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Nursing-Sem 1 > Patho Exam 3 > Flashcards

Patho Exam 3 Flashcards

1
Q

hypothalamus gland

A

activates, controls, integrates peripheral ANS and somatic functions like body temp, sleep, and appetite

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2
Q

hormones produced by the hypothalamus

A 
CRH
GnRH
GHIH
GHRH
MIH
PIH
TRH
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3
Q

pituitary gland

A

“master gland” controlled by hypothalamus. anterior and posterior.

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4
Q

hormones produced by the pituitary gland

A 
FSH
LH
prolactin
ACTH
TSH
GH
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5
Q

hormones produced by the posterior pituitary gland

A

vasopressin/ADH

oxytocin

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6
Q

destruction of the pituitary gland leads to what s/s?

A

extreme weight loss, emaciation, endocrine gland/organ atrophy, hair loss, impotence, amenorrhea, hypo metabolism, hypoglycemia

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7
Q

95% of pituitary tumors are…?

A

benign

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8
Q

what are the s/s of a pituitary tumor?

A

increased pressure, headache, vision changes, loss of peripheral vision, hormone level changes

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9
Q

diabetes insipidus

A

low ADH levels because pituitary is not producing enough. characterized by large quantities of dilute urine, electrolyte imbalances (hypernatremia), excessive thirst (dehydration)

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10
Q

SIADH

A

overproduction of ADH @ pituitary or elsewhere. Characterized by increased blood volume, low quantities of concentrated urine and dilutional hyponatremia (b/c retaining so much water, dilutes salt concentration). S/s include: thirst, mild cramping, nausea, confusion, seizures, coma, irritability, restlessness, dec. appetite, weakness, hallucinations, stupor.

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11
Q

SIADH is commonly the 1st sign of…?

A

lung cancer

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12
Q

thyroid gland

A

butterfly shaped gland at the base of the neck. Controls metabolism via control of HR, RR, C/PNS, body weight, muscle strength, menstrual cycles, body temp, and cholesterol levels.

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13
Q

what hormones does the thyroid gland produce?

A

uses iodine from foods to make T3 (triiodothyronine) and T4 (thyroxine). Levels are maintained by hypothalamus and pituitary via TRH and TSH. Regulate speed at which cells work (i.e. metabolism)

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14
Q

hypothyroidism

A

decreased levels of thyroid hormones that lead to s/s such as: inc. sensitivity to cold, constipation, weight gain, puffy face, hoarseness, muscle weakness, inc. blood cholesterol levels, muscles aches/stiffness, joint pain/swelling, heavy or irregular periods, thing hair, slow HR, depression, dec. memory

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15
Q

myxedema

A

life threatening event of severe uncompensated hypothyroidism. s/s include: hypothermia, unconsciousness, low BP, dec. RR, coma. Can be fatal.

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16
Q

what population is most likely to experience myxedema?

A

older women during cold months

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17
Q

severe hypothyroidism is characterized by what?

A

inc. cholesterol lebels, atherosclerosis, coronary artery disease, poor left ventricular function, and myxedema coma.

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18
Q

how do you dx hypothyroidism?

A

TSH level > 10 is considered hypothyroidism free T4 level and anti-thyroid peroxidase (antibody) levels

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19
Q

what is the presence of anti-tthyroid peroxidase indicative of?

A

Hashimoto’s thyroiditis

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20
Q

what are some causes of hypothyroidism?

A 
Hashimoto's thyroiditis (autoimmune)
thyroid atrophy (aging)
radioactive iodine/thyroidectomy
medications (lithium iodine, antithyroids)
infiltrative thyroid disease (cancer)
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21
Q

what are some complications of hypothyroidism?

A 
birth defects
goiter
heart problems (inc. LDL, pericardial effusions)
infertility (dec. ovulation)
mental health (depression)
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22
Q

hyperthyroidism

A

overactive thyroid leads to overproduction of thyroid hormones

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23
Q

causes of hyperthyroidism?

