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Advanced Pathophysiology > Module 2 > Flashcards

Module 2 Flashcards

1
Q

Definition of subclinical

A

usually present with vague or no symptoms

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2
Q

Definition of virulent

A

the capacity to cause diseases

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3
Q

Definition of incubation

A

from time of infection to time of start of symptoms

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4
Q

A person arrives at the clinic and reports mild tiredness and discomfort after an exposure to a family member with the flu. The nurse suspects the person is in the ______ stage.

A

Prodromal period

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5
Q

Which information is correct regarding parasitic infections

A

Malaria is a common parasitic infection.

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6
Q

A person who is HIV positive is hospitalized with pneumonia caused by Pneumocystis jiroveci. The nurse understands that the development indicates the person

A

has progressed from HIV to AIDS

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7
Q

A nurse is asked how antibiotics work. How should the nurse reply ?

A

inhibition of protein synthesis

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8
Q

The stage of resistance in Selye’s general adaptation syndrome includes

A

mobilization that contributes to the fight or flight response

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9
Q

Which information indicates the nurse has a good understanding of epinephrine. Epinephrine actions include

A

increase of serum glucose concentration (so you will have the energy for the fight or flight response)

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10
Q

A patient has stress and releases cortisol. The nurse realizes that cortisol

A

increases the rate of protein synthesis in the liver

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11
Q

A patient has stress. The nurse realizes some changes in the immune system might include :

A

decrease natural killer cells

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12
Q

The woman has type O negative blood, which means

A

she is a universal donor

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13
Q

O negative

A

universal donor blood

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14
Q

What type of immunologic response is the woman experiencing during the blood transfusion? (she has fever, back pain, & flushing)

A

alloimmunity

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15
Q

The woman experiences a sudden drop in blood pressure, difficulty breathing, and a red itchy rash after taking the antibiotics. The woman is most likely experiencing

A

anaphylaxis

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16
Q

The mechanism of action of most antibiotic agents include:

A

blocking DNA replication

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17
Q

Prodromal stage

A

starts with the initial symptoms is often very mild with feelings of discomfort and tiredness

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18
Q

Invasion stage

A

invasion is farther and affects other body tissues, symptoms of illness are at their worse

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19
Q

Convalescence stage

A

recovery occurs and symptoms decline, or the disease is fatal, or has a period of latency

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20
Q

what is the hallmark of infection

A

fever

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21
Q

Virulence is

A

the capacity to cause severity of disease; potency

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22
Q

Endemic

A

disease with relative high but constant rates of infection in a particular population

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23
Q

Examples of endemic

A

prison or school system

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24
Q

epidemic

A

greatly exceeds the number usually observed

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25
Q

spreads over a large area such as a continent or worldwide

A

pandemic

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26
Q

____ infection is treated with antibiotics

A

bacterial

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27
Q

Gram ____ is above the diaphragm

A

positive

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28
Q

Gram ____ is generally located below the diaphragm

A

negative

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29
Q

Gram +/- tip, hint

A

Positive thoughts above the diaphragm because it is coming from the brain.

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30
Q

enzymes released during growth

A

exotoxins

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31
Q

contained in cell walls

A

endotoxins

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32
Q

Antibiotics work by prohibiting

A

protein synthesis

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33
Q

____ is the major cause of hospital-acquired infecctions and antibiotic resistance

A

Staphylococcus aureus

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34
Q

nosocomial infection

A

hospital-acquired

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35
Q

____ are large microorganisms

A

fungus

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36
Q

How to treat fungal infections

A

anti-fungals

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37
Q

Examples of fungus (2)

A

molds and yeast

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38
Q

Fungal infections are ____

A

systemic

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39
Q

Fungal infections are usually from

A

immunosuppression

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40
Q

Fungal infections are toxic to humans because

A

fungus have similar cell compositions to human cells

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41
Q

____ is the most fungal infection

A

Candida albicans

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42
Q

Candida albicans - where is it located (4)

A

resides in skin, GI, mouth, & vagina

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43
Q

If immune system is intact, candida albicans

A

remains localized

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44
Q

If immune system is compromised, candida albicans

A

can become systemic

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45
Q

Tissue damage caused by parasites is _____

A

secondary to release of enzymes that destroy surrounding extracellular matrix and tissue

