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NUR 2063 / NUR2063: Essentials of
Pathophysiology Exam 2 Review
Questions & Answers
Cryptorchidism Complications - ANSWERSFibrotic tubules with deficiency in spermatogenesis, infertility. Amenorrhea - ANSWERSAbsence of menstruation Amenorrhea Causes - ANSWERSHormonal disturbances Stress Neoplasms (ovarian, adrenal, pituitary tumors) Complications of Dialysis - ANSWERSCardiovascular disease Hypervolemia Depression Prostatitis - ANSWERSInflammation of the prostate. Most common association is E. coli. Prostatitis S/S - ANSWERSFever Chills Tender prostate Low back pain Dysuria Leukocytosis Renal Calculus Cause - ANSWERSUrine becomes supersaturated with specific solute that forms crystals. Crystallization is enhanced when a person is dehydrated or has
higher than normal levels of solute in the urine from excessive secretion (calcium, uric acid). Renal Calculus S/S - ANSWERSDull, localized flank pain Acute discomfort accompanied by nausea and vomiting, diaphoresis (sweating), tachycardia, and tachypnea (abnormal, rapid breathing) Renal colic (intermittent, sharp pain) develops as the stone moves to the ureteropelvic junction Benign Prostatic Hypertrophy S/S - ANSWERSUrinary retention Obstruction to flow Decreased stream Hesitancy; difficulty initiating a stream Interruption of the stream Infection caused by retention .Aldosterone - ANSWERS"salt-retaining hormone". Steroid that promotes the retention of Na+ by the kidneys. Na+ retention promotes water retention, which promotes a higher blood volume and pressur Antidiuretic Hormone (ADH) - ANSWERSPromotes retention of water by kidneys and increases blood pressure. Chronic Renal Failure Risk Factors - ANSWERSDiabetes Hypertension Recurrent pyelonephritis Acute tubular necrosis Glomerulonephritis Polycystic kidney disease Family history of CKD Smoking Age over 65 Ethnicity Chronic Renal Failure Causes - ANSWERSThe outcome of the progressive and irrevocable loss of nephrons. More than 75% of the total number of nephrons must be lost before clinical manifestations appear. .Cystitis Causes - ANSWERSInflammation of the bladder lining, may result from bacterial, fungal, or parasitic infections; chemical irritants; foreign bodies (e.g., stones); or trauma. By far the most common is bacterial infection. Cystitis Pathogenesis - ANSWERSE. coli adheres to bladder epithelium, colonizes, and invades host cells. Cystitis S/S - ANSWERSAcute onset of frequency, urgency, and dysuria; pain may be present in the suprapubic area. The urine may appear pink because of hematuria or cloudy as a result of the infectious organism.
.Hypomenorrhea Causes - ANSWERSEndocrine or systemic disorders interfering with hormones Partial obstruction of menstrual flow Oligomenorrhea - ANSWERSInfrequent menstruation Oligomenorrhea Cause - ANSWERSEndocrine/systemic disorder causing failure to ovulate Polymenorrhea - ANSWERSIncreased frequency of menstruation Polymenorrhea Cause - ANSWERSEndocrine/systemic disorder causing ovulation .Menorrhagia - ANSWERSIncrease in amount or duration of bleeding; prolonged and heavy bleeding Menorrhagia Cause - ANSWERSLesions of reproductive organs .Enuresis - ANSWERSIntermittent incontinence while asleep. Most common in childhood. Stress urinary incontinence (SUI) - ANSWERSOccurs when urine is involuntarily lost with increases in intraabdominal pressure Precipitated by effort or exertion Because of weakening of pelvic muscles or intrinsic urethral sphincter deficiency May be because of obesity, childbirth-related trauma, pelvic surgery, diabetes, or degenerative neurologic diseases that impair nerves that innervate the bladder .Urgency urinary incontinence (UUI) - ANSWERSInvoluntary sudden