Pathopharm Final Exam Diseases Flashcards
Edema
Palpable swelling produced by expansion of the interstitial fluid volume.
Causes = increased capillary filtration pressure, decreased capillary colloidal osmotic pressure. omcreased capillary permeability and obstruction of lymph flow.
Symptoms = may interfere with movement, swelling of the ankles and feet
Treatment = assess daily weight, visual assessment, measurement of the affected part and finger pressure. Elevate feet, Diuretic therapy, elastic support stockings and sleeves.
Diabetes Insipidus
Cause by a deficiency of or decreased response to ADH
Symptoms = Patient excretes large volumes of urine, excessive thirst
Treatment= pharmacologic preparations of ADH (Desmopressin), oral anti diabetic agent (Chlorpropamide) and thiazide diuretics
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Results from a failure of the negative feedback system that regulates the release and inhibition of ADH. May be due to stress or a chronic condition (brain and lung tumor)
Symptoms = marked water retention and dilutional hyponantremia
Treatment = fluid restriction (mild cases), diuretics such as mannitol and furosemide
Isotonic Fluid Volume Deficit (Dehydration)
A decrease in the ECF including the circulating blood volume
There are proportionate losses in sodium and water
A loss in body fluids and is accompanied by a decrease in fluid intake
Loss of body fluids due to loss of GI fluids, polyuria, or sweating due to fever and exercise
Symptoms = thirst, loss of body weigh, signs of water conservation by the kidney, impaired temperature regulation, signs of reduced interstitial vascular volume
Treatment = fluid replacement, usually isotonic electrolyte solutions are used for fluid replacement
Isotonic Fluid Volume Excess (Water intoxication)
An isotonic expansion of the EF compartment with increases in both interstitial and vascular volumes
Causes = inadequate sodium and water elimination, excessive sodium intake in relation to output, excessive fluid intake in relation to output.
Symptoms= acute weight gain, increased interstitial fluid volume, increased vascular volume
Treatment = providing a more favorable balance between sodium and water intake and output, sodium restricted diet, and diuretic therapy
Hyponatremia
A plasma sodium concentration below 135 mEq/L
Causes = administration of sodium free parenteral solution, GI losses, sweating, repeated irrigation of body cavities, diuretic use, increased ADH levels, hypothyroidism, heart failure, liver failure, kidney failure
Symptoms = muscle cramps, weakness, headache, depression, apprehension, personality changes, lethargy, stupor, coma, anorexia, nausea, cramps, diarrhea, vomiting, fingerprint edema (Increased ICF)
Treatment = when caused by water intoxication - limit water intake
Symptomatic Hyponatremia = treated with hypertonic saline solution and loop diuretic to increase water elimination
Hypernatremia
Plasma sodium level above 145 mEq/L
Causes =excessive water losses, decreased water intake, excessive sodium intake
Symptoms = thirst and signs of increased ADH levels
Intracellular dehydration
Signs and symptoms = headache, agitation and restlessness, decreased reflexes, seizures and coma, tachycardia, weak and thready pulse, decreased blood pressure, vascular collapse
Treatment = measures to treat the underlying cause of the disorder and fluid replacement therapy
Hypokalemia
A decrease in plasma potassium levels below 3.5 mEq/L
Causes = inadequate intake, excessive renal losses, excessive GI losses, transcompartmental shift
Symptoms = impaired ability to concentrate urine, anorexia, nausea, vomiting, constipation, abdominal distention, muscle flabbiness, weakness, and fatigue, muscle cramps and tenderness, paresthesias and paralysis, postural hypotension, confusion, depression and metabolic alkalosis
*Prominent U wave
Treatment = increasing the intake of food high in potassium, when needed rapidly = IV
Hyperkalemia
An increase plasma levels of potassium in excess of 5 mEq/L
Causes = excessive intake, release from intracellular compartment, inadequate elimination by the kidneys
Symptoms= nausea, vomiting, cramps, diarrhea, paresthsias, weakness, dizziness, muscle cramps, tall and tented T wave, risk of cardiac arrest
Treatment = decreased intake increase potassium output, hemodailysis or peritoneal dialysis (if have renal failure)
Metabolic Alkalosis
An increase in plasma pH due to primary excess in HC03-
Causes = excessive gain of bicarbonate or alkai, excessive loss of hydrogen ions, increased bicarbonate retention, volume contraction
Symptoms = confusion, hyperactive reflexes, tetany, convulsions, hypotension, arrhythmias, respiratory acidosis due to decreased respiratory rate, signs of compensation (decrease rate and depth of respiration, increased urine pH)
