Midterm Exam: NUR631/ NUR 631 (Latest 2023/2024 Update) Advanced Physiology and Pathophysiology Study Guide| Questions and Verified Answers| 100% Correct – GCU
Midterm Exam: NUR631/ NUR 631 (Latest
2023/2024 Update) Advanced Physiology and
Pathophysiology Study Guide| Questions and
Verified Answers| 100% Correct – GCU
Q: hormonal hyperplasia
Answer:
occurs chiefly in estrogen-dependent organs, such as the uterus and breast (e.g. endometrium
growing after fertilization)
Q: compensatory hyperplasia
Answer:
adaptive mechanism that enables certain organs to regenerate
Q: hyperkalemia treatment
Answer:
Treatment – Give diuretics, glucose/insulin
Kaexelate- insulin stimulates Na_ potassium Dadenosine triphosphatase (K=Dat- pase) pump
Q: Hormones that regulate calcium/phosphate balance are
Answer:
parathyroid hor- mone (PTH), vitamin D and calcitonin
Q: risk of recurrent of autosomal dominant disease
Answer:
50%
Q: cancer that herpes 8 causes
Answer:
Kaposi sarcoma
Q: BRCA1 and BRCA2 mutations increase risk of what?
Answer:
ovarian cancer among women
Q: chronic myelogenous leukemia (CML) diagnosed by?
Answer:
bone marrow
Philadelphia chromosome
Poor prognosis
Transposition of 9 and 22 chromosomes
Q: Acute Lymphocytic Leukemia (ALL)
Answer:
Immature lymphocytes (lymphoblasts) predominate. This form is seen most often in children
and adolescents; onset is sudden
high survival rate
Q: Acute Myelogenous Leukemia (AML)
Answer:
Too many myeloblasts
Most common adult leukemia
Dx by Auer Rods
bone pain and increased WBCs
Survival 24%
Q: Warburg effect
Answer:
cancer cells preferentially use glycolysis while decreasing ox- idative phosphorylation
Glucose feeds tumors
Q: Chronic Lymphocytic Leukemia (CLL)
Answer:
a form of leukemia characterized by extremely high levels of lymphocytes; most often found in
middle-age adults
85% survival rate
Q: polycythemia vera
Answer:
too many RBCs
Tx: blood letting
S&S: Pruritis after warm bath, ruddy complex
Q: Multiple Myeloma diagnosed by
Answer:
Rouleaux blood film and punch out regions and Bence Jones protein (80% of cases)
Q: Multiple Myeloma symptoms
Answer:
Bone pain, anemia, fatigue, recurrent infec- tions
-Lytic bone lesion (punch out bone regions)
Hypercalemia, increase creatinine
Increased ESR
Q: Multiple Myeloma Treatment
Answer:
Steroids, Thalidomide, chemotherapy, autolo- gous, marrow transplant, Bortezomib
Viral therapy
Q: Lymphomas
Answer:
in lymph nodes – B-cells usually
Q: Hodgkin’s lymphoma
Answer:
distinguished from other lymphomas by the presence of large, cancerous lymphocytes known as
Reed-Sternberg cells
Q: Hodgkin’s lymphoma symptoms
Answer:
PAINLESS
enlarged lymph nodes night sweats
fever
weight loss
Q: Burkitt’s lymphoma
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Deafferentation pain
Injury to either the peripheral or central nervous system. Examples: Phantom pain reflects injury to the peripheral nervous system; burning pain below the level of a spinal cord lesion reflects injury to the central nervous system.
myofascial pain syndrome
acute or chronic painful condition of muscles
neuropathic pain
pain that doesn’t adhere to typical phases inherent in nociceptive pain on a deeper level
urticaria in allergic reaction
raised smooth red lesions with central blanching
cystic fibrosis (CF)
A genetic disorder that is present at birth and affects both the respiratory and digestive systems.
CF pathophysiology
AUTOSOMAL RECESSIVE
alteration in function of CFTR channel
respiratory tract
thick mucus impairs mucociliary function
recurrent pulmonary infections
acute bronchitis
pneumonia
chronic inflammatory state
airway restriction
fibrosis/scarring
bronchchiectasis
chronic bronchitis
cycle of progression
Raynaud’s disease
vasospastics d/o of the large arteries and veins in upper and lower extremeties
Medical disorder of the skin that is synonymous with dermatitis and characterized by pruritus w/ lesions that have an indistinct border
eczema or dermatitis
wet gangrene causes __ necrosis
liquefactive
hormonal hyperplasia
occurs chiefly in estrogen-dependent organs, such as the uterus and breast (e.g. endometrium growing after fertilization)
compensatory hyperplasia
adaptive mechanism that enables certain organs to regenerate
hyperkalemia treatment
Treatment –
Give diuretics, glucose/insulin
Kaexelate- insulin stimulates Na_ potassium Dadenosine triphosphatase (K=Datpase) pump
Hormones that regulate calcium/phosphate balance are
parathyroid hormone (PTH), vitamin D and calcitonin
risk of recurrent of autosomal dominant disease
50%
cancer that herpes 8 causes
Kaposi sarcoma
BRCA1 and BRCA2 mutations increase risk of what?
