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14 Questions with answers on cf-nurs6202-
guiding-questions-1pdf
You'll find the list of questions at the end of the document
- Define alogia and provide an example of how it might present in a patient.
Alogia refers to poverty of speech, a negative symptom of schizophrenia and other psychotic disorders. It manifests as a reduction in the amount of speech, reduced speech fluency, or blocking (stopping speech mid- sentence). For example, a patient might respond to a question like 'How was your day?' with a very brief, unelaborated answer like 'Okay,' or they might struggle to find words to express themselves.
- Describe the etiology, risk factors, and epidemiology of Obsessive- Compulsive Disorder (OCD).
The etiology of OCD is multifactorial, involving genetic predisposition, neurobiological factors (e.g., abnormalities in serotonin, glutamate, and dopamine neurotransmitter systems), and environmental influences (e.g., childhood trauma, infections). Risk factors include a family history of OCD or other mental health disorders, a personal history of trauma or abuse, and certain personality traits (e.g., perfectionism, anxiety sensitivity). Epidemiologically, OCD affects approximately 1-2% of the population, with similar rates across genders, although onset may be earlier in males. Onset typically occurs in adolescence or early adulthood.
- Explain the pathophysiologic impact of lead toxicity on a cellular level.
Lead toxicity disrupts numerous cellular processes. At the cellular level, lead interferes with the function of essential enzymes by binding to sulfhydryl groups, inhibiting their activity. It also disrupts calcium homeostasis, which is crucial for neuronal signaling and other cellular functions. Lead can mimic or block calcium's role in various processes, leading to impaired neurotransmitter release, altered gene expression, and mitochondrial dysfunction. Furthermore, lead increases oxidative stress, causing damage to cellular components like DNA and proteins. In the nervous system, lead can damage the blood-brain barrier, increasing its permeability and allowing harmful substances to enter the brain.
- Define a complex partial seizure and describe its key characteristics.
A complex partial seizure (also known as focal seizure with impaired awareness) is a type of seizure that originates in a specific area of the brain and causes altered awareness or loss of consciousness. Key characteristics include: impaired awareness (the person is not fully aware of their surroundings), automatisms (repetitive, involuntary movements such as lip
smacking, chewing, or hand movements), and a postictal state (a period of confusion or drowsiness following the seizure). The person may appear to be conscious but is not responsive to commands or questions.
- Describe the etiology and pathophysiology of bacterial meningoencephalitis.
Bacterial meningoencephalitis is an inflammation of both the meninges (membranes surrounding the brain and spinal cord) and the brain parenchyma itself, caused by a bacterial infection. Etiology: Common bacterial causes include Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae (though less common due to vaccination), and Listeria monocytogenes. Pathophysiology: Bacteria typically enter the central nervous system (CNS) via the bloodstream, often following a respiratory infection. Once in the subarachnoid space, bacteria multiply and release inflammatory mediators (e.g., cytokines, chemokines). These mediators trigger an inflammatory response, leading to increased permeability of the blood-brain barrier, cerebral edema, and increased intracranial pressure. Neutrophils infiltrate the CNS, contributing to further inflammation and tissue damage. The inflammatory process can also disrupt neuronal function and cause neuronal death.
- Differentiate between decerebrate and decorticate posturing, and explain what each indicates about the location of brain damage.
Decorticate posturing involves flexion of the arms at the elbows and wrists, with the legs extended and internally rotated. This indicates damage to the cerebral hemispheres, particularly the corticospinal tracts. Decerebrate posturing involves extension of the arms and legs, with pronation of the arms and plantar flexion of the feet. This indicates more severe damage, typically to the brainstem, specifically at or below the level of the red nucleus.
- Explain the role of plasma cells in the disease process and how they contribute to immunity.
Plasma cells are differentiated B lymphocytes that are specialized for the production and secretion of large quantities of antibodies. In the disease process, plasma cells play a crucial role in humoral immunity by producing antibodies that target specific antigens, such as bacteria, viruses, or toxins. These antibodies can neutralize pathogens, opsonize them for phagocytosis, or activate the complement system to destroy them. In autoimmune diseases, however, plasma cells may produce autoantibodies that attack the body's own tissues, contributing to the pathogenesis of the disease.
