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1
Q

what is chronic kideny deases

A

slow, chronic decline of renal functions. This when >75% kidney function is lost.
caused by damage accumulated from other chronic diseases or AKI
irreversible

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2
Q

what does kidney failure cause

A 
accumaltion of waste
Water imbalance  
Salt imbalance 
Long-term blood pressure out of control 
Acid/base imbalance of blood
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3
Q

what is acute kidney injury

A

sudden damage to the kidneys that causes them tonot workproperly. It can range from minor loss of kidney function to complete kidney failure.
normally a complication of another serious illness.
usually reversible if treated quickly

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4
Q

what does renal failure lead to

A

Impaired renal excretion results in accumulation of waste and toxins in body fluids

Leads to disruption in endocrine and metabolic function, fluid, electrolyte and acid-base disturbances

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5
Q

what is renal failure

A

When kidneys unable to remove body’s metabolic waste

Unable to perform regulatory functions

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6
Q

what is the biliary trees

A

biliary tree is a system of vessels that directs these secretions from the liver, gallbladder and pancreas through a series of ducts into the duodenum.

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7
Q

where is bile stored

A

The liver makes bile which is stored in the gallbladder.

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8
Q

what is bile

A

The bile ducts carry bile. This is a fluid that helps to digest food by breaking down fat.

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9
Q

what is the bile duct

A

The bile ducts are part of the digestive system. They are the tubes that connect the liver and gallbladder to the small bowel.

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10
Q

what is the role of motor neurons

A

controlling the various activities of the body that involve muscle movement including walking, running, speaking, swallowing, breathing and gripping

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11
Q

what is the treatment of a mallory - weiss tear

A 
Self limiting in 80-90% of cases (stop bleeding and heal on its own)
injection or a heat treatment to stop bleeding
Surgical repair (rare)
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12
Q

what are the signs and symptoms of a mallort weiss tear

A 
haematoemesis vomiting of bright red or coffee grounds blood
Melaena (stool with blood) 
- dysphagia/odynophagia
anaemia
fatigue, dizziness, faintness
shortness of breath
abdominal or chest pain
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13
Q

what are the causes of a Mallory-Weiss Tear

A

Causes:
violent coughing, retching, vomiting and/or straining (common cause)
hiatal hernia (rare)
childbirth (rare)

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14
Q

what is a traumatic brain injury

A

an external force results in temporary or permeant brain dysfunction

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15
Q

give some signs and symptoms of a traumatic brain injury

A

Traumatic brain injury can have wide-ranging physical and psychological effects. Some signs or symptoms may appear immediately after the traumatic event, while others may appear days or weeks later

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16
Q

who’s most at risk of a traumatic brain injury

A

The people most at risk of traumatic brain injury include:
Children, especially newborns to 4-year-olds
Young adults, especially those between ages 15 and 24
Adults age 60 and older
Males in any age group

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17
Q

what causes a dramatic brain injury

A

Traumatic brain injury is usually caused by a blow or other traumatic injury to the head or body. The degree of damage can depend on several factors, including the nature of the injury and the force of impact.
Common events causing traumatic brain injury include the following:
Falls.
Vehicle-related collisions.
Violence.
Sports injuries.
Explosive blasts and other combat injuries.
Penetrating wounds
Severe blows to the head with shrapnel or debris, and falls or bodily collisions with objects following a blast.

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18
Q

what are the symptoms of Caudia equina

A

Urinary retention
Urinary and/or fecal incontinence.
“Saddle anethesia” sensory disturbance, which can involve the anus, genitals and buttock region.
Weakness or paralysis of usually more than one nerve root.
Pain in the back and/or legs
Sexual dysfunction.

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19
Q

what are the causes of goitre

A

Iodine Deficiency:

Graves’ Disease:
In this condition the immunes system mistakes the thyroid gland for foreign and beings to attack which causes it to produce excess thyroxine.s.

autoimmune disease that can cause damage to the thyroid

Thyroid Cancer

Pregnancy

Inflammation

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20
Q

what is the role of the thyroid

A

The role of the thyroid is to produce two main hormones: thyroxine triiodothyronine (T-3). The role of these is to regulate the metabolism

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21
Q

what is goitre

A

Goitre is an abnormal enlargement of the thyroid gland.

