Primary Mechanisms of Disease Flashcards
a disorder of nutrition caused by primary deprivation of protein-energy or secondary to deficiency diseases
Malnutrition
Kwashiorkor syndrome
deficiency of protein in the presence of adequate energy (infants) - trauma, burns, sepsis
Marasmus syndrome
combines protein and energy insufficiency, chronic diseases - 20% hospitalized patients
Group of disorders in which intestinal absorption of dietary nutrients is impaired
Malabsorption
loss of appetite
anorexia
forceful expulsion of chyme from the stomach and sometimes from the intestine
emesis, vomiting
blood in vomitus resembling coffee grounds, a brown granular material
hematemesis
yellowish, greenish vomitus is from
the duodenum
deeper brown color
content from lower intestine, recurrent vomiting in persons with intestinal obstruction
recurrent vomiting of undigested food from previous meals
possible pyloric obstruction - problem with gastric emptying
anorexia nervosa
psychological disturbance in which hunger is denied by self-imposed starvation, resulting from a distorted body image and a compulsion to be thin
signs and symptoms: anorexia nervosa
-female adolescent who is meticulous, is a high achiever, and refuses food intake.
-preoccupied with obesity and obsessed with her weight.
-experiences unfazed weight loss.
-family members bring forth attention to provider
-thin hair
-poor wound healing
-dental changes
-amenorrhea, cold intolerance, constipation, bloating, abdominal distress
-hyperactive, over-exercises
-hypotensive, bradycardic, hypothermic
-sadness, insomnia, FOMO
etiology: anorexia nervosa
unknown. family/societal factors are believed
diagnosis: anorexia nervosa
clinical picture and history.
-weight loss (15%)
-emaciated
-fear of weight gain
-absent or irregular menstruation
-hypotensive and bradycardic on exam
-blood tests, UA, ECG
treatment: anorexia nervosa
promote weight and restore nutrition
prognosis: anorexia nervosa
favorable when help is sought timely and willingly
prevention: anorexia nervosa
no certain prevention
patient teaching: anorexia nervosa
build trust and sensitivity in presenting recovery plan
behavioral disorder characterized by recurring episodes of binge eating followed by self-induced vomiting or purging, usually in secret
bulimia
signs and symptoms: bulimia
-binge-purge eating
-fear of becoming fat
-poor dentition, pharyngitis, esophagitis, aspiration, electrolyte abdn.
-gastric dilatation
-abuse laxatives
-compulsive exercise
-swollen salivary glands
-broken blood vessels in eyes
-periods usually followed by self-imposed starvation
-preserved menstruation
patient screening: bulimia
shame and denial of disease
etiology: bulimia
uncertain. psychosocial factors
prognosis: bulimia
years-long treatment, slow process. rare death
pt teaching: bulimia
encourage complicity with POC
disease of the small intestine that is characterized by malabsorption, gluten intolerance, and damage to the lining of the intestine
celiac disease
symptoms and signs: celiac disease
-multisystem
-weight loss
-anorexia
-abdominal cramping
-diarrhea
-flatulence
-abdominal distention
-intestinal bleeding
-weakness
-muscle wasting
-dermatitis herpetiformis
-large, pale, greasy, foul-smelling stools
-malabsorption and malnutrition
etiology: celiac disease
toxic or immunologic reaction to a component of gluten.
genetic factor, occurrence is higher in siblings.
diagnosis: celiac disease
1- positive serologic testing
2- biopsy of small intestine showing changes or destruction of mucosal lining
3- improvement while on a gluten-free diet
treatment: Celiac disease
strictly adhere to gluten free diet. gut heals and reverses malabsorption
prognosis: celiac disease
gradual recovery, life-long gluten free diet. risk for cancer and malnutrition, specially in children.
refers to an excess amount of body weight that may be a result of muscles, bone, fat, and water
overweight
excess amount of body fat
obesity
measure for obesity
body mass index (BMI)
condition in which the body’s cells become resistant to the effects of insulin and changes in metabolism
insulin resistance - can lead to DM2
inflammatory markers seen in obese state
C-reactive protein, IL-6
Primary prevention
protect healthy people from developing a disease or experiencing an injury in the first place
secondary prevention
interventions after an illness or serious risk factors have been diagnosed. goal is to halt the disease in its earliest stages.
