Patho quiz ch. 10-15

Question 1

What is the definition of anemia? What can it lead to?

Answer 1

• Def: reduction in oxygen transport caused by hemoglobin deficit
• Oxygen deficit leads to:
  a. Less energy production in all cells- cell metabolism and reproduction
  b. Compensation mechanisms- tachycardia and peripheral vasoconstriction
  c. General signs of anemia- fatigue pallor (pale face), dyspnea, tachycardia
  d. Decreased regeneration of epithelial cells- stomatitis, inflamed lips, dysphagia, degenerative changes in hair
  e. Sever anemia may lead to angina or congestive heart failure

Question 2

What is iron deficiency anemia? What group of people is most affected? What are some of the causes?

Answer 2

• Def: Insufficiency of iron that impairs hemoglobin synthesis
• Group Affected: all age groups, more common in women of childbearing age
• Causes:
  a. Dietary intake of iron below minimum requirement
  b. Chronic blood loss-bleeding, ulcer, hemorrhoids, cancer
  c. Impaired duodenal absorption of iron
  d. Sever liver disease- iron absorption and storage

Question 3

What is pernicious anemia? How does it affect nerve cells? What are symptoms seen in this disorder?

Answer 3

• Def: Lack of intrinsic factor secreted by parietal cells that allows absorption of vitamin B12
• Affects nerve cells: vitamin B12 is needed for the function and maintenance of neurons, it will cause symptoms in the peripheral nerves, may be irreversible
• Symptoms:
  a. tongue is enlarged, red, sore and shiny
  b. Digestive discomfort-nausea and diarrhea
  c. Feeling of pins and needles, tingling in limbs

Question 4

Sickle cell anemia is what type of disorder? Who is more at risk? What effect does it have on RBCs

Answer 4

• What type: genetic
• More at risk: African ancestry
• Effect on RBCs:
  a. abnormal hemoglobin
  b. unstable and changes shape in hypoxemia
  c. too large to pass through microcirculation
  d. obstruction occurs and can lead to infarctions and areas of necrosis

Question 5

What is the definition of leukemia? What are the differences between acute leukemias and chronic leukemias?

Answer 5

• Def: a group of neoplastic disorders involving abnormal amounts of white blood cells in the bone or lymph nodes.
• Acute: ALL & AML
  a. High proportion of immature nonfunctional cells in bone marrow and peripheral circulation
  b. Onset, abrupt, marked signs of complications
  c. Children and young adults
• Chronic: CLL & CML
  a. High proportion of mature cells but with reduced function
  b. Mild signs and better prognosis
  c. Older adults

Question 6

What is the definition of atherosclerosis? What are the risk factors for developing atherosclerosis?

Answer 6

• Def: presence of atheromas in large arteries, plaques consisting of lipids, calcium and clots
• Related to diet exercise and stress
• Risk factors:
  A. Nonmodifiable
  a. Age
  b. Gender
  c. Genetic or familial factors
  B. Modifiable
  a. Obesity
  b. Cigarette smoking
  c. Diabetes
  d. Poorly controlled hypertension
  e. Oral contraceptives and smoking

Question 7

When does myocardial infarction occur? What are warning signs of it happening?

Answer 7

• Occurs: Coronary artery is totally obstructed
• Signs:
  a. Feeling pressure, heaviness, or burning in chest
  b. Sudden shortness of breath, weakness, fatigue
  c. Nausea, ingestion
  d. Anxiety and fear
  e. Pain may occur and, if present, is usually- substernal, crushing, radiating

Question 8

What defines congestive heart failure? What happens to young children with CHF?

Answer 8

• Def: when heart is unable to pump out sufficient blood to meet metabolic demands of the body, can be a complication of another cardiopulmonary condition or a combination
• Young children:
  a. Feeding difficulties- failure to gain weight or meet guidelines
  b. Short sleep periods
  c. Tripod position to play
  d. Cough, rapid grunting respirations, flared nostrils, wheezing
  e. Radiographs show cardiomegaly
  f. Arterial blood gases used to measure hypoxia

Question 9

What is rheumatic fever? What age group is typically affected? What are some long term effects?

Answer 9

• Def:
  a. acute systemic inflammatory condition
  b. abnormal immune reaction
  c. may occur after an untreated infection
  d. involves heart and joints
• Group affected: Children 5to 15 years
• Long term effects:
  a. Rheumatic heart disease
  b. May be complicated by ineffective endocarditis and heart failure in older adults

Question 10

What are the areas damaged in an individual with hypertension? What are predisposing factors that increase the risk of developing hypertension?

Answer 10

• Areas damaged:
  a. Kidneys
  b. Heart
  c. Brain
  d. Retina
• Predisposing factors increasing the risk of hypertension development:
  a. Increases with age
  b. Men are affected more and severely
  c. Women increase chances after middle age
  d. Genetic factors
  e. Sodium intake, excessive alcohol intake, obesity, smoking, prolonged or recurrent stress

Question 11

Be familiar with what the different color of sputum might indicate.

Answer 11

• Yellowish-green, thick, cloudy mucus
  a. Bacterial infection
• Rusty or dark colored sputum
  a. Sign of pneumococcal pneumonia
• Large amounts of purulent sputum with foul odor
  a. Bronchiectasis
• Thick, tenacious mucus
  a. Asthma or cystic fibrosis
• Blood-tinged sputum
  a. Chronic cough
  b. Sign of tumor
  c. Tuberculosis
• Hemoptysis/ blood tinged frothy sputum
  a. Pulmonary edema

Question 12

What are the different types of viruses that cause influenza? What are some of the symptoms that it manifests?