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46
Q

What is the most common parasitic infection worldwide

A

malaria

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47
Q

What is the most common affliction of humans

A

viral diseases

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48
Q

Examples of viral diseases (5)

A

common cold, cold sores, hepatitis, HIV, and several types of cancers

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49
Q

Viruses are

A

intracellular parasites

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50
Q

Virus life cycle is completely

A

intracellular

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51
Q

Describe virus life cycle (3 steps)

A

Attaches and binds to the host cell.
Penetrates the host cell.
Releases genetic information into the host cytoplasm

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52
Q

RNA viruses enter

A

the host nucleus

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53
Q

DNA virus enter

A

the host nucleus

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54
Q

DNA viruses may

A

integrate the host DNA

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55
Q

DNA virus may make

A

mRNA

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56
Q

_____ surface proteins undergo changes each year

A

influenza

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57
Q

HIV - what percentage are infected but don’t know they are infected/need testing

A

13%

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58
Q

Estimated new HIV infections declined ___% 2017-2021

A

12%

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59
Q

Diagnosis for AIDS is

A

CD4+ T-cell numbers are at or below 200 cells/uL

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60
Q

Natural products of fungus, bacteria, and organisms to kill or inhibit the growth of other microorganisms

A

antimicrobials

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61
Q

They prevent growth or directly kill microorganisms

A

antimicrobials

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62
Q

prevent growth

A

bacteriostatic

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63
Q

directly kill

A

bactericidal

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64
Q

Antimicrobials inhibit

A

production and function of the cell wall

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65
Q

Antimicrobials block

A

DNA replication

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66
Q

Antimicrobials inhibit ______

A

protein synthesis

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67
Q

Antimicrobials also interfere

A

with folic acid metabolism

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68
Q

Antivirals are sometimes less successful because

A

viruses use host enzymes

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69
Q

Witnessed changes from outside forces are called

A

stressors

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70
Q

GAS 3 stages

A

alarm stage
resistance/adaptation stage
exhaustion stage

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71
Q

Alarm stage description

A

triggers the hypothalamic-pituitary-adrenal (HPA) axis (which activates the SNS)

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72
Q

Resistance/adaptation stage description

A

begins with actions of adrenal hormones (cortisol, epi, norepi)

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73
Q

Exhaustion stage is also called the

A

allostatic overload

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74
Q

Exhaustion stage description

A

occurs only if stress continues and adaptation is not successful

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75
Q

The anterior pituitary gland secretes 4 hormones. Name them.

A

Prolactin
Endorphins
Growth hormone (GH)
Adrenocorticotropic hormone (ACTH)

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76
Q

ACTH stimulates what

A

the adrenal gland cortex to release cortisol

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77
Q

Cortisol is a key indicator of

A

stress

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78
Q

What does cortisol do ?

A

elevates blood sugar

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79
Q

Cortisol contributes to the (2)

A

development of metabolic syndrome and the pathogenesis of obesity

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80
Q

Development of diabetes is secondary to

A

cortisol-induced obesity

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81
Q

What does chronic cortisol induce ?
(3 areas)

A

lipogenesis in the abdomen, trunk, and face

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82
Q

What does chronic cortisol result in

A

obesity

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83
Q

Proteins found in the brain that have pain-relieving capabilities are
(2)

A

endorphins and enkephalins

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84
Q

stress-age syndrome: Excitability changes in the (2 places)

A

limbic system & hypothalamus

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85
Q

Stress-age syndrome: catecholamines, ADH, ACTH, and cortisol
Increases or decreases

A

Increase

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86
Q

what decreases in stress-age syndrome
(3)

A

testosterone, thyroxine, and other hormones

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87
Q

stress age syndrome effects of opioids

A

alterations of opioid peptides that bind opioids in the brain

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88
Q

stress-age syndrome on immune system

A

immunodepression and alteration in lipoproteins

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89
Q

stress-age syndrome on the blood

A

hypercoagulation of the blood

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90
Q

stress-age syndrome on free radicals

A

free radical damage of cells destroying cell membranes

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91
Q

Stress-age syndrome

A

lower adaptive reserve and coping mechanisms

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92
Q

An individual has primary hypertension & recurrent strokes. Which drug should the nurse be prepared to administer?