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22
Q

what are the signs and symptoms of goitre

A

A swelling at the bottom of the neck that might be obvious to see as well as palpate

  • Tight feeling in throat
  • Coughing
  • Hoarseness in voice
  • Dysphagia
  • Difficult in breathing
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23
Q

what is the risk factors to goitre

A

-Iodine deficiency
-Female
-Over 40
-Medical history of autoimmune diseases
-Pregnancy and menopause
-Medications such as amiodarone and psychiatric drugs containing lithium
–Radiation exposure

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24
Q

what is gastric motility

A

Paralysis of the stomach (fails to empty content into intestine)

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25
Q

what is the cause of gastric motility

A
  • diabetes (most common cause -1/3 of the cases)
    • neurological disorders such as MS, Parkinson’s disease
    • connective tissue disorders
    • post surgical complications
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26
Q

what are the signs and symptoms of gastric motility

A

Stomach/abdominal pain, bloating, heartburn, nausea, vomiting, early satiety, malnourishment, dehydration, weight loss, fatigue

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27
Q

how to diagnose gastric motility

A

Gastric Emptying Study (GES) using radioactive material traced by a scanner
Upper endoscopy
Barium x-rays
Wireless motility capsules (SmartPill)

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28
Q

what is the treatment for gastric motility

A

Dietary changes (small, frequent meals low in fat and fibre)
Medication to increase motility
Symptom management medications
Surgeries and/or feeding tubes, total parenteral nutrition

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29
Q

what is alcoholic induced liver disease

A

alcohol is sent to the stomach which is sent to the liver for processing

the liver breaks down alcohol leading to the liver making more fatty acids

this causes the liver to get large, heaver, greasy and tender

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30
Q

what is the treatment to jaundice

A

phototherapy

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31
Q

what are the causes jaundice

A

viral hepatitis

drugs / alcohol

cirrhosis (permeant damage to the liver )

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32
Q

explain the pathophysiology of jaundice

A

billrubin

red blood cells breakdown when they are old

this leaves high levels of uncondrigated bilirubin in the blood

this is then sent to the liver to congregate the bilirubin

if the liver is damages and cannot conjugate bilirubin

leads to an increase of bilirubin in the blood

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33
Q

what is jaundice

A

yellowing of the skin and eyes

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34
Q

what are the symptoms of hepatitis

A

fever
nausea
enlarged liver causing pain

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35
Q

what is the pathophysiology of hepatitis

A

virus targets the cells in the liver

infect the cells so immune cells attack the liver

they recognise these proteins shouldn’t be their

cytotoxic killing happens

cuasing inflammation and liver death

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36
Q

what is hepatitis

A

inflammation of the liver due to a virus

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37
Q

what is the pathophysiology of portal hypertension

A

obstruction prevents blood flow

blood accumulates in the portal system

causing pressure to rise above 12mmhg (this causes portal hypertension)

this stops the liver being able to perform its function approitay

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38
Q

what is portal hypertension

A

high blood pressure in the hepatic portal system

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39
Q

what are the symptoms of hemochrombtosis

A

joint pain
adominal pain
fatigue
bonze or grey skin

40
Q

what are the complication of hemochrombtosis

A

liver gets mostly left over iron leading to liver choruses

comlication depends on where iron is absorbed

41
Q

explain the pathophysiology of hemochrombtosis

A

extra iron is disposeted in organs mostly the liver

slowly damages the cells and causes cell death

this is due to a genetic mutation in chromosome 6 leading to unable to regulate the iron being let into the blood stream therefore to much is let in

42
Q

at what age is hemochrombtosis diagnose

A

age 50 plus in men

10-20 years after the menopause

43
Q

what is hemochrombtosis

A

metabolic disorder where the body absorbs to much iron- it leads to elevated iron in the blood

44
Q

what is the function of the kidney’s

A

Removal of waste (anything not necessary or toxic)
Water balance (water in = water out)
Salt balance (homeostasis of blood osmolarity)
Long-term blood pressure homeostasis
Acid/base balance of blood