A 
Grave's disease
toxic nodular or multi-nodular goiter 
thyroiditis
excessive iodine consumption
pregnancy
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24
Q

signs and symptoms of hyperthyroidism?

A

increased metabolism. fatigue, muscles weakness, hand tremors, mood swings, nervousness, restlessness, anxiety, inc HR, inc. RR, palpitations, dry skin, trouble sleeping, weight loss, inc. freq. of bowel movements, light or skipped periods. Speeds up body processes.

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25
Q

parathyroid gland

A

four small glands in neck that produce parathyroid hormone (parathormone) and calcitonin.

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26
Q

hyperparathyroidism

A

overproduction of parathormone leading to bone decalcification and inc. calcium in the blood stream, which may result in calcium-containing kidney stones. signs and symptoms include: apathy, fatigue, muscle weakness, nausea, vomiting, constipation, hypertension, and cardiac dys-arrhythmias

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27
Q

how do you dx hyperparathyroidism?

A

persistent hypercalcemia and elevated parathormone levels. bone changes on x-ray or bone scan.

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28
Q

hypoparathyroidism

A

underproduction of parathormone which leads to hypocalcemia. usually occurs after recent neck surgery, with family hx, or with autoimmune diseases like Addison’s.

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29
Q

s/s of hypoparathyroidism?

A

tetany (muscle spasms/cramps @ fingers and hands), paresthesias (tingling), LOC with grand mal seizures, malformation of teeth, impaired kidney function, heart arrhythmias, fainting, stunted growth, slow mental development, calcium deposits a@ brain, cataracts. cannot reverse complications once happen, but may be able to prevent or keep from progressing.

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30
Q

adrenal gland

A

two glands @ top of kidneys. 2 main components include the cortex (outer) and medulla (inner) parts.

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31
Q

cortex of the adrenal

A

outer portion of the gland. produces hormones vital to life such as cortisol (metabolism, stress) and aldosterone (BP control). Produces 2 main groups of corticosteroids: glucocorticoids and mineralocorticoids.

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32
Q

what controls the release of glucocorticoids?

A

signals from hypothalamus (CRH) and pituitary glands (ACTH)

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33
Q

what controls the release of mineralocorticoids?

A

signals from the kidney

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34
Q

what hormones are released from the cortex of the adrenal gland?

A

hydrocortisone
corticosterone
aldosterone
sex hormones

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35
Q

medulla of the adrenal

A

inner portion of the adrenal gland that produces non-essential hormones after physical or emotional stress.

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36
Q

hormones produced by the medulla of the adrenal gland?

A

epinephrine (inc. HR, RR, BGC, etc.)

norepinephrine (vasoconstriction, inc. BP

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37
Q

Addison’s disease

A

adrenal cortex does not produce enough cortisol or aldosterone

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38
Q

adrenal cancer

A

rare, but aggressive cancer that usually becomes malignant

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39
Q

Cushing’s syndrome

A

uncommon, characterized by overproductions of cortisol. Also happens with chronic corticosteroid use. “Moon face.”

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40
Q

congenital adrenal hyperplasia

A

genetic. low cortisol levels and other hormone issues like low aldosterone

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41
Q

pheochromocytoma

A

rare adrenal tumor that results in over-release of epinephrine and norepinephrine. always in “fight or flight” mode. s/s include: pain (chest), irritability, nervousness, pallor, palpitations, inc. HR, severe headache, sweating, weight loss, hand tremor, sleeping problems, inc. BP. Occurs in “attack” as adrenal medulla releases hormones every 15-20 min.

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42
Q

how to dx pheochromocytoma?

A

abdominal CT, biopsy, serum catecholamines, glucose, serum metanephrien, MRI, urine tests

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43
Q

primary aldosteronism

A

adrenal glands produce too much aldosterone, so you lose potassium and retain sodium, which leads to water retention along with inc. blood volume and BP. if untreated, stroke, heart disease. HTN that occurs with this may be curable. resistant hypertension

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44
Q

pancreatic islets

A

islets of Langerhorn. endocrine cells @ pancreas that control the pancreatic feedback system that regulates blood glucose, insulin, glycogen, glucagon, and somatostatin levels.