A

ACE inhibitors

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93
Q

A person has atherosclerosis. Which pathophysiologic process has occured?

A

Macrophages release enzymes and toxic oxygen radicals that create oxidative stress.

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94
Q

A person with an MI is releasing angiotensin II. How should the nurse interpret this finding?

A

Counterproductive. It causes the heart to work harder.

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95
Q

A person has been diagnosed with valvular regurgitation. What pathophysiologic process is the person experiencing. The valves…

A

fail to close completely, causing the blood to backflow

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96
Q

systolic heart failure is associated with the activation of

A

renin-angiotensin-aldosterone system (RAAS)

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97
Q

The fetus receives oxygenated blood and nutrients through the

A

umbilical vein

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98
Q

Agonists binds to receptors &

A

prolongs the response

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99
Q

Antagonists binds to receptors &

A

shortens the response

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100
Q

A child is admitted with acute hypoxia. The nurse anticipates the child will exhibit

A

clubbing of the nail beds

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101
Q

In a child with a ventricular septal defect (VSD), blood flow is shunted from the

A

left ventricle to the right ventricle

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102
Q

A nurse is assessing a child with coarctation of the heart. What will the nurse find?

A

high blood pressure in the upper extremities with decreased pulses in feet

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103
Q

A child with Kawasaki in an acute phase is admitted to the hospital. The nurse understands the child will

A

be febrile

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104
Q

During pulmonary stenosis, resistance to blood flow causes

A

right ventricular hypertrophy

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105
Q

Primary hypertension is extremely complication

A

interaction of genetics and the environment mediated by neurohumoral effects

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106
Q

Also overactivity of

A

sympathetic nervous system, RAAS, and alterations in natriuretic peptides

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107
Q

Hypertension caused by 4 things :

A

caused by inflammation, endothelial dysfunction, obesity-related hormones, and insulin resistance

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108
Q

Secondary hypertension caused by

A

systemic disease that raises peripheral vascular resistance and/or cardiac output

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109
Q

Complicated hypertension

A

hypertrophy and hyperplasia with associated fibrosis of the tunica intima and media in a process called vascular remodeling

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110
Q

Malignant hypertension (hypertensive crisis); rapidly progressive hypertension

A

diastolic pressure is usually > 140 and can lead to encephalopathy

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111
Q

Clinical manifestations of early HTN

A

early stages of HTN have no clinical manifestations other than elevated blood pressure

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112
Q

HTN diagnosis

A

elevated readings on at least 2 occasions

113
Q

HTN treatment
(non-pharm treatments, 4)

A

reducing/eliminating risk factors, dietary approaches to stop HTN (DASH), smoking cessation, exercise program that promotes endurance and relaxation

114
Q

HTN pharmacologic therapies

A

ACE-inhibitors, ARBs, or aldosterone antagonists

115
Q

ACE-inhibitors, ARBs, and aldosterone antagonists are effective in those with (3 things)

A

heart failure, chronic kidney disease, and after an MI or recurrent stroke

116
Q

arterial thrombus formation is the activation of … & caused by …

A

activation of coagulation cascade and caused by roughening of the tunica intima by atherosclerosis

117
Q

PVD - thromboangiitis obliterans is also known as

A

Buerger’s disease

118
Q

Buergers disease
what is it, how does it present, and mainly occurs in whom ?

A

occurs mainly in smokers, inflammatory disease of the peripheral arteries, sluggish blood flow, rubor (redness), and cyanosis

119
Q

Reynaud’s disease is

A

episodic vasospasm (ischemia) in the arteries and arterioles of the fingers

120
Q

Clinical manifestations of Reynaud’s disease

A

changes in skin color and sensation caused by ischemia

121
Q

Reynaud’s disease is a ____ ____ disorder

A

a primary vasospastic disorder

122
Q

Difference between Reynauds & Buergers

A

reynauds is episodic vasospasm. Beurger’s is inflammatory disease of peripheral arteries.