45
Q

what are the signs and symptoms of kidney stones

A

Pain
Haematuria (blood in urine)
Raised temperature
Nausea and Vomiting

46
Q

explain the pathophysiology of anaphylaxis

A

these cells are preformed to the thing and individual is allergic to

an antigen enters the body- what they are allergic to

helper t-cells that suited for the specific antigen recognise the antigen

immune cells comes as back up from a B-cell (these produce antibodies)

makes IgE cells- these bind to cells that produce inflammatory agents (Mast cells)

this causes hives, swelling and closing of the airways

47
Q

what is secondary hyperthyroidism

A

causes by overstimulation by the thyroid- pituarty producing to much TSH

48
Q

what is primary hyperthryoism

A

causes by thyroid pathology- abnormally producing to much thyroid hormone

49
Q

what is hyperthyroidism

A 
anxiety 
sweating
tachycardia 
weight loss 
fatigue 
frequent loss stools
50
Q

what is a thyroid storm

A

more acute severe presentation- more serve symptoms

51
Q

what is the pathophysiolgy of hyperthyroidism

A

increase synthesis and secretion of bodys t3 and t4

52
Q

what is hyperthyroidism

A

elevated thyroid hormone levels- thyroid producing to much thyroxine

53
Q

what is the causes of Addison’s disease

A

autoimmune destruction - immune system attack healthy tissues in adrenal Cortex

54
Q

what is primary adrenal insufficiency

A

adrenal cortex gets progressively damaged over time

55
Q

what is Addison’s disease

A

adrenal gland can’t produce enough horses the body needs

56
Q

what is anaphylaxis ?

A

immune response that the body uses against allergies antigens

57
Q

What is a Mallory- Weiss tear

A

Test of the tissues in the lower esophagus

58
Q

What is Pyclonephritis

A

Inflammation of the kidney that develops quickly—>usually a result of bacteria infection

The infection starts at the lower urinary system and makes it’s way towards the kidney

Common cause:upper urinary infections, faliure of the valve that stops Urine flowing backwards

59
Q

Risk factors for Pyclonephritis

A

Female sex
Sexual intercourse
Catheters

60
Q

How does Pyclonephritis happen

A

Starts by bacteria attaching to the epithelium in the kidney—>triggers and inflammatory response—>white blood cells are weed out

61
Q

Symptoms of Pyclonephritis

A 
Fever 
Chills 
Pain when peeing 
Nausea 
Vomiting
62
Q

Treatments for Pyclonephritis

A

Antibiotics

Staying hydrated

63
Q

Kidney stones

A

Substances stick together forming crystals or stones—>kidney removes excessive calcium into our urine—>builds up and sticks together—>overtime forms a stone

3 step process
Crystallisation
Aggravation
Crystal growth

Eventually get too large to pass

64
Q

Diagnosis of kidney stones

A

Urine analysis
Ultra sound
CT
X-ray

65
Q

Risk factors of Kidney stones

A

Male
Age
Family history
Dehydration

66
Q

Overall meaning of cardiomyopathy

A

Cardiomyopathy is a general term used for a disease of the heart muscle, where the walls of the heart chambers have became stretched,thickens or stiffens

67
Q

Dilated cardiomyopathy

A

The muscle walls become stretched and thinner, so they cannot contract properly to pump blood

68
Q

Hypertrophic cardiomyopathy

A

The heart muscle enlarge and the walls of the heart chambers thicken, the heart chambers reduce in size and cannot hold as much blood therefore meaning the walls cannot relax and may stiffen

69
Q

Restrictive cardiomyopathy

A

The walls of the main heart chambers become stiff and rigid and cannot relax properly after contracting

70
Q

Polycystic kidney disease

A

Genetic disease which the kidneys become filled with hundreds of cysts causing them all to be larger

They develop in both the outer layer(cortex) and the inner layer(medulla)

71
Q

What is the pathophysiology of polycystic kidney disease

A

Cysts fill with liquid and get bigger overtime—>this can cause blood vessels to be compromised—>this can starve the blood vessels of oxygen—>can lead to hypotension

72
Q

Meningitis

A

Affects the menigines
3 protective layers around the brain and spinal cord “inflammation of the meniges” two inner layers

Cerebrospinal fluid: clear watery fluid which is pumped around the spinal cord and brain, cushions them for impact.