ovarian cancer among women
chronic myelogenous leukemia (CML) diagnosed by?
bone marrow Philadelphia chromosome
Poor prognosis
Transposition of 9 and 22 chromosomes
Acute Lymphocytic Leukemia (ALL)
Immature lymphocytes (lymphoblasts) predominate. This form is seen most often in children and adolescents; onset is sudden
high survival rate
Acute Myelogenous Leukemia (AML)
Too many myeloblasts
Most common adult leukemia
Dx by Auer Rods
bone pain and increased WBCs
Survival 24%
Warburg effect
cancer cells preferentially use glycolysis while decreasing oxidative phosphorylation
Glucose feeds tumors
Chronic Lymphocytic Leukemia (CLL)
a form of leukemia characterized by extremely high levels of lymphocytes; most often found in middle-age adults
85% survival rate
polycythemia vera
too many RBCs
Tx: blood letting
S&S: Pruritis after warm bath, ruddy complex
Multiple Myeloma diagnosed by:
Rouleaux blood film and punch out regions and Bence Jones protein (80% of cases)
Multiple Myeloma symptoms
Bone pain, anemia, fatigue, recurrent infections
-Lytic bone lesion (punch out bone regions)
Hypercalemia, increase creatinine
Increased ESR
Multiple Myeloma Treatment
Steroids, Thalidomide, chemotherapy, autologous, marrow transplant, Bortezomib
Viral therapy
Lymphomas
in lymph nodes – B-cells usually
Hodgkin’s lymphoma
distinguished from other lymphomas by the presence of large, cancerous lymphocytes known as Reed-Sternberg cells
Hodgkin’s lymphoma symptoms
PAINLESS
enlarged lymph nodes
night sweats
fever
weight loss
Burkitt’s lymphoma
tumor in maxilla and mandible
Burkitt’s lymphoma diagnosed by:
starry sky pattern on bone marrow
Caused by: EBV (90%)
Non-Hodgkin’s Lymphoma
the term used to describe all lymphomas other than Hodgkin’s lymphoma
Dx: biopsy
Tx: Rituximab (kills all cells like complement)
Hemophilia Type A
Congenital Factor VIII (8) deficiency caused by inversion or deletion of a major portion of the X chromosome genome or a missense mutation
X-linked
Hemophilia Type B (christmas disease)
Factor IX deficiency
Hemophilia Diagnosis
History, physical exam
Decreased factor VIII or IX
Prolonged activated partial thromboplastin time
( PTT)
Normal PT
PTT
partial thromboplastin time
Heparin
Intrinsic pathway
intrinsic pathway
initial coagulation pathway that begins with vascular damage (exposure to collagen fibers) or contact with foreign substances, and results in the activation of the common pathway
PTT
heparin blocks
extrinsic pathway
initial coagulation pathway that begins with tissue factor and results in the activation of the common pathway
PT
warfarin blocks
oncotic pressure
The pressure of water to move, typically into the capillary, as the result of the presence of plasma proteins.
osmotic pressure
the pressure that would have to be applied to a pure solvent to prevent it from passing into a given solution by osmosis,
often used to express the concentration of the solution.
hydrostatic pressure
Pressure exerted by a volume of fluid against a wall, membrane, or some other structure that encloses the fluid.
Hypernatremia causes
excess water loss, excess sodium administration, diabetes insipidus, heat stroke, hypertonic IV solutions
Hypernatremia S/S
You are ‘fried’ or S.A.L.T.
F – Fever (low grade), flushed skin
R – Restless (irritable)
I – Increased fluid retention and increased BP
E – Edema (peripheral and pitting)
D – Decreased urinary output, dry mouth
S = Skin flushed
A = Agitation
L = Low-grade fever
T = Thirst
Repolarization
Return of the cell to resting state, caused by reentry of potassium into the cell while sodium exits the cell.
Hyperpolarization
The movement of the membrane potential of a cell away from rest potential in a more negative direction.
