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Pathophysiology-NRSE-2016-001 > Final Exam Blueprint > Flashcards

Final Exam Blueprint Flashcards

1
Q

What type of DM is caused by no insulin production by the beta cells of the pancreatic islet cells of Langerhans?

A

Type 1 DM

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2
Q

What type of DM is characterized by insulin resistance?

A

Type 2 DM

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3
Q

What are some DM manifestations?

A

polydipsia (increased thirst), polyphagia(increased hunger), polyuria (more peeing), weight loss, blurred vision, fatigue, retinopathy, and neuropathy

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4
Q

What risk is increased for individuals with gestational diabetes?

A

type 2 diabetes for mother and child

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5
Q

What are some complications of diabetes mellitus?

A

Blindness (from retinopathy) , impaired blood vessels (from prolonged hyperglycemia) causes delayed wound healing and increases risk of infection, neuropathy which can result in gangrene, osteomyelitis, and amputation. Diabetic Ketoacidosis can result from prolonged hyperglycemia and no insulin.

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6
Q

What is metabolic syndrome?

A

a cluster of cooccurring risk factors (hyperglycemia, hypertension, hypercholesterolemia, and large waste circumference) that increase risk for diabetes, cardiovascular disease, and stroke

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7
Q

What A1C level indicates diabetes?

A

> 6.7

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8
Q

What is DKA? What it is caused by?

A

-diabetic ketoacidosis, a complication of diabetes where body produces excess ketones
-triggered by insufficient insulin, which can be caused by infection or illness

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9
Q

What is the name of the insulin resistance that occurs during pregnancy?

A

gestational diabetes

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10
Q

What are the manifestations of hypoparathyroidism?

A

hypocalcemia (Chvosteks and Trosseaus), patchy hair loss, fatigue, abdominal cramping, and memory loss

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11
Q

What are the manifestations of hyperparathyroidism?

A

hypercalcemia, kidney stones, osteoporosis (pathologic fractures), polyuria, constipation, bone pain, and vomiting

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12
Q

What are the manifestations of Cushings Syndrome?

A

obesity (especially in trunk), “moon face,” “buffalo hump,” thin arms and legs, purple striae, weak muscles, acne, psychosis

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13
Q

What are the manifestations of hypothyroidism?

A

sluggishness, weight gain, depression, constipation, facial edema, hypotension, goiter

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14
Q

What happens to T3, T4 and TSH in hypothyroidism?

A

increased TSH (thyroid stimulating hormone), and decrease T3 and T4

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15
Q

What are the manifestations of hyperthyroidism?

A

everything speeds up (weight loss, thyroid storm, goiter, diarrhea, hypertension, exophthalmos, tremor)

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16
Q

What is thyroid storm?

A

complication of hyperthyroidism characterized by high temp, hypertension, and arrythmia caused by heart working too fast; can lead to heart attack

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17
Q

What happens to TSH, T3 and T4 during hyperthyroidism?

A

decreased TSH and increased T3 & T4

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18
Q

What is somatic pain?

A

pain resulting from noxious stimuli (cutting, crushing, pinching, extreme temps.) to skin, joints, muscles, and tendons

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19
Q

What is visceral pain?

A

caused by stimuli to internal organs

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20
Q

What is referred pain?

A

type of visceral pain that occurs away from the site of the stimulus (teeth hurting during a heart attack)

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21
Q

What is phantom pain?

A

exists after the removal of a body part (amputation)

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22
Q

What is intractable pain?

A

chronically progressing pain that is unrelenting and debilitating (rheumatoid arthritis, degenerating disks, cancer, and is common in crushing injuries)

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23
Q

What is neuropathic pain?

A

results from damage to peripheral nerves by disease (diabetes mellitus) or injury; leads to paresthesia + pain = (prickly, stabbing and burning)

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24
Q

What is the concern for sensory impairment?

A

changes in hearing, vision, and other abnormal responses that can result in risk for injury

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25
Q

What are the manifestations of conjunctivitis?

A

edema, pain, blurry vision, photophobia, watery/mucus-like exudate with viral infections, and yellow-green exudate with bacterial

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26
Q

What are cataracts?