Inflammation trigger
autoimmune-where the body attacks itself

73
Q

Direct spread of meningitis

A

Pathogen gets inside the skull or the spine and penetrates the meniges, ends up in the cerebral spinal fluid

Causes: pathogens comes up the nose or through the skin

Skull fracture: bacteria, virus, fungal

Hematogenus spread-Pathogens enters the blood stream—>moves through the endothelial cells into the blood vessels—>gets into the celebrum spine fluid—>it’s then starts to multiply—>white blood cells then respond

74
Q

Symptoms of meningitis

A 
Headache
Fevers 
Neck stiffness 
Photophobea 
Altered mental state

Diagnosis
Kernigs spine
Lumbar puncture

Treatment
Antibiotics,steroids,drug treatment

75
Q

What is Multiple sclerosis

A

It effects the brain and spinal cord
Myelin is the sheath that surrounds the axons of the neurons, allows them to send electrical impulses

What happens during MS

The immune system attacks and destroys then myelin—>leads to a breakdown in communication—>leads to sensory,motor and cognitive problems—>blood brain barrier only lets certain molecules and cells through—>immune cells are only allowed through if they have the right surface molecule—>once t-cells get through and activates on the mylin, it sends more t-cells to the sight—>t-cells release cytokines that help dictate the blood vessels allow loads of immune cells in response—>they then cause inflammation and release antibodies that start to damage the mylien—>this leaves behind areas of scare tissue

76
Q

Causes and symptoms of Multiple sclerosis

A 
Genetics
Female 
Gene coding 
Environmental factors infection 
Vitamin D deficiency 
Symptoms 
Difficulty in speaking 
Tremors 
Involuntary eye moment 
Fatigue 
Loss of balance/dizziness

Diagnosis
MRI scans

Treatment
Medications
Immunosuppressants

77
Q

B-cells and T-cells

A

B-cells recognise antigens
Engulfs, antigens once they are binded to receptors—>realises lymphoids that multiply by mitosis allowing duplication of b-cells—>also releases plasma that releases antibodies

Cytokines-signalling proteins—> leads to inflammation—>recit and activate more cells of immune system

T-cells have t-cell receptors that are specific to a single antigen

78
Q

What two hormones control the glucose in the body

A

Insulin and glucagon

79
Q

What is glucose

A

A source of energy

80
Q

What is insulin

A

Hormone produced by beta cells in the pancreas

Can bind to insulin receptors in cell membranes allows glucose to be transported into the cell

81
Q

What is glucagon

A

Realised by alpha cells
Gets liver to generate new molecules of glucose
Breaks down into glucose
All gets into blood

82
Q

Diabetes type 1 and 2

A

Type 1- Dosent produce enough insulin, type 4 hypersensitivity response, where T-cells attack the pancreas in particular, the beta cells, means less insulin is produced and glucose remains in the blood as it can’t enter the beta cells

TYPE 2- bosh tissues don’t respond well to insulin, body providing enough insulin but cells don’t react to transport->cells are insulin resistant->leads to body realising more insulin to get the same effect->does this by increasing beta cells attempt to make more insulin

83
Q

Diabetic ketoacidosis

A

Ketone bodies-increase acidity In blood->this can have major effects on your body->lead to laboured breathing->reduce co2 to overall reduce acidity

Symptoms-nausea,vomiting,mental changes,fruity breath

Treatment-fluids for dehydration,insulin to lower blood glucose levels,replacement of electrolytes

Hypoglycaemia-glucose Levels low
Hyperglycaemia-glucose level high

Hypoglycaemia-imbalance in glucose production and use of glucose( can lead to death)

Causes
Tumors
Metabolic errors
Excessive insulin

Symptoms
Tremors 
Shaking 
Tachycardia 
Same symptoms as a stroke
84
Q

Symptoms and risk factors for diabetes

A 
Symptoms
Hungry(polyphagia)
Increased wee(Glucose wee)
Glucose wee(polypharia)
Increase thirst(polyclipsa)

Risk factors
Obesity
Lack of exercise
Hypertension

85
Q

What is hyperglycaemia

A

Medical term for high blood sugar

It can effect people with type 1 and 2 diabetes as well as pregnant women with gestational diabetes