Depolarization
The process during the action potential when sodium is rushing into the cell causing the interior to become more positive.
refractory period
a period of inactivity after a neuron has fired
G6PD
damaged hemoglobin in RBC (Heinz bodies) causing hemolysis and splenic sequestration
g6pd
glucose-6-phosphate dehydrogenase
exotoxin
a toxin released by a living bacterial cell into its surroundings.
Endotoxins
go into serum when bacteria die and their cell walls break down
Endotoxin versus exotoxin
Endotoxins are the Lipopolysaccharide-protein complexes (LPS), responsible for making an integral part of the cell wall of Gram-Negative Bacteria and are released at the time of cell death or lysis of bacteria. Exotoxins are the proteins which are secreted by few species of bacteria and get diffuse into the nearby or surrounding medium. Secondly, endotoxins are heat stable, weakly immunogenic while exotoxins are heat labile, highly antigenic.
Klinefelter Syndrome (XXY)
underdeveloped sex organs, breast development, large hands, and long arms and legs, infertility
Turner Syndrome
A chromosomal disorder in females in which either an X chromosome is missing, making the person XO instead of XX, or part of one X chromosome is deleted.
Normal CO2
35-45 mmHg
Normal CO3 range
22-26
normal calcium range
8.5-10.5 mg/dL
Normal MCV range
80-100
normal MCHC values
32-36 g/dL
Hemosiderosis vs. hemochromatosis
Excess body iron leads to hemosiderosis or hemochromatosis based on deposition and damage
Hemosiderosis: iron deposition in tissues
Hemochromatosis: organ damage due to iron
aplastic anemia
a normocytic-normochromic type of anemia characterized by the failure of bone marrow to produce red blood cells
Aplastic anemia causes
Drugs (phenylbutazone), Infection (parvovirus), Benzene (also causes acute leukemia)
pernicious anemia
lack of mature erythrocytes caused by inability to absorb vitamin B12 into the bloodstream
Macrocytic anemia causes
(MCV >100)
- folate acid deficiency
- vitamin B12 deficiency
- liver dz
- drugs (phenytoin, cytotoxic meds)
Microcytic anemia causes
“Find Those Small Cells”:
Fe deficiency
Thalassemia
Sideroblastic
Chronic disease
thrombocytopenia
a condition in which there is an abnormally small number of platelets circulating in the blood
Disseminated Intravascular Coagulation (DIC)
abnormal activation of the proteins involved in blood coagulation, causing small blood clots to form in vessels and cutting off the supply of oxygen to distal tissues
Hemophilia
An X-linked recessive disorder in which blood fails to clot properly, leading to excessive bleeding if injured.
Christmas Disease (Hemophilia B)
Factor IX deficiency
vasospasm
occurs following subarachnoid hemorrhage or brain aneurysm. Brain blood vessel narrows blocking blood flow.
platelet plug formation
Triggered by exposure of platelets to collagen
Platelets adhere to rough surface to form a plug
Clotting Cascade: Intrinsic Pathway
Activated when there is:
— Trauma to blood
— Blood comes in contact with collagen from traumatized blood vessel wall
All required factors found within the blood
Order of WBC abundance
Never Let Monkeys Eat Bananas
Macrophage function
phagocytosis and antigen presentation
natural killer cells (NK cells)
pursue diseased cells (such as those infected by viruses or cancer)
complement
causes hole in cell wall which lyses pathogens
plasma cell
A white blood cell that produces a single type of antibody
Types of hypersensitivity reactions
Type I: IgE mediated (e.g. Hay Fever “allergic rhinitis”)
Type II: IgG/IgM Tissue-specific reactions (e.g. Hemolysis in drug allergies)
Type III: IgG/IgM Immune complex mediated (e.g. Gluten “wheat” allergy)
Type IV: No antibody involved. Cell mediated (e.g. poison ivy “contact dermatitis” allergy).
Somogyi effect vs. Dawn phenomenon
SOMOGYI: High night-time insulin leads to low overnight glucose. Then stress hormone release increases morning glucose. Decrease insulin.
DAWN: High morning glucose from GH secretion without overnight hypoglycemia. Increase insulin.
superior colliculi (midbrain)
reflexes for certain visual activities and movements of the head and trunk in response to visual stimuli
inferior colliculi (midbrain)
coordinate movements of the head, eyes, and trunk in response to auditory stimuli
Lateral Colliculus
auditory relay
frontal lobe
associated with reasoning, planning, parts of speech, movement, emotions, and problem solving
Broca’s area here
parietal lobe
receives sensory input for touch and body position
temporal lobe
A region of the cerebral cortex responsible for hearing and language.
