 Hypersensivity

A

Type I hypersensitivity reactions are also called immediate reactions because they are the fastest out of the 4 different hypersensitivity types. This is because mast cells and basophils are primed by antigen specific IgE antibodies during the initial exposure to the antigen, so when the body is exposed to the antigen in the future, the mast cells are ready to attach to the antigen and release proinflammatory molecules.

One of these is histamine and it could cause vasodilation, increase vessel permeability, and cause smooth muscle contractions. Other proinflammatory molecules like interleukin and prostaglandin attract more immune cells to the area which ramps up the immune response. The antigens that trigger a type 1 hypersensitivity reaction are called allergens and common ones include bee venom, foods like peanuts, shell-fish, airborne particles like pollen or animal dander, or contact based allergens like latex or animal hair.

Disease caused by type 1 hypersensitivity include Asthma, allergic rhinitis, contact dermatitis, and eczema. The most dangerous perhaps is anaphylaxis, which is a systemic condition that could cause anaphylactic shock and even death.

26
Q

Type 2 Hypersensitivity

A

Type II hypersensitivity reactions are mediated by autoantibodies against the body’s own cells, which activate cellular toxicity mechanisms. The main risk factor is having a blood transfusion, as well as a personal or family history of type II hypersensitivity reactions. Common types of type II reactions include immune thrombocytic purpura, autoimmune hemolytic anemia, pernicious anemia, rheumatic fever, Goodpasture syndrome, and transfusion reactions.

Type II hypersensitivity begins when the body is exposed to an antigen and IgM or IgG antibodies are produced. These antibodies can be directed against a foreign antigen, like a medication or a red blood cell from a transfusion; or against self antigens. Autoantibodies can cause damage to self cells, which is the case with Goodpasture syndrome, a condition associated with kidney and lung damage; or disrupt the normal function of cells, like with myasthenia gravis and Graves disease. Additional manifestations depend on the particular type of reaction.

27
Q

Type 3 Hypersensitivity

A

With type III hypersensitivity reactions, IgM or IgG antibodies bind to soluble antigens, forming immune complexes that precipitate in small blood vessels in the skin, kidneys, lungs and joints. Here, they activate the complement system, and cause tissue damage.

Important risk factors include positive family history; genetic predisposition; infections, like hepatitis B; vaccines, antitoxins, and antivenins; and using some medications, like penicillins and cephalosporins. Some common types of type III hypersensitivity reactions include those associated with systemic lupus erythematosus, rheumatoid arthritis, serum sickness, post-streptococcal glomerulonephritis and hypersensitivity pneumonitis. Clinical manifestations vary depending on the specific condition.

28
Q

Type 4 Hypersensitivity

A

A type IV or delayed T cell mediated hypersensitivity reaction is when T cells overreact to an antigen, most commonly viruses, bacteria, fungi, some medications like antibiotics or anticonvulsants, or plant oils like in poison ivy. Pathology-wise, type IV reactions occur when T helper cells or killer T cells overreact to exogenous or endogenous antigens and over proliferate. So if the antigen is encountered again, a larger than normal immune response occurs.The end result in inflammation and destruction of surrounding tissue.

Some common types of type IV reactions include allergic contact dermatitis, the PPD test, endocrine conditions like type I diabetes and Hashimoto’s thyroiditis; multiple sclerosis, sarcoidosis, Crohn disease, Stevens-Johnson syndrome, transplant rejections, and drug induced hypersensitivity syndrome. Clinical manifestations vary depending on the specific disorder.

29
Q

Appendicitis

A

Patho: Inflammation of the vermiform appendix
* Inflammation accompanies the ulceration and temporarily obstructs the appendix
* Obstruction, if present, is usually caused by stool
* Mucus outflow is blocked, which distends the organs
* Pressure within appendix increases and appendix contracts
* Bacteria multiply and inflammation and pressure continue to increase, affecting blood flow to the organ and causing severe abdominal pain

S/S
* Periumbilical pain with progression and radiation to **RLQ **
* With rebound tenderness
* Pain between right hip area and belly button
* Low-grade fever

Complication
* Rupture is life threatening, appendectomy is only treatment
* Perforation: peritonitis
* High fever
* Tachycardia and pnea
* Rigid board like abdomen

Treatment
* Watch and wait
* Antibiotics
* Surgery
* No heating pads
* No laxatives and enemas: no added pressure to bowels

Need CT scan for diagnosis

30
Q

AST/ALT

A

Liver Enzyme Tests
* enzyme released from hepatic cells when there is cell lysis - pancreatitis, cirrosis, hepatitis.
* normal range: 8-20