A

clouding of the lens of the eye that results in hazy vision caused by breakdown of proteins

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27
Q

What are some common manifestations of Monosomy X (Turner’s Syndrome)?
-deletion of X chromosome

A

affects only females
-short stature, gonadal streaks (lack of ovaries), lymphedema, broad chest with wide-spaced nipples, low-set ears, and small lower jaw

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28
Q

What are the manifestations of Polysomy X (Klinefelter’s Sundrome)?
-multiple X chromosomes

A

affects males
-small genitals, sparse facial/body hair, sexual dysfunction, and gynecomastia (female-like breasts)
-increases risk for osteoporosis and breast cancer

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29
Q

Which cellular adaptation occurs due to decreased work demands on a cell, so cell becomes smaller?

A

atrophy

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30
Q

Which cellular adaptation occurs due to increased work demands, so cells increase in size?

A

hypertrophy

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31
Q

Which cellular adaptation is an increased number of cells occurring in an organ or tissue ?
ex. endometrial hyperplasia; over secretion of estrogen

A

hyperplasia

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32
Q

Which cellular adaptation is where one adult cell is REPLACED by another normal cell type?
ex. ciliary changes in a smokers lungs

A

metaplasia

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33
Q

Which cellular adaptation is where cells mutate into cells of a different size, shape, and appearance (often indicated as precancerous cells)?
ex. cervical cells exposed to HPV- cervix begins growing abnormal cells

A

dysplasia

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34
Q

What is cellular death caused by injury, disease, or ischemia that causes the cell to swell and burst?

A

necrosis

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35
Q

This is a type of necrosis in which caustic (capable of dissolving) enzymes dissolve or liquify necrotic cells:

A

liquefaction necrosis

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36
Q

This is a type of necrosis in which necrotic cells disintegrate, but the cellular debris remain in the area for months or years (cottage cheese-like appearance):
ex. tuberculosis

A

caseous necrosis

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37
Q

This is a type of necrosis in which lipase enzymes break down intracellular triglycerides into free fatty acids, which then combine with magnesium, sodium, and calcium to form soaps:

A

fat necrosis

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38
Q

This is a type of necrosis usually caused by interruption in blood flow:

A

coagulative

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39
Q

which type of necrosis is commonly associated with breast injury or acute pancreatitis?

A

fat necrosis

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40
Q

What type of immunity provides immediate, nonspecific protection?

A

innate immunity

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41
Q

What type of immunity takes 7-10 days to provide specific protection from an antigen?

A

adaptive immunity

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42
Q

what are the 5 components of the innate immunity?

A

barriers, inflammatory response, pyrogens, interferons, and complement proteins

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43
Q

What type of hypersensitivity reaction is IGE mediated and is common in anaphylaxis and asthma? (<30 mins- several hours)

A

type I

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44
Q

What type of hypersensitivity reaction is cell-mediated, known and delayed-type and is common in contact dermatitis and Crohn’s disease? (1-3 days)

A

type Iv (4)

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45
Q

This is programmed cell death that usually occurs because of morphologic (structure or form) changes/ cells shrink and break down:

A

apoptosis

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46
Q

What can cause cell death due to inadequate blood flow, leading to less oxygen (known as infarction)?

A

ischemia

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47
Q

What find of immune issue reflects a defect with the immune system?

A

primary immunodeficiency

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48
Q

What kind of immune issue reflects underlying disease or factors suppressing the immune system?
ex. chemo, liver disease, stress, etc

A

secondary/acquired immunodeficiency

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49
Q

What type of incontinence is triggered by coughing, sneezing, laughing, exercising, and lifting heavy objects?

A

stress incontinence

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50
Q

What type of incontinence is characterized by the intense, sudden urge to urinate, followed by an involuntary loss of urine?

A

overactive/urge incontinence

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51
Q

What type of incontinence is caused by trauma or damage to the nervous system?

A

reflex incontinence

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52
Q

What type of incontinence is caused by the inability to empty the bladder (retention)? What are the manifestations?

A

overflow incontinence
-dribbling and weak stream

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53
Q

What type of incontinence is caused by prostate enlargement, urethral blockage, and bladder damage?