Not injecting insulin properly or expired insulin
Not using enough insulin or oral diabetes medication
Being inactive
Having illness or infection
Using meds such as steroids
Being injured or having surgery
Emotional stress

86
Q

Treatment for diabetes

A

Insulin therapy

87
Q

What is Parkinson’s

A

Progressive neurological condition where your brain gets damage overtime

Symptoms-
Tremors 
Postural instability 
Vision problems 
Rigidity 
Freezing 
Slow movement 
Stiff movement

Causes
Not enough chemical dopamine(this is caused by a loss of nerve ending cells)->chemicals that inflict movement->causes symptoms

88
Q

Caudi equina

A

Collection of nerves at the end of the spinal cord is called caudiequina

Carnes nerves that control the bladder as nerves for the movement of legs

Extreme pressure or swelling at the nerve endings of the spine

89
Q

Types of encephalitis

A

Primary-occurs when a virus directly effects the brain, can be concentrated in one area or widespread

Secondary-results from a faulty immune system reaction to an infection elsewhere in the body, instead of attacking only cells In the body causing infection the faulty immune system also attacks the healthy cells in the brain, normally occurs 2-3 weeks after initial infection

Causes-
Viruses
Autoimmune and metabolic

Risk factors
Young and old
People who have immune compromise

Signs and symptoms 
Headaches 
Aches and pains 
Feeling generally unwell 
Fever 
Altered mental state
90
Q

Gastric erosion

A

Mucous membrane lining the stomach becomes inflamed

91
Q

Stomach ulceration

A

Open sores that develop in the stomach lining

Signs and symptoms
Pain in center of stomach
Indigestion
Heartburn

Causes 
Layer protecting the stomach lining from acid breaks down 
Leads to a damaged stomach lining 
Infection 
Long term anti inflammatory drugs

Common in men over 60

92
Q

Gastric-intestinal varices

A

Swollen burns found in the stomach and oesophagus->often occurs due to pressure on the liver->or abnormalities with portal veins

93
Q

Haemotenits

A

“Vomiting blood”
Coffee ground colour-due to bring partially digested In the stomach

Upper GI tract->as blood is lost the total volume blood is decreased->cause construction in blood vessels->impaired blood flow to the vital organs

Causes
Swallowed blood
Gastro-osephagous reflux disease

94
Q

Motor neuroN disease

A

Affects the brain and spinal cord And causes weakness and gets worse overtime
Progressive degeneration of the motor neuron

Symptoms 
Weakness 
Slurred speech 
Weak grip 
Muscle cramps 
Weight loss

Causes
Mutation of DNA
Virus
Toxins and chemicals

Motor neurons control skeletal movement, overtime leads to weakened muscles

ALS effects upper and lower motor neurons

95
Q

Renal failure

A

Pre-renal sudden drop in blood pressure(shock)
Inter-renal-direct damage to kidneys due to inflammation
Postrenal-sudden obstruction of urine flow

Signs and symptoms 
Acidosis 
Electrolyte imbalance 
Accumulation of urea 
No urine produced 
Diagnosis 
Urine test 
Blood test 
Kidney biopsy 
Imaging tests

Management
Treating underlying cause
Dialysis
Correction of fluid

96
Q

What is dementia

A

Loss of memory and other thinking abilities to interfere with daily life

Types of dementia
Vascular dementia-damage to the blood to the brain, problem solving and memory loss

Treatment
Medications
Counselling
CBT
Cognitive rehab 
Activities such as music art  
Lewy body dementia-abnormal clumps of protein, slow movements and tremors

Mixed dementia-people of 80 years show a mix of all dementia

Frontotemporal-breakdown of nerve cells and their connections in the frontal lobes, behaviour change

Alzheimer’s disease- plaques and tangles in the brain with lumps of proteins called amyloid, damage healthy sounds around them

97
Q

What is a stroke

A

A stroke is where a part of your brain Dosent receive blood supply and gets cut off, urgent hospital attention is needed

Causes
A stroke can happen due to either a blood clot in the brain or a bleed on the brain, a blocked artery(ischemic stroke) leaking or bursting of a blood vessel(haemorrhagic stroke)

Treatments
Medicines To treat blood clots
Brain surgery

Applied pathophysiology (8 decks)

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