31
Q

Cholecysitis

A

Patho
* Inflammation of the gallbladder caused by gallstones
* Block ducts, creates backup of bile and inflammation

Risk Factors
* Obesity and high calorie, high cholesterol diet
* Increased estrogen levels
* Use of clofibrate
* Age over 40
* Diabetes mellitus, ileal disease, blood disorders, liver disease, or pancreatitis

S/S
* RUQ pain that radiates to right shoulder
* N/V
* high WBC
* Fevers with chills
* Tachycardia
* High bilirubin: jaundice, dark urine, light colored stools
* Lack of enzymes from pancreas can make steatorrhea

Treatment
* Dietary modification
* Lifestyle modifications
* NPO, IVF, antibiotics
* Surgical removal
* Gallbladder removal
* Choledochotomy
* Exploration of common bile duct

32
Q

Constipation

A

Patho
* Infrequent bowel moments
* Less than 3 stools per week
* Lumpy, hard stools
* Straining to have a bowel movement

Causes
* stress
* low fluid and fiber
* lack of exercise

Treatment
* high fluid and fiber
* ambulation
* laxatives

Complications
* Fecal incontinence (encopresis): leakage of stool
* laxative overdose: NVD, abdominal cramping from dehydration and electrolyte

33
Q

Crohn’s Disease

A

Patho
* Inflammation of any part of the GI tract
* Mouth to anus
* Skip lesions that do not bleed
* Good tissue mixed with bad tissue
* Inflamed tissue with fistulas, fissures, and abscesses
* Granulomas: bumps and lumps all over the small intestine
* Malabsorption of nutrients
* Inflammatory Bowel Disease, autoimmune

Types
* Regional enteritis
* Of the colon

Causes
* Stress, smoking, sepsis
* Lymphatic obstruction
* Infection
* Allergies
* Immune disorders
* Genetic factors: Nod2 mutation

S/S
* 5 loose stools per day with no blood
* Steatorrhea
* Abdominal pain
* Diarrhea
* Possible constipation

Complication
* Clotting disorders
* Jaundice
* Edema
* Metabolic disorders
* Toxic megacolon: becomes too big and spill of feces into cavity
* Rapid death from peritonitis: report to HCP
* Fever over 100.3
* Rebound tenderness
* Rigid board like abdomen
* Restlessness
* Tachycardia and pnea

Treatment
* Drugs
* Sulfasalazine: inflammation
* Steroids: for swelling
* Antidiarrheal: loperamide “low bowel movements”, dicyclomine “dry cycle”
* Diet
* Surgical: ostomies

34
Q

Diarrhea

A

Patho
* loose, watery and possibly more-frequent bowel movements
* may be an indicator of IBS, IBD, celiac, C-diff

Causes
* viruses, bacteria, parasites
* meds
* lactose intolerance
* digestive disorders

S/S
* abdominal cramping and bloating
* NV
* vomiting
* fever
* blood or mucus in stool

Treatment
* IV fluids
* check electrolytes
* add antidiarrheals when no infections are present

35
Q

Diverticulitis

A

Patho
* small, bulging pouches (diverticula) develop in your digestive tract and become inflammed

Causes
* constipation, withholding stool

S/S
* diarrhea
* abdominal pain
* feeling need to defecate and cannot

Complication
* perforation

Treatment
* diet modifications, exercise
* fluid replacement
* meds: antibiotics, analgesics, antispasmodics
* colon resection, temporary colostomy

36
Q

Gastritis

A

Patho
* inflammation of the lining of the stomach
* acute or chronic

Acute
* Inflammation of gastric mucosa (stomach lining)

Causes
* Alcohol & spicy food
* Aspirin
* NSAIDs

Manifestations:
* Hematemesis (vomiting blood)
* Epigastric pain (heartburn) & cramps

Chronic
* Atrophy of gastric mucosa

Cause
* H. Pylori infection

Complications:
* Increased risk for peptic ulcers & gastric cancer

37
Q

GERD

A

Patho
* Backflow of gastric or duodenal contents into esophagus and past lower esophageal sphincter
* Heartburn
* Can lead to inflammation and even cancer

Causes
* Weakened lower esophageal sphincter
* Increased abdominal pressure
* Hiatal hernia: upper part of the stomach bulges, and acid gets stuck
* Medications
* Food or alcohol ingestion or cigarette smoking
* Nasogastric intubation for more than 4 days