tertiary prevention
helps people manage complicated, long-term health problems
what level of effects of abnormalities does pathphysiology focus on?
organ level, noticing cellular changes
essential lab procedures for pathophysiology
-biopsy
-autopsy
-analysis of body fluids
identification of a specific disease through evaluation of signs and symptoms, lab test, or other tools
diagnosis
causative factors in a particular disease
etiology
unknown etiology
idiopathic
disease caused by error, procedure, treatment
iatrogenic
encompass the tendencies that promote the development of a disease in an individual indicating a high risk
predisposing factor
examples of predisposing factors
age, gender, inherited factors, occupational exposure, certain dietary practices
measure designed to preserve health and prevent the spread of a disease
prophylaxis
examples of disease prevention
vaccination, dietary or lifestyle modifications, removal of harmful materials in the environment, cessation of potentially harmful actives
period of life from old age to death
senescence
gradual deterioration of the functions of the immune system
immunosenescence
average life span in the us
78.7 years
when ovaries cease to respond to FSH and LH, resulting in lack of ovulation, cessation of menstrual cycle, and declining estrogen and progesterone levels
menopause
central part of the gland around the urethra hypertrophies, resulting in some degree of obstruction of the urethra
benign prostatic hypertrophy (BPH)
masses of tiny tangled fibrils
neurofibrils
ventilation is limited in aging individuals for
-elasticity in the lung tissue is reduced
-the costal cartilage between the ribs and the sternum calcifies, reducing rib movement
-skeletal muscle atrophies and weakens
-any skeletal change may reduce thoracic movement
dry mouth
xerostomia
frequent urination during the night
nocturia
severe risk factors associated with osteoporosis in older persons
-hereditary predisposition
- decreased estrogen levels
-decreased weight-bearing activity or stress on bone
-decreased intake of calcium, vitamins C and D, at all ages
-decreased intestinal absorption of calcium
-decreased osteoblastic activity, increased risk with glucocorticoid/cortisol use
recommendations to reduce the risk and the progression of osteoporosis with aging include
-increased calcium intake plus adequate vitamin D
-walking and all other weight-bearing exercise, physiotherapy, rehab
-drugs: bisphosphonates (fosamax)
-individual hormonal therapy (selective estrogen receptor modulators, estrogen replacement therapy, synthetic calcitonin, or parathyroid hormone
cancer is common in elderly why
immune system becomes less effective surveillance unit, higher cumulative exposure to carcinogens
principal factors underlying complications in drug therapies in older adults
-altered pharmacokinetics
-multiple and severe illnesses
-multidrug therapy
-poor adherence
physiologic changes that affect drug absorption of drugs in older adults
-increased gastric pH
-decreased absorptive surface area
-decreased splanchnic blood flow
-decreased GI mobility
-delayed gastric emptying
physiologic changes affecting the distribution of drugs in older adults
-increased body fat
-decreased lean body mass
-decreased total body water
-decreased serum albumin
-decreased cardiac output
physiologic changes affecting the metabolism of drugs in older adults
-decreased hepatic blood flow
-decreased hepatic mass
-decreased activity of hepatic enzymes
physiologic changes affecting excretion of drugs in older adults
-decreased renal blood flow
-decreased glomerular filtration rate
-decreased tubular secretion
-decreased number of nephrons
rate of absorption is ___ in older adults
delayed
factors altering drug distribution in older adults
-increased percentage of body fat
-decreased percentage of lean body mass
-decreased total body water
-reduced concentration of serum albumin
increased body fat retains lipid soluble drugs, reducing plasma levels, …
reducing responses
decline in lean body mass and total body water, water-soluble drugs become distributed in smaller volume than younger adults
concentration of drug increases, effects are more intense
most important cause of adverse drug reactions in older adults
drug accumulation secondary to reduced renal excretion