Wernicke’s area here
occipital lobe
A region of the cerebral cortex that processes visual information
meninges
three layers of connective tissue in which the brain and spinal cord are wrapped
UMN lesion
Upper Motor Neuron lesions everything goes UP!
Weakness (+)
Reflexes (⬆)
Tone (⬆)
Babinski (+)
Spastic paralysis (+)
total body water amount
28L
11 interstitial
5 intravascular
does ADH increase or decrease serum oncotic pressure?
decreases
keeps more water, dilutes blood/serum
does aldosterone affect blood osmolarity?
NO (unlike ADH)
blood osmolarity
300 mOsm/L
If blood osmolarity is too high:
the bloodstream absorbs too much water. This raises the blood volume, resulting in high blood pressure and a potentially dangerous strain on the heart and arteries
if blood osmolarity is too low
too much water stays in tissue, blood pressure drops, and edema occurs
ANP causes what?
↑ GFR and ↑ Na+ filtration with no compensatory Na reabsorption in distal nephron
Does ANP increase or decrease Blood pressure?
decrease
What does BNP do?
released from ventricular myocardium (heart ventricles) in response to elevated end diastolic volume (preload)
causes vasodilation, natriuresis (sodium excretion) and diuresis
ANP & BNP stimulate
renal elimination of Na+ (thus lowering BP)
LMN lesion
Lower Motor Neuron lesions everything LOWERED
Atrophy (+)
Weakness (+)
Fasiculation* (+)
Reflexes (⬇)
Tone (⬇)
Babinski (-)
Flaccid paralysis (+)
CSF production
choroid plexus and ependymal cells produce csf, csf is reabsorbed by arachnoid villi and into the saggital sinus
TBI (traumatic brain injury)
Brain dysfunction caused by an outside force, usually a violent blow to the head.
dermatome
Area of skin supplied by a single spinal nerve
Embryonic Development of the Brain
- neural tube forms brain + spinal cord
- anterior end of neural tube begins to expand + develops constrictions that divide 3 primary brain vesicles
1) prosencephalon: forebrain
2) mesencephalon: midbrain
3) rhombencephalon: hindbrain
Myelomeningocele (spina bifida)
most severe form of spina bifida in which the spinal cord and meninges protrude through the spine
epidural hematoma
a collection of blood in the space between the skull and dura mater
subdural hematoma
collection of blood under the dura mater
subarachnoid hemorrhage
Bleeding into the subarachnoid space, where the cerebrospinal fluid circulates.
autosomal dominant disorders
Huntington disease, achondroplasia, marfan’s
autosomal recessive disorders
Tay-Sachs, Cystic fibrosis, sickle cell anemia, phenylketonuria
Glucose-6-phosphate dehydrogenase deficiency
Glucose-6-phosphate dehydrogenase deficiency is a genetic disorder that affects red blood cells, which carry oxygen from the lungs to tissues throughout the body. In affected individuals, a defect in an enzyme called glucose-6-phosphate dehydrogenase causes red blood cells to break down prematurely. This destruction of red blood cells is called hemolysis.
“collagen-like” proteins deficiencies causes:
muscle and tendon deficiences
the most common symptom of cancer treatment is:
pain and fatigue
hypomethylation
Reduced methylation of DNA. This results in the activation of oncogenes genes and the resulting formation of tumours.
symptoms of shock in newborns
hypotension.
peripheral vasoconstriction.
tachycardia (sometimes only bradycardia in ELBW)
tachypnoea and/or apnoea.
hypoxia.
metabolic acidosis.
CNS disturbance (lethargy, irritability)
gastrointestinal disturbance.
innate immunity
•”Feverishly Fast”
•Within minutes
•Causes fevers
•Non-Specific
•No Memory
•Quick Response
•First line of defense
adaptive immunity types
humoral immunity and cell-mediated immunity
cell-mediated immunity
•T-Cells
•Naïve T-cells
•Clonal selection
•Clonal Expansion
•Clonal Deletion
•T Helper Cells
•Cytotoxic T-Cells
•Regulatory T-cells
•Memory T-cells
•
humoral immunity
•B-Cells
•Naïve B-cells
•Clonal selection
•Clonal Expansion
•Clonal Deletion
•Antibodies
•IgA, IgD, IgE, IgG, IgM
•Memory B-cells
•NK Cells (Natural Killer)
Neutrophils
Most abundant white blood cell.,
“suicide bombers”
The most abundant type of white blood cell. Phagocytic and tend to self-destruct as they destroy foreign invaders, limiting their life span to a few days.
Dendridic cells
“barbarians”
second line of defense.