S/S
* NV
* Burning sensation in throat, chest
* Epigastric pain following a meal
* Radiating pain to the arm and chest

Treatment
* diet therapy: small meals
* positioning: lie down 3 hours after a meal
* increased fluid intake
* stop smoking
* surgery: tighten LES
* Upper gastrointestinal endoscopy: see if the lower esophageal sphincter is closing properly
* Meds: antacids, H2 blockers, PPI

38
Q

GI Bleed

A

Causes
* Upper: gastritis, GERD, peptic ulcer, esophageal varcies from cirrhosis
* Lower: hemorrhoids, colorectal cancer, diverticulosis, UC

S/S
* Upper: vomiting “coffee ground emesis” - blood that has been digested
* Melena stool: blood from upper and made it through digestion

Complications
* Hypovolemic shock - hemorrhagic shock
* Low CBC: H&H

39
Q

IBD

A

Inflammatory bowel disease (IBD) is a term for two conditions (Crohn’s disease and ulcerative colitis) that are characterized by chronic inflammation of the gastrointestinal (GI) tract.

40
Q

Pancreatitis

A

Patho:
* Inflammation of the pancreas
* Autodigestion of own enzymes: protease, lipase, amylase

Cause
* Biliary tract disease
* Alcoholism
* Gallbladder disease
* CF
* Surgery that causes trauma: ERCP procedure, clears gallstones

Diagnostics
* Elevated enzymes - amylase, lipase
* Elevated glucose, lack of insulin
* Elevated WBC over 10k: fever
* Elevated coagulation time: PT and aPTT
* Elevated bili

S/S
* LUQ pain, may have epigastric pain or pain radiating to the back
* Bruising: Turner’s sign - on side of body, Cullen’s - on abdomen near bellybutton
* Liver disease symptoms: jaundice, HTN

Treatment
* maintain circulation, fluid volume, and pain relief
* NPO because eating stim more enzymes
* IV pain meds: hydromorphone
* meds: antacids, PPI, H2 blockers
* diet low in fat and sugars, enzymes with meals

41
Q

Peptic Ulcer Disease

A

Patho
* Open sores in mucosal membrane of upper GI tract - stomach
* Erosions in lining of stomach and adjacent areas of the GI tract from the gastric acid

Types
* duodenal
* gastric
* stress: from traumatic event

Cause: Gastric
* gastric pain
* Gnawing, dyspepsia: burning pain to the back, often occurring after meals
* weight loss
* vomiting blood

Duodenal
* Pain decreased with food, 2-3 hours after meals
* Worst at night
* Weight gain
* Blood in stool “melena” dark tarry stool

Complication
* GI bleed

Treatment
* drugs and surgery

42
Q

Ulcerative Colitis

A

Patho
* Inflammation of the mucosa in the colon that causes ulcerations
* Bleeding colon, sores
* Inflammatory Bowel Disease, autoimmune

Causes
* Related to abnormal immune response to GI tract
* Stress, smoking, sepsis

S/S
* Lower quadrant pain
* Cramping
* 15-20 Bloody stools per day
* Cause anemia and decrease in H&H
* Rebound tenderness – must be reported

Complication
* GI bleed

Treatment
* Diet mod
* Drugs
* Surgery

43
Q

Hepatitis

A

Patho
* most common infection that leads to liver failure

Cause
* Post viral infection
* Alcohol
* Autoimmune diseases
* Unprotected sex
* Sharing blood and body fluids

S/S
* Three or more liquid stool/day for more than 2 days
* Flu like symptoms
* NV
* Elevated liver enzymes: ALT and AST, bili: jaundice
* Pruritus: itching
* Dark colored urine
* Clay colored stools
* Elevated PT and aPTT: bruising
* Low albumin: edema, cannot attact water

Treatment
* New drugs vs interferon alpha
* Post-viral infection commonly resolves within a few weeks
* Apply moisturizer and use cold compresses, stay out of sun

44
Q

BPH

A

Patho
* prostate enlargement that compresses the urethra & surrounding bladder causing difficulty urinating

S/S
* Urinary retention
* Urinary frequency
* Nocturia
* Straining to void

Complications
* UTI S/S

Treatment
* avoid caffeine and bladder training
* Finasteride

45
Q

BUN

A

Blood, urea, nitrogen
* 6 to 24 mg/dL
* How are the kidneys working
* Can fluctuate with protein intake
* Indicator of hydration

46
Q

Creatinine

A

A waste product that comes from the normal wear and tear on muscles of the body.
* Over 1.3 = damaged kidney

Pathopharmacology (6 decks)

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