Treatment = potassium chloride (accompanying K+ deficit), fluid replacement with normal saline (volume contraction)
Metabolic Acidosis
Decreased plasm HC03- concentration along with a decrease in pH
The body compensates for the decrease in pH by increasing the respiratory rate in an effort to decrease PC02 and H2C03 levels
Causes= excess metabolic acids (increased anion gap), excessive bicarbonate loss (normal anion gap), increased chloride levels (normal anion gap)
Symptoms = anorexia, nausea and vomiting, abdominal pain, weakness, lethargy, general malaise, confusion, stupor, coma, depression of vital signs, peripheral vasodilation, decreased heart rate, arrhythmias, warm and flushed skin, increased rate and depth of respiration, hyperkalemia, acid urine
Treatment = correcting the underlying cause and restoring the fluids and electrolytes that have been lost. Supplement sodium bicarbonate
Respiratory Acidosis
Occurs in condition that impair alveolar ventilation and cause an increase in plasma PC02, along with a decrease in pH, result of decreased ventilation
Cause = depression of respiratory center, lung disease, airway obstruction, disorders of chest wall and respiratory muscles, breathing air with high C02 content
Symptoms = headache, weakness, confusion,depression, paranoia, hallucinations, tremors, paralysis, stupor, coma,skin warm and flushed, and acid urine
Treatment= improving ventilation, mechanical ventilation
Respiratory Alkalosis
Decrease in PC02, which produces can elevation in pH and decrease in HC03-
Causes =excessive ventilation - anxiety, hypoxia, lung disease, stimulation of respiratory center, mechanical ventilation
Symptoms= constriction of cerebral vessels and increased neuronal excitability, dizziness, panic, lightheadedness, tetany, numbness, tingling, seizures, arrhythmias
Treatment= administration of supplemental oxygen, changing ventilator settings, people with hyperventilation should rebreathe using a paper bag
Vitiligo
Pigmentary problem
Causes = precipitated by emotional stress or physical trauma, hypothyroidism, Grave’s, addison, pernicious anemia, Type 2 diabetes, and melanoma
Symptoms = sudden appearance of white patches on the skin, with definite smooth borders on the face, axillae neck or extremities
Treatment = self-tanning lotion, skin stains and cosmetic, irradiation, skin grafting, micropigmentation
Impetigo
Superficial bacterial infection caused by Staphylococci or group A
Causes= during warm summer months, or in warm moist climates, common among infants and young children
Symptoms = appears as small vesicle or pustule or as a large bulla on the face, pruritus often accompanies the lesion
Treatment = oral or intravenous antibiotics
Herpes Zoster (shingles)
An acute, localized vesicular eruption distributed over a dermatomal segment of the skin
Cause= by same herpesvirus, varicella zoster which causes chickenpox.
Symptoms = burning pain, a tingling sensation, extreme sensitivity of the skin to touch, and pruritus along the affected dermatoma
Treatment = antiviral agent, within 72 hours of rash development
Acne Vulgaris
Chronic inflammatory disease, a disorder of adolescents and young adults
Causes= increased sebum production, increased proliferation of the keratinizing epidermal cells that form the sebaceous cells, colonization and proliferation of P. Acnes and inflammation
Also due to poor hygiene, acne as an infectious process, diets high in fatty content and certain foods
Symptoms = acne vulgaris lesions on the back, chest, and shoulders
Treatment = topical agent and systemic antibiotics
Benzoyl peroxide= topical antibacterial, causes vasodilation and increased blood flow
Contact Dermatitis
Allergic Contact Dermatitis = result from cell-mediated, hypersensitivity to an allergen
Irritant Contact Dermatitis = chemicals that irritate the skin
cause irritant contact dermatitis
Cause = mechanical means
Symptoms= burning or stinging sensations, dryness,erythema, or edema, inflammation and vesicles
Treatment= washing affective area (minor case), applying antipruritic creams or lotions and bandaging the exposed areas. Topical corticosterioid may be helpful.
Urticaria (hives)
Pale, raised, itchy papules, that occur in the most superficial aspect of the dermis anywhere on the skin
Cause= immunologic reaction to an antigen in an IgE hypersensitivity response or nonimmunologic response to something unknown
Symptoms = small wheals blanched with pressure, Angioedema(when swelling occurs in the deeper dermis), may be swelling of the tongue and upper airways
Treatment = ice cube to the skin is used to differentiate physical urticaria from chronic urticaria due to other causes, most are treated with second- generation antihistamines that block H1 receptors and do not cause drowsiness (they inhibit vasodilatation, and relieve pruritus)