Download Advanced Pathophysiology Final Exam: Key Concepts and Answers and more Exams Pathophysiology in PDF only on Docsity!
NR507- ADVANCED PATHOPHYSIOLOGY FINAL EXAM
UPDATED QUESTIONS WITH VERIFIED CORRECT ANSWERS
"Renal Calculi (Renal Stones) - CORRECT ANSWER Goals of Treatment:
Manage acute pain Promote passage of stone Reduce size of stone Prevent new stone formation"
"Chronic Renal Failure - CORRECT ANSWER Chronic Kidney Disease (CKD) is a progressive loss
of renal function associated with systemic disease such as hypertension, diabetes mellitus (most significant risk factor), systemic lupus erythematosus or intrinsic kidney disease CKD stage is determined by estimates of GFR and albuminuria"
"Who is a candidate for dialysis? - CORRECT ANSWER End-stage renal disease (ESRD) is the
final stage of CKD with the number one cause being diabetes mellitus combined with hypertension. At this point, the patient is completely dependent on dialysis to survive. CKD is classified into five stages and is based on the patient's GFR rather than symptoms. Patients will need dialysis when the following symptoms are present: --Metabolic acidosis. --Hyperkalemia: Hyperkalemia in the presence of EKG changes (peaked T-waves) is an indication for dialysis. --Hyperkalemia by itself is not an indication for dialysis. --Drug toxicity: Drug toxicity due to the following drugs is an indication for dialysis and include salicylates, Lithium, Isopropanol, Methanol and Ethylene glycol). --Fluid volume overload that is not responsive to diuretics. --Uremic symptoms due to nitrogenous wastes in the blood stream."
"Stage I CKD - CORRECT ANSWER There is kidney damage with normal or elevated GFR
"Stage II CKD - CORRECT ANSWER There is kidney damage with mild decrease in GFR
"Stage III CKD - CORRECT ANSWER There is a moderate decrease in GFR
"Stage IV CKD - CORRECT ANSWER There is a severe decrease in GFR
"Stage V CKD - CORRECT ANSWER Kidney failure- End-stage renal disease
<15 (dialysis) Once Stage IV is reached, progression to Stage V is inevitable as well as dialysis or kidney transplant"
"Complications of Decreased GFR - CORRECT ANSWER Anemia
Hypertension Decreased calcium absorption Hyperlipidemia Heart failure Left ventricular hypertrophy Fluid volume overload Hyperkalemia Hyperparathyroidism Hyperphosphatemia Metabolic acidosis Malnutrition (late complication)"
"GERD - CORRECT ANSWER Warning signs include: Symptoms over age of 50:
-Dysphagia (difficulty swallowing) -Odynophagia (pain on swallowing) -Nausea and vomiting -Weight loss -Melena -Early satiety (feeling full after eating very little food"
"Major Depressive Disorder - CORRECT ANSWER SSRIs are the standard first-line treatment
for major depression Initial selection of an antidepressant includes: -Assessment of symptoms -Age -Side effects -Safety -Cost"
"Social Anxiety Disorder - CORRECT ANSWER Fear and avoidance of social situations
"Hyperparathyroidism - CORRECT ANSWER Characterized by stimulation of parathyroid gland
in response to hypocalcemia"
"Hypercalcemia - CORRECT ANSWER Hypercalcemia & Hypophosphatemia may be
asymptomatic or 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"
"Hypoparathyroidism - CORRECT ANSWER Hypomagnesemia inhibits PTH secretion
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" Cushing's syndrome characterized by patterns of fat deposition have been described as "truncal obesity", "moon face" and "buffalo hump""
"Adrenal Crisis- Hypocortisolism - CORRECT ANSWER Onset of adrenal crisis is signified by
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- Adrenal Insufficiency - CORRECT ANSWER Lab work that indicates
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"
"Type 1 Diabetes - CORRECT ANSWER Environmental factors:
Viral infections, particularly enteroviruses, coxsackievirus, other infectious microorganisms
Helicobacter pylori Exposure to cow's milk proteins Lack of Vitamin D"
"Diagnostic Criteria for Diabetes - CORRECT ANSWER According to American Diabetes
Association is: Hemoglobin A1C greater than or equal to 6.5%"
"Actions of Insulin - CORRECT ANSWER Insulin promotes glucose uptake mostly in the liver,
muscle and adipose tissue"
"Autonomic Neuropathy-Complication of Diabetes - CORRECT ANSWER Autonomic
Neuropathy includes: GI Symptoms: --Decreased esophageal motility --Gastroparesis --Delayed gastric emptying"
"Hypoglycemia - CORRECT ANSWER Neurogenic reactions occur when the decrease in blood
glucose level is rapid and present with --Tachycardia --Palpitations --Diaphoresis --Tremors --Pallor --Arousal anxiety"
"Alzheimer's Disease - CORRECT ANSWER Decreased short-term memory occurs with mild
cognitive decline as a result of a reduced hippocampus size"
"Parkinson's Disease - CORRECT ANSWER Symptoms associated with bradykinesia = shuffling
gait Other classic symptoms: --Resting tremor --Rigidity --Postural disturbance --Dysarthria --Dysphagia"
--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"
"Cerebrovascular Accident - CORRECT ANSWER Review s/s depending on the artery infarcted
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"
"Rosacea - CORRECT ANSWER Familial tendency, several genes identified
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)"
"Melanoma - CORRECT ANSWER Most aggressive skin cancer
Thickness of lesion impacts prognosis"
"Plaque Psoriasis - CORRECT ANSWER Typical lesion is well-demarcated, thick, silery,
erythematous plaque surrounded by normal skin that can appear anywhere on the body"
“Acute renal failure - CORRECT ANSWER Reversible
Determining prognosis- kidneys respond to diuretic with good output; this indicates that kidneys are functioning well"
"Acute Pyelonephritis - CORRECT ANSWER Diagnosing by clinical symptoms alone can be
difficult; 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"
"Hiatal Hernia - CORRECT ANSWER Often asymptomatic
Generally, a wide variety of symptoms develop later in life and are associated with other GI disorders, primarily GERD --Sliding hiatal hernia: treatment usually conservative. Individuals can diminish reflux by eating small, frequent meals and avoiding the recumbent position after eating. Abdominal supports and tight clothing are avoided and weight control recommended for obese individuals."
"Duodenal Ulcer - CORRECT ANSWER Characteristic manifestation = chronic intermittent pain
in epigastric area Pain begins 30 minutes to 2 hours after eating when stomach is empty Not unusual for pain to occur in middle of the night and disappear by morning"
"Peptic Ulcer Disease - CORRECT ANSWER Peptic ulcer is a break or ulceration in the
protective mucosal lining of the lower esophagus, stomach or duodenum Least likely to occur in the large intestine"
"Schizophrenia Negative symptoms - CORRECT ANSWER Flattened affect
Alogia Anhedonia Attention deficits
"Cluster Headache - CORRECT ANSWER Unilateral trigeminal distribution of severe pain with
ipsilateral autonomic manifestations, including tearing on the affected side, ptosis of the ipsilateral eye and congestion of the nasal mucosa Occurs in one side of the head primarily in men between 20 to 50 years of age Pain may alternate sides with each headache episode Severe, stabbing and throbbing Pain often referred to the midface and teeth"