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45
Q

diabetes

A

group of metabolic diseases characterized by hyperglycemia that result from insulin production defects or insulin action defects. Affects nearly 10% of the US population. Results in huge healthcare expenditures.

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46
Q

hospitalization rates for adults and kids with diabetes?

A

2.4 and 5.3x greater than average population

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47
Q

T1 diabetes

A

destruction of pancreatic beta cells (genetic, triggered by env. event like infection) results in dec. insulin production and unchecked glucose production at the liver. Glucose requires insulin to enter cells, so cannot enter cells. To meet energy needs, body metabolizes fat to glycerol and free fatty acids. Body uses glycerol as glucose and F.A. are broken down to ketones that are excreted in the urine with large amounts of water. Fasting hyperglycemia.

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48
Q

T2 diabetes

A

pancreas produces enough insulin, but fat/liver/muscle cells fail to respond to it correctly (insulin resistance). Glucose cannot enter cells resulting in hyperglycemia. 90-95% of patients with diabetes are T2.

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49
Q

diabetic ketoacidosis

A

common with T1 but not T2 diabetes. Fat is broken down in to free fatty acids, which is metabolized to ketones. Ketones & glucose build up in bloodstream, excreted @ urine with large amounts of water. Dehydration results, worsening ketoacidosis (dec. pH). Causes low BP and shock.

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50
Q

s/s of diabetic ketoacidosis

A 
osmotic diuresis
vomiting
acidosis
cerebellar dysfunction
cerebral edema
fluid/electrolyte depletion
shock
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51
Q

s/s T2 diabetes

A

NOT diabetic ketoacidosis
fatigue, irritability, polyuria, polydypsia, poor healing wounds, vaginal infections, blurred vision (with hyperglycemia)

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52
Q

what are some risk factors for T2 diabetes?

A

family history, obesity, race/ethnicity (not Caucasian), age >45, impaired fasting glucose, hypertension, low HDLs, high triglycerides, history of gestational diabetes or delivery of >lb baby.

53
Q

metabolic syndrome

A

constellation of symptoms associated with beta cell failure and rising glucose levels. these include: hypertension, high cholesterol, abdominal obesity, and hyperglycemia.

54
Q

gestational diabetes

A

any degree of glucose intolerance with onset anytime during pregnancy. Placental hormones can lead to insulin resistance. Clinical manifestations = 3P’s (polyuria, polydipsia, polyphagia.

55
Q

Normal vs. diabetic levels for A1c, fasting plasma glucose, and oral glucose tolerance test

A

Normal: A1c ~5%, FPG <99, OGTT <139

Diabetes: A1c 6.5+, FPG 126+, OGTT 200+

56
Q

what organs are damaged by hyperglycemia?

A

eyes, kidneys, nervous system, GUT organs, sexual organs, bladder, GI, cardiac system

57
Q

micro and macro-vascular complications of diabetes

A

diabetes causes chronic inflammation, which damages micro and macrovascular tissue. These changes lead to inc. risk for coronary artery disease, cerebrovascular disease, diabetic retinopathy, nephropathy, and neuropathy.

58
Q

hematemesis

A

blood in vomit

59
Q

hematochezia

A

bright red stools (visible blood)

60
Q

melena

A

black, tarry stools (blood acted on by GI tract)

61
Q

occult bleeding

A

stools look normal but products are present in stool in small amounts (Guiac test)

62
Q

hyperkalemia and GI

A

results in hyper excitability of GI smooth muscle and inc. GI motility (diarrhea)

63
Q

hypokalemia and GI

A

dec. excitability of GI smooth muscle and motility, so constipation

64
Q

hypercalcemia and GI

A

causes dec. excitability of GI smooth muscle, dec. motility, and inc. strength of contractions. Constipation.

65
Q

hypocalcemia and GI

A

inc. excitability of GI smooth muscle and inc. motility. dec. strength of contractions. Diarrhea.