proper index of renal function
creatinine clearance
drugs used primarily for cardiac disorders
beta-adrenergic blocking agents
outer layers of skin have been scraped away or roughed up and deeper layers are exposed
abrasion
portion of the skin and possibly underlying tissue is torn away, either completely or partially
avulsion
signs and symptoms: abrasions
-raw and reddened
-painful
-small amount of bleeding
patient screening: abrasions
-prompt cleansing
-tetenus prophylaxis should be confirmed
etiology: abrasions
friction created when a rough, hard surface comes in contact with skin as a consequence of a scraping or sliding type of motion
diagnosis: abrasions
subjective information, history, and visual inspection
treatment: abrasions
-gentle washing and irrigation
-foreign particles removed
- germicidal ointment or cream may be applied
-dressing may be applied as well, depending on the size and location of abrasion
-prophylaxis with tdap injection is confirmed or administered
patient teaching: abrasions
appropriate wound care clean and dry
signs and symptoms: avulsions
-pain and bleeding
-still partially attached
patient screening: avulsions
-prompt cleansing
-closure of the open wound
-reattachment if possible
-tetanus prophylaxis confirmed
etiology: avulsions
entangled in machinery, clothing, entrapped causing skin, tissue, bone to be torn and pulled away from the body
diagnosis: avulsions
-visual inspection of the affected part
-history of the mechanism of injury
treatment: avulsions
-controlling bleeding
-cleansing area
-surgically repair the tissue
-sterile dressing
-tetanus prophylaxis confirmation or administration
pt teaching: avulsions
-reinforce safety guidelines
-would care
pointed or sharp foreign object penetrates the soft tissue
puncture
signs and symptoms: puncture
-pain
-very little bleeding
-redness at site
-no dramatic appearance
patient screening: punctures
-prompt assessment and cleansing
-tetanus prophylaxis confirmation
-stabilization of impaled objects
etiology: puncture
sharp, pointed object penetrates the skin and underlying soft tissue
diagnosis: puncture
-visual examination
-history
-radiographic studies
treatment: puncture
-removal of foreign body
-copious irrigation oft he wound
-sterile dressing applies
-tetanus prophylaxis confirmed
a part of the body is compressed with extreme force between two surfaces
crushing
signs and symptoms: crushing injuries
-any body part
-pain
-immobility
patient screening: crushing injuries
prompt assessment and intervention
treatment: crushing injuries
-cleansed
-irrigated
-debrided
patient teaching: crushing injuries
-safety guidelines
-wound care
sharp object cuts the skin and possibly underlying soft tissue
lacerations
signs and symptoms: lacerations
-pain
-moderate to severe bleeding
-smooth or jagged edges
patient screening:
prompt cleansing and repair
etiology: lacerations
sharp instrument cuts skin and underlying soft tissue
diagnosis: lacerations
-visual examination
-history
laceration with smooth edges that can be approximated cleanly is termed
incision
treatment: lacerations
-cleansed with germicidal soap
-taping edges
-butterfly dressing
-steri-strips
-blood control
-suture
-tetanus prophylaxis
patient teaching: lacerations
-wound care
-tetanus prophylaxis
-suture removal
signs and symptoms: foreign bodies in the ear
-stuffiness
-something in ear
-buzzing in ear
-decreased hearing
etiology: foreign bodies in ear
-flying insects
-smaller objects by children
-debris
diagnosis: foreign objects in the ear
visual and/or otoscopic inspection of the ear canal
treatment: foreign bodies in the ear
-removal of offending object without damaging the ear canal or tympanic membrane
signs and symptoms: foreign bodies in the eye
-scratching
-irritation
-blurred or compromised vision
-tearing
patient screening: foreign objects in the eye
prompt evaluation and intervention
etiology: foreign bodies in the eye
many sources
diagnosis: foreign bodies in the eye
ophthalmoscopic exam of the eye
treatment: foreign bodies in the eye
removal of small offending material
signs and symptoms: foreign bodies in the nose
constricted nares
etiology: foreign bodies in the nose
children wading object
diagnosis: foreign bodies in the nose
-history and visualization
-often mucus dripping