A

overflow incontinence

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54
Q

What kind of incontinence is caused by a physical or mental impairment that prevents toileting in time?

A

functional incontinence

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55
Q

What type of incontinence is caused by a temporary condition, such as a UTI, delirium, alcohol, etc?

A

transient incontinence

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56
Q

What type of urinary issue is characterized by a continuous leakage of urine, all times of the day or random large volumes uncontrolled?

A

gross total incontinence

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57
Q

What are the manifestations of anemia?

A

weakness, fatigue, pallor, dyspnea, and tachycardia

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58
Q

What are the manifestations of iron-deficiency anemia?

A

cyanotic sclera, brittle nails, decreased appetite, headache, irritability, stomatitis, pica (unusual cravings)

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59
Q

What are the manifestations of pernicious anemia?

A

bleeding gums, diarrhea, impaired smell, Babinski’s sign (big toe dorsiflexes and toes fan out)

60
Q

What are the manifestations of aplastic anemia?

A

combination of symptoms from anemia (fatigue, weakness, pallor), leukocytopenia (frequent infection), and thrombocytopenia (bleeding)

61
Q

What are the manifestations of sickle cell anemia?

A

sickle cell crisis ( painful episodes of ischemia and necrosis) that can be triggered by dehydration, stress or fever

62
Q

What are the manifestations of polycythemia vera?

A

sluggish blood flow, tissue ischemia and necrosis, hypertension, heart failure, hemorrhage, organomegaly, vision abnormalities

63
Q

What is the most alarming manifestation of thrombocytopenia?

A

risk for bleeding

64
Q

What is indicated by leukocytosis (increased WBC)?

A

presence of infection

65
Q

What are the manifestations of lymphoma?

A

enlarged lymph nodes, night sweats, pruritus, splenomegaly, and retrosternal chest pain

66
Q

What type of lymphoma is identified by the presence of Reed-Sternberg Cells?

A

Hodgkin Lymphoma

67
Q

What are the manifestations of leukemia?

A

leukopenia (recurrent infections), anemia, thrombocytopenia, lymphadenopathy, joint swelling, bone pain, weight loss, anorexia, hepatomegaly, and CNS dysfunction

68
Q

What suspicious and likely indicative of skin cancer on an integumentary system assessment?

A

Asymmetry
Border Irregularity
Color variations
Diameter> 6mm
Evolving shape
consistent bleeding

69
Q

What is the most common type of skin cancer that rarely metastasizes?

A

basal cell carcinoma

70
Q

What type of skin cancer is least common, most serious, and often metastasizes?

A

melanoma

71
Q

Rule of 9’s: head and neck

A

9%

72
Q

Rule of 9’s: arms (each)

A

9%

73
Q

Rule of 9’s: trunk (anterior and posterior individually)

A

18% each

74
Q

Rule of 9’s: legs (each)

A

18% each

75
Q

Rule of 9’s: genitalia & perineum

A

1%

76
Q

What type of burn is characterized by redness, edema, pain, and impact to epidermis? (superficial)

A

first degree burn

77
Q

What type of burn is characterized by partial thickness damage, affecting the epidermis AND dermis, with presence of pain, erythema, and blistering?

A

second degree burn

78
Q

What type of burn is a full thickness burn that extends into deeper tissues and causes white, blackened, charred, numb skin?

A

third degree

79
Q

What are the manifestations of cellulitis?

A

swollen, warm, tender area of erythema. Leukocytosis, malaise, etc.
Can lead to necrotizing fasciitis and sepsis

80
Q

What are the manifestations of psoriasis?

A

silver plaque due to build up of keratinocytes, psoriatic arthritis

81
Q

What are the primary risks for pressure injuries?

A

friction, shear, unrelieved pressure, and moisture

82
Q

Which stage of pressure injury is characterized by intact, nonblanchable skin with the presence of erythema?