66
Q

osmotic diarrhea

A

unabsorbable osmotic particles in GI tract cause osmotic movement of water from GI cells to the lumen.

67
Q

secretory diarrhea

A

inflammation or infectious process that involves cells of GI tract and causes those cells to secrete excessive fluid into lumen

68
Q

diarrhea and electrolyte imbalance

A

potassium and bicarbonate usually reabsorbed in GI tract, but with diarrhea more is lost leading to metabolic acidosis and hypokalemia

69
Q

dysphagia

A

difficulty swallowing

70
Q

esophagitis

A

infection/inflammation of the esophagus, often related to GERD reflux into lower esophagus

71
Q

achalasia

A

dysphagia associated with inability of lower esophageal sphincter to release

72
Q

GERD

A

gastro-esophageal reflux disease. backward movement of gastric contents into esophagus, leads to complications like Barrett’s esophagus

73
Q

Barrett’s esophagus

A

change in tissue types @ esophagus, increases risk for cancer

74
Q

hiatal hernia

A

protrusion of part of the stomach upward into the thorax

75
Q

esophageal cancer

A

uncommon. associated with Barrett’s esophagus and long term GERD. Presents with dysphagia.

76
Q

gastritis

A

inflammation of stomach

77
Q

stress ulcers

A

stress activates SNS, which shunts blood away from GI tract. Stomach acid then irritates ischemia gastric mucosa and causes ulcers. can lead to massive bleeding.

78
Q

peptic ulcer disease

A

ulcerative disorder @ duodenum associated with h. pylori infections.

79
Q

stomach cancer

A

bulky, irregular shaped ulcers with jagged edges. risk factors include dietary habits and chronic gastritis.

80
Q

IBS

A

chronic and recurrent intestinal symptoms not explained by structural or biochemical abnormalities

81
Q

inflammatory bowel disease

A

two types: ulcerative colitis and Crohn’s disease

82
Q

ulcerative colitis

A

non-specific inflammatory condition at the colon. confined to the colon or rectum. Confluent lesions, pinpoint mucosal hemorrhages, and crypt abscesses

83
Q

Crohn’s disease

A

recurrent, granulatomous inflammatory response. Affects various sites along the GI tract (NOT JUST RECTUM/COLON). Skip lesions, cobblestone appearance, and complications such as fistula development.

84
Q

diverticular disease

A

pouch-like herniations of the superficial layers of the colon through muscles of bowel wall. Risks include low fiber diet, high intake of processed foods…does not exist in undeveloped nations.

85
Q

appendicitis

A

inflammation of the appendix wall. Pain localized at the right lower quadrant with elevated WBC and rebound tenderness.

86
Q

peritonitis

A

inflammation of the membrane lining of the abdominal cavity and covering visceral organs.

87
Q

gallbladder

A

pear-shaped organ. hollow. R side of abdomen. primary function is to store and secrete bile. (bile salts are recycled)

88
Q

cholecystitis

A

inflammation of the gallbladder. s/s include severe pain in RUQ that radiates to shoulder/back. Tenderness w/ palpation. Nausea, vomiting, fever, usually occurs after a large fatty or fatty meal. Caused by gallstones, tumors, or obstruction of bile duct.

89
Q

cholelithiasis

A

gallstones. usually asymptomiatic. Most common symptom is biliary colic. Does not cause dyspepsia or fatty food intolerance. Risk factors: 4Fs = fat, female, forty or older, family hx

90
Q

pancreas

A

two main functions include 95% exocrine (digestion) and 5% endocrine (blood sugar regulation).

91
Q

pancreatitis

A

inflammation of the pancreas. Acute pancreatitis is a medical emergency and char. by severe LUQ pain radiated to pack. Cullen and Grey Turner signs indicate intra-abdomial bleeding. Chronic is usually undetected. Classic s/s include: persistent pain, excess fat in feces, jaundice, LUQ mass as scar tissue replaces pancreatic tissue

92
Q

causes of pancreatitis

A

mostly alcohol abuse and gallstones

93
Q

liver

A

largest gland of body. ~3lb solid organ. reddish-brown color, rubbery.