leakage of urine along with or immediately following the sensation of a need to urinate (urgency) Because of an overactive detrusor muscle May be idiopathic, because of bladder infection, radiation therapy, tumors or stones, or CNS damage Overactive Bladder Syndrome - ANSWERSUrgency associated with increased daytime frequency and nocturia Mixed Incontinence - ANSWERSResults from a combination of stress and urge incontinence Neurogenic Bladder - ANSWERSBroad classification of voiding dysfunction in which the specific cause is a pathology that produces a disruption of nervous communication governing micturition. Overflow Incontinence - ANSWERSBladder becomes so full that it leaks urine, or "overflows" Causes: obstruction of the urethra; underactive/inactive detrusor muscle
Functional Incontinence - ANSWERSRelated to physical or environmental limitations resulting in an inability to access a toilet in time Transient Incontinence - ANSWERSSudden onset and as a result of potentially reversible conditions such as infections, constipation, or fecal impaction. .HSV-1 Pathogenesis - ANSWERSAssociated with infection above the waist (oral, lips, eyes, epidermis). Often affects children <5 years. HSV-1 S/S - ANSWERS"Cold sores," "chancres" HSV-2 Pathogenesis - ANSWERS"Genital herpes" Mostly genital, anal, and perianal HSV-2 S/S - ANSWERSOral lesions Genital infection includes fluid-filled vesicles after 3-7-day incubation period Type 1 Diabetes Mellitus - ANSWERSAbsolute insulin deficiency Type 2 Diabetes Mellitus - ANSWERSInsulin resistance leads to a relative lack of insulin .Acromegaly - ANSWERSCaused by high IGF (insulin like growth factor) and elevated GH (growth hormone). Coarse facial features, defined jaw, deepened voice, increased shoe size. Occurs in adults. .Pituitary Gigantism - ANSWERSExcess GH that occurs in childhood before the skeletal epiphyses closes. Left untreated, may grow >8' tall with increased risk of cardiomegaly and heart failure. Hyperthyroidism S/S - ANSWERSInsomnia, restlessness, tremor, irritability, palpitations, heat intolerance, diaphoresis, diarrhea, inability to concentrate that interferes with work performance; enlarged thyroid gland Increased basal metabolic rate leads to weight loss, although appetite and dietary intake increase. Amenorrhea/scant menses Hyperthyroidism Lab Values - ANSWERSUndetectable TSH levels are the best indicator. Elevated serum T4 and T3. Hypothyroidism Lab Values - ANSWERSIncreased TSH levels. Low serum T4 and T3. Thyroid Storm - ANSWERS(Accelerated hyperthyroidism) Form of life-threatening thyrotoxicosis that occurs when excessive amounts of thyroid hormones are acutely released into circulation Increased temperature Tachycardia
Diabetes Insipidus S/S - ANSWERSPolyuria (excessive urination) Patient may void up to 15 L of urine daily Nocturia Polydipsia (excessive drinking) Hypernatremia Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Pathogenesis - ANSWERSExcessive ADH from ectopic production from tumors, notably primary lung malignancies Excess ADH stimulates renal tubules to reabsorb water despite decreased blood osmolality. Adrenal insufficiency and hypothyroidism can cause increased ADH secretion and hyponatremia. SIADH S/S - ANSWERSHyponatremia High urine osmolality Low serum osmolality Weakness, muscle cramps, N/V, postural BP changes, poor skin turgor, fatigue, anorexia, lethargy Confusion, hemiparesis, seizures, coma Primary Endocrine Disorder - ANSWERSIntrinsic malfunction of the hormone-producing gland. Ex. thyroid gland fails to secrete thyroid hormones and serum level T4 becomes lower Secondary Endocrine Disorder - ANSWERSMalfunction of the hypothalamus/pituitary cells that control the hormone-producing target