- Describe the pathophysiology of edema formation.
Edema is the accumulation of excess fluid in the interstitial space. The pathophysiology involves imbalances in the forces that regulate fluid movement between capillaries and tissues, primarily hydrostatic pressure and oncotic pressure. Increased capillary hydrostatic pressure (e.g., due to heart failure or venous obstruction) forces more fluid out of the capillaries into the interstitial space. Decreased plasma oncotic pressure (e.g., due to
airways, leading to hyperinflation of the lungs. Finally, ventilation-perfusion (V/Q) mismatch develops, where some areas of the lung are ventilated but not perfused (or vice versa), leading to hypoxemia (low blood oxygen levels). Over time, chronic inflammation can lead to airway remodeling, with irreversible changes like thickening of the airway walls and increased smooth muscle mass.
- What are tumor markers and what role do they play in the body?
Tumor markers are substances produced by cancer cells or other cells of the body in response to cancer or certain benign (noncancerous) conditions. These substances can be found in the blood, urine, stool, other body fluids, or tissues of some patients with cancer. Most tumor markers are proteins, but they can also be other molecules, such as hormones or enzymes. They play a limited role in the body itself, as they are primarily indicators of disease. Clinically, tumor markers are used to help detect cancer, estimate prognosis, monitor treatment response, and detect recurrence. However, they are not perfect; elevated levels can occur in non-cancerous conditions, and some cancers do not produce detectable levels of any known tumor marker. Therefore, they are usually used in conjunction with other diagnostic tests, such as imaging and biopsy.
- What is the most common organism involved in Community Acquired Pneumonia?
The most common organism involved in Community Acquired Pneumonia (CAP) is Streptococcus pneumoniae (also known as pneumococcus).
- Based on the pathophysiology, how will the Nurse Practitioner differentiate between Type I and Type II diabetes?
The key difference lies in the underlying pathophysiology. In Type I diabetes, there is autoimmune destruction of the pancreatic beta cells, leading to absolute insulin deficiency. This means the body produces little to no insulin. In Type II diabetes, there is insulin resistance, where the body's cells do not respond properly to insulin, coupled with a relative insulin deficiency. The pancreas may initially produce enough insulin, but over time, it may not be able to keep up with the increased demand due to insulin resistance, leading to decreased insulin production. Clinically, Type I often presents with abrupt onset, usually in childhood or adolescence, with symptoms like polyuria, polydipsia, polyphagia, and weight loss. Patients are often thin or normal weight. They require exogenous insulin for survival. Type II typically has a more gradual onset, often in adulthood, and is associated with obesity, family history, and sedentary lifestyle. Patients may be asymptomatic for years or present with subtle symptoms. They may be managed with lifestyle modifications, oral medications, or insulin, depending on the severity of the disease. Diagnostic tests will also differentiate the two. Type I patients will often have autoantibodies (e.g., anti-GAD, anti-islet cell antibodies) present, indicating autoimmune destruction. C-peptide levels (a measure of insulin production) will be low or absent. Type II patients will typically not have autoantibodies, and C- peptide levels may be normal or elevated early in the disease, but decrease as the disease progresses.
14 Questions on cf-nurs6202-guiding-
questions-1pdf
Define alogia and provide an example of how it might present in a patient.
Describe the etiology, risk factors, and epidemiology of Obsessive- Compulsive Disorder (OCD).
Explain the pathophysiologic impact of lead toxicity on a cellular level.
Define a complex partial seizure and describe its key characteristics.
Describe the etiology and pathophysiology of bacterial meningoencephalitis.
Differentiate between decerebrate and decorticate posturing, and explain what each indicates about the location of brain damage.
Explain the role of plasma cells in the disease process and how they contribute to immunity.
Describe the pathophysiology of edema formation.
Explain the pathophysiologic process of a Type I hypersensitivity reaction, including the antibody involved.
Describe the pathophysiologic process of atherosclerosis and its impact on the development of aneurysms.
What physiologic changes occur in the patient with uncontrolled asthma?
What are tumor markers and what role do they play in the body?
What is the most common organism involved in Community Acquired Pneumonia?
Based on the pathophysiology, how will the Nurse Practitioner differentiate between Type I and Type II diabetes?