A

stage 1

83
Q

What stage of pressure injury is characterized by partial thickness loss of the epidermis, erosion or blister, but no exposed subcutaneous tissue? -shallow open ulcer with pink-red wound bed

A

stage II

84
Q

What stage of pressure injury does this BEST describe: full thickness skin loss with damage to subcutaneous tissue, where subcutaneous fat may be visible? -no visible tendon, muscle, or bone

A

stage III

85
Q

What stage of pressure injury is characterized by full thickness loss of skin? -possible muscle, bone, and tendon exposure, and possible tunneling

A

stage IV

86
Q

What type of injury is expected when there is visible area of purple/maroon skin, and skin is nonblanchable, and upon palpation feels jello-like/mooshy?

A

deep tissue injury

87
Q

What type of injury is expected when there is visible area of purple/maroon skin, and skin is nonblanchable, and upon palpation feels jello-like/mooshy?

A

unstageable

88
Q

What is the normal blood pH?

A

7.35-7.45

89
Q

What is normal range of PaCO2?

A

45-35 mmHg

90
Q

What is the normal range of HCO3?

A

22-26 mEQ/L

91
Q

What type of solution is responsible for putting more fluid in the intravascular space? When would you use this solution?

A

isotonic
hypovolemia

92
Q

What type of solution would cause a cell to swell and burst due to low concentration of solutes?

A

hypotonic

93
Q

What type of solution would cause a cell to shrink/crenate due to high concentration of solutes?

A

hypertonic

94
Q

What is the term for the amount of blood the heart pumps in one minute?

A

cardiac output

95
Q

What compensatory mechanism is activated in the kidney’s when renal blood flow is decreased, as with hypotensive states?

A

RAAS (renin-angiotensin-aldosterone system)

96
Q

What are the risk factors for endocarditis?

A

IV drug use, recent heart procedures, poor dental hygiene, and Marfan Syndrome

97
Q

What are the risk factors for CAD (coronary artery disease)?

A

tobacco use, obesity, physical inactivity, stress, DM, hyperlipidemia, and hypertension

98
Q

What are the manifestations of cad (coronary artery disease)?

A

angina, nausea, vomiting, fatigue, heart attack

99
Q

What are the manifestations of valve regurgitation?

A

dyspnea on exertion, ventricular hypertrophy, lightheadedness/fainting, syncope

100
Q

What are hypertension risk factors?

A

age, inactivity, tobacco use, high-sodium diet, excess alcohol, and stress

101
Q

What are the treatment options of hypertension?

A

decreased dietary sodium (DASH diet), saturated fat, and cholesterol, as well as minimize sweets, added sugar, and red meat

102
Q

What type of heart failure is characterized by blood backing up into pulmonary circulation, causing pulmonary congestion, dyspnea, and activity intolerance?

A

left-sided heart failure

103
Q

Which heart failure causes blood to back up into the peripheral circulation, causing edema & weight gain?

A

right-sided heart failure

104
Q

What is the name of the distinct assortment of symptoms that appears in individuals with cardiac tamponade? (low b.p., muffled heart sounds, JVD)?

A

Beck’s Triad

105
Q

What are the three manifestations that make up Becks Triad, the system of manifestations that appear with cardiac tamponade?

A

low b.p.
muffled heart sounds
jugular vein distensions

106
Q

What are the three manifestations that make up Becks Triad, the system of manifestations that appear with cardiac tamponade?

A

low b.p.
muffled heart sounds
jugular vein distensions

107
Q

What is referred to as the death of the myocardium from a sudden blockage of coronary artery blood flow?

A

myocardial infarction

108
Q

What may you expect with troponin levels in an individual who has had a myocardial infarction within the last 2 weeks?

A

elevated

109
Q

What is cholelithiasis? What type of diet causes this condition?

A

gallstones (hard deposit of digestive fluid)
high fat diet

110
Q

What are the manifestations of cholelithiasis?

A

colicky pain, abdominal pain, clay-colored stools, abdominal distension, jaundice

111
Q

Dark, tarry stool associated with a significant amount of bleeding in the g.i. tract?

A

melena

112
Q

Blood in the vomitus (coffee ground appearance)?

A

hematemesis

113
Q

What is known as bright red blood found in the stool?

A

hematochezia

114
Q

What are the manifestations of liver failure?

A

jaundice, ascites, hepatomegaly, pain in right upper quadrant, vomiting, diarrhea

115
Q

What is the most common cause of chronic gastritis?