94
Q

Kupffer cells

A

@ liver. breakdown old RBCs, producing bilirubin.

95
Q

functions of liver

A

digestion, metabolism, detoxification, storage, production, immunity.

96
Q

liver and digestion

A

produces bile to aid digestion

97
Q

liver and metabolism

A

metabolizes carbs, lipids, proteins into bio-useful materials. Absorbs/releases glucose

98
Q

liver and detoxification

A

hepatocytes monitor blood and remove toxic substances before they reach rest of body

99
Q

liver and storage

A

stores many nutrients, vitamins, minerals, glucose, fatty acids.

100
Q

liver and production

A

produces clotting factors like prothrombin, fibrinogen, and albumins

101
Q

liver and immunity

A

Kupffer cells are immune cells that capture and digest bacteria, parasites, fungi, old RBCs, and cell debris. Fixed macrophages.

102
Q

hepatic dysfunction caused by…?

A

damage to the liver cells, primary liver disease, bile obstruction, problematic hepatic circulation

103
Q

jaundice

A

skin, sclera discolored yellow because of too much bilirubin (>3mg/dL causes yellowing)

104
Q

portal hypertension

A

increase in blood pressure at portal venous system, leads to ascites and varices

105
Q

ascites

A

fluid accumulation in abdominal cavity due to increased BP and decreased albumin levels (pressure gradient). Failure of liver to metabolize aldosterone leads to inc. water and sodium retention @ kidneys.

106
Q

esophageal varices

A

abnormal, enlarged veins at esophagus. Rupture, bleeding = major complication of portal hypertension. High mortality rate. 30% of all upper GI bleeds.

107
Q

osteogenic cells

A

stem cells @ inner layer of periosteum. Gives rise to osteoblasts.

108
Q

osteoblasts

A

build bone

109
Q

osteoclasts

A

crush/break down bone matrix (remodeling &calcium release)

110
Q

osteocytes

A

mature bone cells

111
Q

remodeling requires what types of bone cells?

A

osteoclasts and osteoblasts

112
Q

compact bone (cortical)

A

organized, solid, strong.
haversian system.
covers spongy bone, forms cylinder around central marrow cavity, 85% skeleton

113
Q

spongy bone (cancellous)

A

no haversian system. contain trabecular, located at ends of bone and center of flat bones, can withstand forces from many directions. “inner” porous bone.

114
Q

bones in the skeleton? axial? appendicular?

A 
206
80 axial (skull, spine, ribs), 126 appendicular (extremities, shoulder, pelvis)
115
Q

bone integrity/maintenance includes…

A

remodeling and repair

116
Q

4 stages of bone repair?

A

hematoma formation
fibrocartilage callus formation
bony callus formation
bone remodeling

117
Q

synarthrosis joints

A

no movement. Fibrous or fixed joints.

118
Q

amphiarthrosis

A

slightly movable joints i.e. intervertebral or pubic symphysis

119
Q

diathrosis

A

very moveable. synovial joints, ball& socket, freely movable.

120
Q

fibrous joints

A

bone to bone juncture

121
Q

cartilaginous joints

A

symphysis and synchondrosis

122
Q

synovial joints

A

uni-bi-or multi-axial

123
Q

joint capsule

A

fibrous connective tissue that covers ends of bone where they meet in a joint

124
Q

synovial membrane

A

smooth inner lining of joint capsule (non-articular portion of synovial joint and any ligaments/tendons in cavity)

125
Q

synovial cavity

A

enclosed, fluid-filled space b/t articulating surfaces of 2 bones

126
Q

synovial fluid

A

lubricating fluid in joints. superfiltrated plasma from blood vessels. nourishes articulate cartilage pads

127
Q

articular cartilage

A

layer of hyaline cartilage that covers the end of each bone to reduce friction and distribute weight-bearing forces.

128
Q

contraction/relaxation of muscles requires…?

A

large amounts of ATP and calcium (catalyst for myosin/actin).

Nursing-Sem 1 (13 decks)

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