Answer 12

• Causes:
  a. Type A most prevalent
  b. Type B
  c. Type C
• Symptoms:
  a. acute onset with fever
  b. marked fatigue,
  c. aching pain in body
  d. viral pneumonia

Question 13

Know what microbe causes tuberculosis and its characteristics. Why’s it becoming a more serious problem?

Answer 13

• Microbe: M. tuberculosis
  a. Resistant to drying and many disinfectants
  b. Survives in dried sputum for weeks
  c. Destroyed by ultraviolet, heat, alcohol, glutaraldehyde, formaldehyde
• Serious problem:
  a. Homelessness and crowding in shelters
  b. HIV infection
  c. Lack of health care
  d. Multidrug resistant TB

Question 14

Know the differences between early signs, systemic signs, and signs of metastases associated with lung cancer.

Answer 14

• Early signs:
  a. Persistent productive cough
  b. Detection on radiograph
  c. Hemoptysis (coughing of blood)
  d. Plueral involvement
  e. Chest pain
  f. Hoarseness, facial or arm edema, headache, dysphagia(difficulty swallowing) or atelectasis (collapse of lung)
• Systemic signs:
  a. Weight loss, anemia, fatigue
• Signs of metastases
  a. Bone pain
  b. Cognitive deficits
  c. Motor deficits

Question 15

What are the causes of pulmonary embolus? What can it lead to?

Answer 15

• Causes: 90% deep vein thromboses in legs and are preventable
• Leads to: death, lung failure, obstruction

Question 16

Know what a “cerebrovascular accident” is, how quick can damage be caused during a CVA?

Answer 16

• Def: Stoke, an infarction of brain tissue that results from lack of blood
• Quickness in damage:
  a. 5 minutes causes irreversible nerve cell damage

Question 17

Be familiar with the different types of CVAs

Answer 17

A. Occlusion of an artery by an atheroma- in large arteries
B. Sudden obstruction caused by an embolus-lodging in a cerebral artery
C. Intracerebral hemorrhage- a rupture of a cerebral artery with severe hypertension

Question 18

Know what happens during a cerebral aneurysm and the signs of symptoms

Answer 18

• What happens:
  a. Localized weakness in the wall of an artery
  b. Cerebral aneurysms frequently multiply-circle of Willis
  c. Slow bleed cases vascular type headache
  d. Leads to sudden fatal increase in ICP and death
• Signs and symptoms:
  a. Lose of visual field or visual disturbances
  b. Headache and photophobia
  c. Intermittent periods of dysfunction
  d. Nuchal rigidity caused by meningeal irritation
  e. Vomiting, seizures, loss of consciousness in case of massive rupture; rapidly followed by death.

Question 19

Be familiar with the signs and symptoms of Alzheimer’s disease, what are the treatments?

Answer 19

• Signs and symptoms:
  a. Behavioral changes
  b. Irritability, hostile mood swings
  c. Gradual loss of memory, lack of concentration
  d. Impaired learning, poor judgement
  e. Decline of cognitive, memory, language
  f. Change in food intake
  g. Inability to recognize family, lack of environmental awareness, incontinence, inability to function
• Treatments:
  a. Not specific
  b. Anticholinesterase drugs
  c. Occupational therapy, psychologists, speech therapy
  d. Team approach of caregivers

Question 20

Which neurotransmitters are associated with depression? What are some indicators of depression?

Answer 20

• Neurotransmitters:
  a. Norepinephrine
  b. Serotonin
• Indicators:
  a. Unfounded sadness
  b. Lack of energy
  c. Loss of self-esteem and motivation
  d. Irritability and agitation
  e. Insomnia or excessive sleep
  f. Loss of appetite and libido

Question 21

Know the difference between type 1 and type 2 diabetes

Answer 21

• Type 1:
  a. autoimmune destruction of beta cells in pancreas
  b. Insulin replacement required
  c. Acute in children and adolescents
  d. Genetics
• Type 2:
  a. Decreased production of insulin/increased resistance by body cells to insulin
  b. Slow onset, found in older 50+ years
  c. Obesity
  d. Metabolic syndrome
  e. Teens and young adults

Question 22

What is seen in a patient during the initial stages of diabetes?

Answer 22

• Insulin deficit -decreased transport of glucose
• Blood glucose levels rise
• Excess glucose found in urine
• Large urine volume
• Fluid loss through urine-dehydration

Question 23

What are the signs and symptoms of hypoglycemic shock? What are the emergency treatments for hypoglycemic shock?

Answer 23

• Signs and symptoms:
  a. Disorientation and change in behavior
  b. Appear impaired
  c. Anxiety and decreased responsiveness
  d. Decreased blood glucose
  e. Decreased BP, increased heart rate
  f. Decreasing level of consciousness – immediate administration of glucose
• Emergency treatments:
  a. Conscious-Give sweet fruit juice, honey, candy, or sugar
  b. Unconscious- give nothing by mouth, intravenous glucose 50%
• Diabetic ketoacidosis (diabetic coma/hyperglycemia)- insulin, fluid, sodium bicarbonate

Question 24

Be familiar with what happens in macroangiopathy which occurs during chronic complications of diabetes?

Answer 24

• Def: affects large arteries by abnormal lipid levels
• Effects:
  a. High incidence of heart attacks, strokes, peripheral vascular disease
  b. Ulcers on feet and legs-slow healing, infectious, gangrenous
  c. Amputation may be necessary

Question 25

What are the types of diseases that arise from hyperthyroidism and hypothyroidism?

Answer 25

• Hyperthyroidism:
  A. Exophthalmos
  a. Presence of protruding, staring eyes, decreased blink and eye movement
• Hypothyroidism:
  a. Iodine deficient
  b. Hashimoto thyroiditis- autoimmune/attacking the thyroid
  c. Tumor
  d. Cretinism- short stature, severe cognitive deficits