123
Q

Atherosclerosis is

A

the thickening and hardening caused by the accumulation of lipid-laden macrophages in the arterial wall

124
Q

Main symptoms of atherosclerosis are the result of

A

inadequate perfusion of tissues

125
Q

Coronary artery disease is any ____ disorder that ….

A

any vascular disorder that narrows or occludes the coronary arteries

126
Q

CAD results in an imbalance between …..

A

coronary supply of blood and myocardial demand for oxygen and nutrients

127
Q

CAD most common cause is

A

atherosclerosis

128
Q

CAD non-modifiable risks (4)

A

advanced age, family history, male gender, or women after menopause

129
Q

CAD modifiable risks (5)

A

dyslipidemia, smoking, diabetes/insulin resistance, obesity, sedentary lifestyle

130
Q

CAD modifiable diet

A

atherogenic diet - high in salts, fats, transfats, and carbs

131
Q

dyslipidemia meaning

A

dietary fat packaged into chylomicrons for absorption in the small intestines

132
Q

Chylomicrons transports what to where

A

transports lipids eaten from the intestine to the liver and peripheral cells

133
Q

Triglycerides may be

A

removed and either stored by adipose tissue or used by muscle as an energy source

134
Q

LDLs are responsible for

A

the delivery of cholesterol to the tissues, important in atherogenesis

135
Q

HDLs are responsible for

A

reverse cholesterol transport. they are the bulldozers !

136
Q

Angiotensin II systemic effects on MI :

A

peripheral vasoconstriction and fluid retention

137
Q

Cardiomyopathies effects

A

neurohumoral responses to ischemic heart disease or hypertension on the heart muscle cause remodeling

138
Q

Many cases of cardiomyopathies are

A

idiopathic

139
Q

Hypertrophic cardiomyopathy can be (2 things)

A

obstructive (inherited thickness of septal wall) or valvular due to HTN

140
Q

Hypertrophic obstructive cardiomyopathy treatment (4 things)

A

beta blockers or ACE inhibitors, surgical resection of the hypertrophied myocardium, septal ablation, prophylactic placement of an implantable cardioverter-defibrillators in high-risk individuals

141
Q

Stenosis does not ____ correctly

A

open

142
Q

Regurgitation does not ____ correctly

A

close

143
Q

Valvular stenosis is usually (which valves)

A

aortic or mitral

144
Q

Valvular regurgitation is usually (which valves)

A

aortic, mitral, tricuspid

145
Q

What 3 things assist in determining which valve is abnormal

A

characteristic heart sounds, cardiac murmurs, and systemic complaints

146
Q

Aortic regurgitation (does not close correctly) clinical manifestations

A

widened pulse pressure as a result of increased stroke volume and diastolic backflow

147
Q

Mitral regurgitation (does not close correctly) most common causes (6)

A

mitral valve prolapse, rheumatic heart disease, infective endocarditis, MI, connective tissue disease, dilated cardiomyopathy

148
Q

mitral valve prolapse syndrome clinical manifestations are

A

asymptomatic

149
Q

Rheumatic fever (inflammatory disease) is caused by

A

infection strep throat

150
Q

Rheumatic fever clinical manifestations (5)

A

carditis (murmur), polyarthritis, subcutaneous modules, chorea, erythema marginatum

151
Q

heart failure definition is the inability to …

A

generate adequate cardiac output

152
Q

Systolic heart failure is an EF under …. ?

A

EF<40, inability of the heart to generate adequate cardiac output

153
Q

Diastolic heart failure is EF under…. ?

A

EF>40, heart failure with preserved ejection fraction

154
Q

high output heart failure

A

inability of the heart to supply the body with bloodborne nutrients

155
Q

endocardial cushions

A

instrumental in closing the atrial septum, dividing the atrioventricular (AV) canals into the right and left AV orifices, and closing the septum

156
Q

Septum primum & septum secundum

A

atrial separation

157
Q

Ostium primum

A

gap that closes by the endocardial cushions

158
Q

Ostium secundum

A

fenestrations or openings that develop in the superior portion of the septum primum

159
Q

Foramen ovale

A

nonfused septum secundum and ostium secundum result in the formation of a flapped orifice

