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A collection of questions and answers related to various topics in advanced pathophysiology. It covers a wide range of conditions, including mental health disorders, thyroid disorders, kidney disease, gastrointestinal disorders, endocrine disorders, diabetes, neurological disorders, and headaches. Useful for students studying advanced pathophysiology, as it offers a quick overview of key concepts and potential exam questions.
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major depression Initial selection of an antidepressant includes: -Assessment of symptoms -Age -Side effects -Safety -Cost"
Example: anxious person may feel very uncomfortable having a conversation or interacting with others and very conscious of being scrutinized and humiliated or rejected by others"
structural brain abnormalities A consistent finding is the enlargement of the lateral and third ventricles and the widening of frontocortical fissures and sulci ."
Hallucinations Delusions Formal thought disorder Bizarre behavior"
Alogia Anhedonia Attention deficits Apathy"
attention and planning"
Affects between 0.1% and 2% of the U.S. population More common in women and elderly Hormone replacement therapy with the hormone levothyroxine is the treatment of choice"
Review hypothalamic-pituitary axis (Picture) Thyroid-releasing hormone (hypothalamus)"
disease = pretibial myxedema and exophthalmos Treatment directed at controlling excessive TH production, secretion or action and includes antithyroid drug therapy (methimazole or propylthiouracil), radioactive iodine therapy (absorbed only by thyroid tissue, causing death of cells), and surgery Goal of radioactive iodine ablation for the treatment of Grave's disease is to destroy overactive thyroid tissue"
<15 (dialysis) Once Stage IV is reached, progression to Stage V is inevitable as well as dialysis or kidney transplant"
Hypertension Decreased calcium absorption
Infiltrative Changes: involving the orbital contents with enlargement of the ocular muscles. These changes affect more than half of individuals with Grave's Disease. Increased secretion of hyaluronic acid, adipogenesis, inflammation and edema of the orbital contents results in exophthalmos (protrusion of the eyeball), periorbital edema and extraocular muscle weakness leading to strabismus and diplopia (double vision)"
response to hypocalcemia"
affected individuals may present with symptoms related to the neuromuscular changes that include paresthesias and muscle cramps Patients with hypercalcemia can have low bone density that is most noted in the distal one-third of the radius"
Hypomagnesemia may be related to chronic alcoholism, malnutrition, malabsorption, increased renal clearance of magnesium caused by the use of aminoglycoside antibiotics or certain chemotherapeutic agents, or prolonged magnesium-deficient parenteral nutritional therapy"
Dry skin Loss of body and scalp hair Hypoplasia of developing teeth Horizontal ridges on nails Cataracts Basal ganglia calcifications Bone deformities Bowing of the long bones"
--Occurs because of cortisol-induced insulin resistance and increased gluconeogenesis and glycogen storage by the liver Cushing's syndrome characterized by patterns of fat deposition have been described as "truncal obesity", "moon face" and "buffalo hump""
hypotension
Hypotension can progress to complete vascular collapse and shock. This is known as adrenal crisis or addisonian crisis and develops with undiagnosed disease, acute withdrawal of glucocorticoid therapy or the occurrence of infection or other comorbid stressful events"
primary hypocortisolism: --Serum and urine levels of cortisol are depressed with primary hypocortisolism, and ACTH levels are increased When prescribing cortisol, the NP should keep in mind: --With acute stressors (infection, surgery, trauma), additional cortisol must be administered to approximate the amount of cortisol that might be expected to be secreted if normal adrenal function were present"
Viral infections, particularly enteroviruses, coxsackievirus, other infectious microorganisms Helicobacter pylori Exposure to cow's milk proteins Lack of Vitamin D"
Hemoglobin A1C greater than or equal to 6.5%"
and adipose tissue"
includes: GI Symptoms: --Decreased esophageal motility --Gastroparesis --Delayed gastric emptying"
level is rapid and present with --Tachycardia --Palpitations --Diaphoresis --Tremors --Pallor --Arousal anxiety"
decline as a result of a reduced hippocampus size"
Migraine with aura with visual, sensory or motor symptoms Migraine without aura (most common) Chronic migraine"
recurrent headache Not vascular or migrainous Average age of onset is during the second decade of life Usually mild to moderate bilateral headache with sensation of a tight band or pressure around head"
asymmetry and inability to close eye, smile or frown on the affected side"
results in severe and sharp stabbing pain that can worsen with chewing"
infection including Characterized by clinical manifestations of systemic infection including --Fever --Tachycardia --Chills And clinical manifestations of meningeal irritation including --Severe throbbing headache --Severe photophobia --Nuchal rigidity --Positive Kernig and Brudzinski signs --Fever --Tachycardia --Chills And clinical manifestations of meningeal irritation including --Severe throbbing headache --Severe photophobia
--Nuchal rigidity --Positive Kernig and Brudzinski signs"
Example: infarct in the ACA will result in motor: contralateral paralysis or paresis (greater in foot and thigh) Sensory deficits associated with basilar artery infarct include contralateral loss of vibratory sense, sense of position with dysmetria, loss of two-point discrimination, impaired rapid alternating movements"
Neurovascular dysregulation, infection and factors that trigger altered innate and adaptive immune response involved (ex: chronic sun exposure/damage, heat, drinking alcohol or hot beverages, hormonal fluctuations, Demodex folliculorum/mites colonization, mental stress and anxiety)"
Thickness of lesion impacts prognosis"
plaque surrounded by normal skin that can appear anywhere on the body"
Determining prognosis- kidneys respond to diuretic with good output; this indicates that kidneys are functioning well"
can be similar to cystitis Diagnosis established by: -Urine culture -Urinalysis (WBC casts indicates pyelonephritis, but may not always be present) -Signs/Symptoms -Complicated pyelonephritis requires blood cultures and urinary tract imaging"
Manage acute pain Promote passage of stone Reduce size of stone Prevent new stone formation"