gland. Ex. Pituitary gland fails to release TSH, secondarily reducing thyroid gland production, so both T4 and TSH levels are abnormally low in circulation. Hormones Released by Anterior Pituitary Gland - ANSWERSGrowth hormone Thyroid-stimulating hormone Adrenocorticotropic hormone (stimulates secretion of glucocorticoids (cortisol and aldosterone)) Parathyroid Gland - ANSWERSRegulates parathyroid hormone (PTH) Detects serum calcium concentration and help maintains constant levels through the regulation of calcium absorption and resorption from bone Bladder Cancer - ANSWERSPredisposing factors include smoking and exposure to carcinogenic chemicals (cigarettes, aniline, dyes, paint, cement) Chronic UTI is associated with increased risk Graves' Disease - ANSWERSForm of hyperthyroidism with increased synthesis and secretion of T4 and T3 that presents with thyromegaly (diffusely enlarged thyroid),
thyrotoxicosis, and, often, exophthalmos (enlargement of retroorbital muscles causing protrusion of the eyes). Cortisol - ANSWERSCan exhibit mineralorticoid (function is to maintain normal salt and water balance by promoting sodium retention and potassium excretion) activity in high concentrations. Gastroesophageal Reflux Disease (GERD) - ANSWERSThe backflow of gastric contents into the esophagus through the LES GERD S/S - ANSWERSReflux esophagitis (esophageal inflammation caused by the highly acidic refluxed material) Heartburn Regurgitation Chest pain Complications include esophageal strictures & Barrett's esophagus Functional Obstruction - ANSWERSthe loss of propulsive ability by the bowel and may occur after abdominal surgery or in association with hypokalemia, peritonitis, severe trauma spinal fractures, ureteral distention, and the administration of medications such as narcotics. Antibiotic-Associated Colitis (Pseudomembranous Enterocolitis) - ANSWERSAcute inflammation and necrosis of the large intestine, usually affecting the mucosa, but sometimes extending to other areas. .Antibiotic-Associated Colitis (Pseudomembranous Enterocolitis) Causes - ANSWERSClostridium difficile (exposure to antibiotics) Patients with cancer or who have undergone abdominal surgery are at particular risk. .S/S of Enterocolitis - ANSWERSDiarrhea (often bloody) Abdominal pain Fever Leukocytosis Sepsis Colonic perforation (rare) Mechanical Obstruction S/S - ANSWERSIncreased bowel sounds initially, accompanied by abdominal pain, nausea, and vomiting Mechanical Obstruction Pathogenesis - ANSWERSAdhesions, hernia, tumors, impacted feces, volvulus (twisting), or intussusception (telescoping). Hirschsprung Disease - ANSWERSCongenital disorder of the large intestine in which the autonomic ganglia are reduced or absent.
Flatus Bloating Epigastric burning .Appendicitis S/S - ANSWERSPeriumbilical pain RLQ pain ("McBurney's point") (classic, but may be anywhere) Nausea Vomiting Fever Diarrhea RLQ tenderness Systemic signs of inflammation C Difficile Treatment - ANSWERSMetronidazole Oral vancomycin Oral fidaxomicin Fecal transplant Complications of Perforated Gallbladder, Bowel - ANSWERSNecrosis leading to bowel gangrene, sepsis, peritonitis, and shock. Hepatitis s/s - ANSWERSJaundice RUQ pain Malaise Anorexia Nausea Low-grade fever Dysphagia Type 1 - ANSWERSProblems in delivery of food/fluid into esophagus. Worse with liquids than solids. .Dysphagia Type 2 - ANSWERSProblems in transport of bolus down esophagus. Sensation food is "stuck" behind sternum. Dysphagia Type 3 - ANSWERSProblems in bolus entry into stomach. Tightness or pain in substernal area during swallowing process Cryptorchidism Pathogenesis - ANSWERS"Hidden testes": testes incompletely descended, external to the canal or located in a position other than scrotum