160
Q

bulbis cordis

A

separates the aorta from the pulmonary artery

161
Q

truncus arteriosus

A

torsion occurs within the anterosuperior region of the loop

162
Q

ductus arteriosus

A

communication exists between the aorta and the pulmonary artery

163
Q

foramen ovale is the opening …

A

between the atria

164
Q

Newborn HR

A

100-180

165
Q

Newborns have a _____ oxygen demand (high or low)

A

high

166
Q

HF/CHF in children

A

neurohumoral and hemodynamic changes create abnormal ventricular wall stress and cause the myocardium to hypertrophy

167
Q

Hypoxemia due to congenital birth defects

A

heart defects that allow desaturated blood to enter the systemic system without passing through the lungs resulting in hypoxemia and cyanosis

168
Q

hypoxemia

A

arterial oxygen tension is below normal

169
Q

cyanosis

A

deoxygenated blood

170
Q

defects that cause hypoxemia and cyanosis

A

obstruction & shunting, TOF, and mixing of saturated and unsaturated blood

171
Q

mild hypoxemia

A

occasionally when stressed

172
Q

severe hypoxemia (in babies)

A

feeding intolerance (can’t breathe and suck at the same time)

173
Q

_____ that cause _____ obstruction and shunting from the right side of the heart to the left side as in TOF

A

Lesions;obstruction

174
Q

Defects increasing pulmonary blood flow

A

Patent Ductus Ateriosus (PDA)

175
Q

PDA is the failure of

A

the ductus ateriosus to close

176
Q

PDA normally closes

A

within the 1st few hours of birth

177
Q

PDA allows blood

A

to shunt from the pulmonary artery to the aorta

178
Q

Clinical manifestations of PDA ( 2 descriptions of murmur)

A

continuous, machinery-type murmur

179
Q

atrial septal defect clinical manifestations

A

often asymptomatic, diagnosed by murmur

180
Q

defects decreasing pulmonary blood flow

A

TOF

181
Q

Kawasaki disease causes

A

unknown, acute self-limiting vasculitis

182
Q

Clinical manifestations of Kawasaki’s 3 stages

A

acute, subacute, and convalescent

183
Q

Acute stage of Kawasaki’s (4)

A

fever, conjunctivitis, oral changes, rash

184
Q

subacute stage of Kawasaki’s (3)

A

begins when fever ends, desquamation of palms & soles occurs, marked thrombocytosis

185
Q

Convalescent stage of Kawasaki’s (3)

A

continued elevation of erythrocyte sedimentation rate and platelets, arthritis

186
Q

diagnosis of Kawasaki’s disease

A

oral changes - strawberry tongue

187
Q

Acquired HTN in children …

A

hypertension are commonly asymptomatic, blood pressure checks

188
Q

Most common macrocytic anemia

A

pernicious anemia

189
Q

Pernicious anemia lacks

A

intrinsic factor from gastric cells

190
Q

What causes an increased risk of PA

A

gastrectomy or gastric bypass

191
Q

Pernicious anemia is due to _ deficiency

A

B12 deficiency

192
Q

pernicious anemia is common with what surgery

A

with gastric bypass surgery

193
Q

Folate (folic acid) is an essential vitamin for

A

RNA & DNA synthesis

194
Q

Where does folate absorption occur ?

A

in the upper small intestine

195
Q

Absorption of folate is NOT ….

A

dependent on any other facilitating factors

196
Q

Folic acid/folate deficiency anemia clinical manifestations (4)

A

severe chelilosis (scales of lip/mouth), stomatitis (mouth inflammation), painful oral ulcerations, dysphagia

197
Q

Microcytic-hypochromic anemia

A

IDA - iron deficiency anemia

198
Q

Most common type of anemia worldwide

A

iron-deficient

199
Q

What is the measure of iron in circulation

A

serum iron

200
Q

What is the measure of iron in storage

A

serum ferritin

201
Q

What is the reticulocyte count

A

the ability of bone marrow to produce RBCs

202
Q

Lab finding of hemoglobin and hematocrit ?