A

helicobacter pylori

116
Q

What manifestations are associated with a small bowel obstruction? What function is impaired?

A

colicky pain (sudden and severe)
-ability to pass gas or stool

117
Q

What is GERD (gastroesophageal reflux disease)?

A

the inappropriate movement of stomach contents into the esophagus, causing irritation to esophageal mucosa

118
Q

What are some causes of inflammatory bowel disease?

A

genetically associated autoimmune that has been activated by an infection

119
Q

Which IBD affects mouth to anus and is characterized by skip lesions/cobblestone appearance?

A

Crohn’s disease

120
Q

Which IBD is a progressive condition of the rectum and colon and causes erosions, intermittent abdominal pain, and frequent watery stools with blood and mucus?

A

ulcerative colitis

121
Q

What condition is characterized autodigestion and can cause upper abdominal pain that radiates to the back?

A

pancreatitis

122
Q

What type of acute kidney injury is caused by ureter/bladder obstruction or dysfunction (stones, tumors, BPH)?

A

postrenal kidney injury

123
Q

Hypovolemia, hypotension, and fluid loss are associated with what condition?

A

pre-renal kidney injury

124
Q

What type of kidney injury is the client who hemorrhaged due to trauma at risk for?

A

pre-renal kidney injury

125
Q

What type of acute kidney injury is caused by acute tubular necrosis (impaired blood supply), hemolytic uremic syndrome, glomerulonephritis, or prolonged drug exposure?

A

intrarenal kidney injury

126
Q

What are the manifestations of UTI?

A

dysuria, suprapubic pain, frequency, urgency

127
Q

What are important treatment options for nephrolithiasis (kidney stones)?

A

encourage fluids, strain all urine, and make dietary changes based on stone composition

128
Q

What is the leading cause of chronic kidney disease?

A

diabetes mellitus

129
Q

What is chronic kidney disease?

A

gradual loss of renal function

130
Q

What lab value is important to assess with CKD?

A

GFR; when it drops less than 15 clients must go on dialysis

131
Q

What are some complications of influenza?

A

secondary bacterial pneumonia, encephalitis, and myocarditis

132
Q

What are the manifestations of influenza?

A

sudden onset symptoms (fever, chills, headache, aches)

133
Q

What should be included in a teaching about tuberculosis?

A

respiratory isolation, night sweats, and hemoptysis (coughing up blood)

134
Q

How is tuberculosis diagnosed?

A

skin test, chest X-ray, and sputum culture

135
Q

What are the treatment options for cystic fibrosis?

A

chest physiotherapy, coughing exercises, mucus thinners, and increased fluid

136
Q

What are the manifestations for asthma?

A

wheezing, shortness of breath, dyspnea, chest tightness, cough and anxiety

137
Q

What treatment option is added to emphysema that is not also used in chronic bronchitis?

A

pursed lip breathing

138
Q

What are the treatment options for chronic bronchitis?

A

limited oxygen therapy, bronchodilators, antibiotics, corticosteroids, chest physiotherapy, and increased hydration

139
Q

What is atelectasis?

A

collapse of the alveoli

140
Q

Which STI is known as the “silent STI” and can cause infertility and PID (pelvic inflammatory disease)?

A

chlamydia

141
Q

What are some causes of epididymitis?

A

anal sex, tuberculosis, recent catheterizations, STIs, e. Coli

142
Q

What is a thrombotic stroke?

A

CVA caused by a blood clot

143
Q

What causes a hemorrhagic stroke?

A

bleeding into the brain by the rupture of blood vessels

144
Q

What are the manifestations of meningitis?

A

fever, severe headache, stiff neck, mental status changes, rash, and bulging fontanelle

145
Q

What are some manifestations of Parkinson’s disease?

A

tremors, mask-like face, shuffling gait, unsteady movement, rigid movement, monotone voice, etc

146
Q

What are some major manifestations of a TBI (traumatic brain injury)?

A

seizures, fluid draining from nose, mouth or ears, inability to move limbs, stiff neck, and vomiting

Pathophysiology-NRSE-2016-001 (7 decks)

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