A

HGB is 1/3 of HCT

203
Q

Anemia of chronic disease (4 causes)

A

infections, cancer, inflammatory, or autoimmune diseases

204
Q

Pathological mechanisms of anemia of chronic diseases

A

decreased erythrocyte life span, suppressed production of erythropoietin, ineffective bone marrow response to erythropoietin, and altered ion metabolism

205
Q

Pancytopenia is the

A

reduction or absence of all 3 types of blood cells (anemia, neutropenia, thrombocytopenia)

206
Q

Penia

A

low (penis is down south)

207
Q

Philia

A

high (Philly is in the north)

208
Q

Pathophysiology of aplastic anemia

A

hypocellular bone marrow that has been replaced with fat

209
Q

hemolytic anemia

A

accelerated destruction of RBCs

210
Q

polycythemia

A

overproduction of RBCs occur

211
Q

relative polycythemia

A

result of dehydration

212
Q

Polycythemia vera (PCV) is an

A

overproduction of RBCs

213
Q

Leukocytosis is the

A

increased levels of WBCs

213
Q

Polycythemia is coupled frequently with …

A

increased levels of WBC (leukocytosis) and platelets (thrombocytosis)

214
Q

Thrombocytosis is the

A

increased levels of platelets

215
Q

Death from ____ is increased 5x in polycythemia vera (PCV)

A

cerebral thrombosis

216
Q

Polycythemia vera (PCV) is an acquired mutation

A

janus kinase 2 (JAK2)

217
Q

Immune Thrombocytopenic Purpura (ITP) is a

A

low platelet disorder

218
Q

Immune Thrombocytopenic Purpura is when

A

antibody coated platelets are sequestered and removed from circulation

219
Q

ITP acute form develops

A

after viral infections

220
Q

Thrombotic microangiopathy is

A

platelets aggregate and cause occlusion of arterioles and capillaries

221
Q

pathognomonic pentad

A

ischemic signs & symptoms most often involve the CNS

222
Q

Causes of disorders of coagulation (6)

A

defects or deficiencies of clotting factors,
vitamin K deficiency,
liver disease,
CV abnormalities, vasculitis,
and impaired hemostasis

223
Q

Disseminated Intravascular Coagulation (DIC) is a

A

complex, acquired disorder where clotting and hemorrhage occur

224
Q

Disseminated Intravascular Coagulation (DIC) is characterized by

A

a cycle of intravascular clotting followed by active bleeding

225
Q

cytosis also means

A

high

226
Q

Granulocytosis (neutrophilia) is the

A

premature release of immature leukocytes is termed a shift to the left

227
Q

leukemoid reaction

A

Gun example - automatic spray vs a sharp shooter

228
Q

eosinophilia - eosinophils are high or low

A

high

229
Q

eosinophilia causes are

A

allergic, parasitic, and some cases of asthma.
Worms, wheezes and weird diseases

230
Q

infectious mononucleosis is caused by this virus

A

Epstein-Barre virus (EBV)

231
Q

Most common childhood leukemia

A

ALL (acute lymphoblastic leukemia)

232
Q

Lymphomas make up a diverse groups of

A

neoplasms that develop from the proliferation of malignant lymphocytes in the lymphoid system

233
Q

Primary lymphoid tissue is located in

A

the thymus, bone marrow

234
Q

Secondary lymphoid tissue is located in

A

lymph nodes, spleen, tonsils, intestinal lymphoid tissue

235
Q

Non-hodgkins lymphoma is linked to

A

chromosome translocations

236
Q

non-hodgkins lymphoma changes in

A

proto-oncogenes (turn-on switch) and tumor-suppressor (turn-off switch) genes contribute to cell immortality thus an increase in malignant cells

237
Q

Waldenstrom macroglobulinemia

A

also called lymphoplamacytic lymphoma is rare

238
Q

a majority of blood disorders (in children) revolves around

A

erythrocytes/anemia

239
Q

Acquired disorders of erythrocytes are

A

hemolytic disease of the fetus and newborn (HDFN)

240
Q

HDFN (hemolytic disease of the fetus and newborn) is

A

maternal blood and fetal blood are antigenically incompatible

241
Q

HDFN (hemolytic disease of the fetus and newborn) means

A

maternal antibody is directed against fetal antigens

242
Q

Glucose-6-phospate dehydrogenase deficiency (G6PD) is a deficiency

A

that shortens red blood cells life span

243
Q

Sickle cell disease is characterized by the presence of

A

abnormal hemoglobin

244
Q

Sickle cell disease’s 2 prominent attributes

A

deoxygenation and dehydration

245
Q

4 types of sickle cell crisis

A

Vasoocclusive
Aplastic
Sequestration
Hyperhemolytic

246
Q

Vasocclusive crisis

A

pain crisis, sickling is in microcirculation, extremely painful and symmetric.
Hands and feet exhibit painful swelling (hand-foot syndrome)
Acute chest syndrome

247
Q

Hemophilias

A

serious bleeding disorders

248
Q

leukemia is the most common ____

A

malignancy of childhood

249
Q

mechanisms of hormonal alterations

A

too much or too little hormone

250
Q

SIADH

A

levels of anti-diuretic hormone (ADH) are abnormally high

251
Q

SIADH action :

A

water retention, action of ADH on renal collecting ducts increases their permeability to water, thus increasing water reabsorption by the kidneys

252
Q

Hyponatremia is sodium less than

A

135

253
Q

Diabetes insipidus

A

insufficiency of ADH, polyuria, and polydipsia, partial or total inability to concentrate the urine

254
Q

DI clinical manifestations

A

polyuria, nocturia, continual thirst, low-urine specific gravity <1.010, low urine osmolality (<200), hypernatremia, diuresis

255
Q

3 clinical manifestation of Graves’ disease

A

ophthalmopathy, diplopia, and pretibial myxedema

256
Q

Ophthalmopathy

A

exophthalmos - increased secretion of hyaluronic acid, orbital fat accumulation, inflammation, and edema of the orbital contents

257
Q

diplopia

A

double vision

258
Q

pretibial myxedema

A

(Graves’ dermopathy) leg swelling

259
Q

Secondary hyperparathyroidism

A

hypercalcemia does NOT occur

260
Q

hypoparathyroidism clinical manifestations

A

hypocalcemia

261
Q

Diabetes mellitus affects metabolism of

A

fat, protein, and carbohydrates

262
Q

DM is characterized by

A

hyperglycemia, resulting from defects in insulin secretion, insulin action, or both

263
Q

DM categories

A

DM1
DM2
other specific types
gestational diabetes

264
Q

DM type 1 is

A

pancreatic atrophy and loss of beta cells resulting in a deficit of insulin and amylin and an increase in glucagon

265
Q

DM type 2 risk factors

A

age, obesity, HTN, physical inactivity, and family history, and metabolic syndrome

266
Q

metabolic syndrome

A

central obesity, dyslipidemia, prehypertension, and elevated fasting blood glucose level

267
Q

DM type 2 is characterized by 2 mechanisms

A

insulin resistance and decreased insulin secretion by beta cells

268
Q

DM2 alterations in the production of

A

adipokines by adipose tissue: leptin resistance

269
Q

DM2 - elevated

A

serum fatty acids and intracellular lipid deposits

270
Q

DM2 release of

A

inflammatory cytokines from adipose tissue

271
Q

DM2 reduced

A

insulin-stimulated mitochondrial activity

272
Q

DM2 is ____ - associated insulin resistance

A

obesity-associated

273
Q

Cushings clinical manifestations

A

truncal obesity
moon face
buffalo hump
sodium retention
renal stones
purple striae
brown/bronze skin

274
Q

Addison’s disease clinical manifestations

A

hypercortisolism
hypoaldosteronism
weakness
hyperpigmentation (very tan)
vitiligo

275
Q

Addison’s abrupt discontinuation

A

of steroids can cause Addison’s crisis

276
Q

Obesity - WAT (white adipose tissue)

A

stores energy
tend to hypertrophy in obesity releasing adipokines
increasing vascularity
increasing insulin resistance
increase inflammation resulting in dysregulation of food intake and energy metabolism

277
Q

Brown Adipose Tissue (BAT)

A

burns energy
can be protective against obesity as increases metabolism but is decreased in obesity

278
Q

Anorexia of aging

A

due to reduced energy needs
waning hunger
diminished sense of tast and smell
decreased saliva production
altered GI satiety mechanisms
co-morbities
meds

Advanced Pathophysiology (5 decks)

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