APCs
Naive T cells
Mature T cell that has left the thymus but no yet encountered its specific Ag.
3rd line of defense
what neurotransmitter is reduced in schitzophrenics?
GABA
what food item is inappropriate for a person taking an MAOI?
foods with tyramine
ex: aged cheese, liver, raisins, avocado
**can have ham
causes hypertensive crisis**
panic disorder has a genetic component in which chromosome?
11
panic disorder treatment should likely not include:
benzos
PTSD (Post Traumatic Stress Disorder) has a decrease in _ receptors
benzo
OCD (Obsessive Compulsive Disorder)
an anxiety disorder characterized by unwanted repetitive thoughts and/or actions
Somogyi effect
early-morning hyperglycemia that occurs as a result of nighttime hypoglycemic episodes
Dawn phenomenon
A nocturnal release of growth hormone, which may cause blood glucose level elevations before breakfast in the client with diabetes mellitus. Treatment includes administering an evening dose of intermediate acting insulin at 10 pm.
proteses
enzymes that break down protein into peptides and amino acids
lipid bilayer
flexible double-layered sheet that makes up the cell membrane and forms a barrier between the cell and its surroundings
absolute refractory period
time during which another action potential is impossible; limits maximal firing rate
Metaplasia
changing from one type of mature tissue to another
Hyperplasia
increase in number of cells
Hemosiderosis
abnormal increase of iron in blood
parasitic invasion calls what white blood cell?
eosinophil?
do not use __ on wounds
hydrogen peroxide
Use normal saline instead
Type 2 hypersensitivity
antibody mediated
Phagocytes
White blood cells that attack invading pathogens
Exotoxins
toxic substances that bacteria secrete into their environment
released when we see bacterial growth – gram positive
Stress suppresses the immune response through the action of __.
suppressing helper ts – cortisol up
how much of our blood can we lose before hypovolemic shock?
15%
adrenaline causes _
vasoconstriction and cold/clamminess
neurogenic shock sign is
vasodilation
septic shock recovery looking for:
WBC going up with bands maturing and getting up there.
children shock causes:
venous congestion and splenomegaly
children with aids are more likely to develop:
non-hodgkins lymphoma
albumin is lost with:
ascites, burns, kidney d/os, malabsorption
anaplasia
loss of differentiation of cells; reversion to a more primitive cell type
diagnoses for low h&h and hemoglobin
chronic loss of blood
malnutrition
cancer linked to congenital malformation syndrome
wilms tumor
natural killer cells
non specific can kill tumor cells
lymph nodes have during infection
proliferation of b cells
Hemochromatosis
a genetic disorder in which the intestines absorb too much iron
bronze colored tan skin
arrhythmias
HELP syndrome
hemolysis, elevated liver enzymes, low platelets
ALL diagnosis
Increase lymphoblast, Increase 30% lymphocytes
Decrease WBC, Platelet
early signs of leukemia
anorexia, bone pain and bruising
most common cause of anemia in kids
iron deficiency
microcytic hypochromic anemia treatment
cord blood
Von Willebrand Disease
automal dominant
g6p6
x linked
drug that stops growth hormone
somatastatin
Meniere’s disease testing
clinical (vertigo, nystagmus, sensorineural hearing loss)
balance – romberg, heel-toe
CT/MRI (for acoustic neuromas)
S&S of meniere’s disease
sudden onset
n/v
Meniere’s disease causes
allergies, infection, hypothyroid issues, overproduction or decreased absorption of lymph
Meniere’s triad
vertigo
hearing loss
tinnitus
Sodium function
135-145
related to RAS system in adrenal glands. 90% in ECF
regulates water
Hyponatremia S/S
peripheral edema
weight gain
lethargy
restlessness
muscle weakness
seizures
Causes of hyponatremia include
diarrhea, vomiting, excess sweating, wounds, SIADH, CHF, addison’s, hypopituitary, gastric suctioning
hypernatremia symptoms
Fever
Restless
Increased fluid retention
Edema
Decreased urine output
Addison’s disease causes
autoimmune (MCC)
infection (TB), histoplasmosis, coccidiodomycosis
metastasis
waterhouse-friderichsen syndrome (hemorrhagic adrenalitis commonly caused by bacteria)
Testing for Addison’s disease
andrenocortical hormone levels
ACTH lvls
CT/MRI
Addison’s disease symptoms
muscle weakness, fatigue, weight loss, darkening of skin, low blood pressure, salt craving, low blood sugar, nausea, diarrhea, vomiting, joint pains, depression, and body hair loss.
Symptoms of Cushing’s Disease
“Buffalo” hump, truncal obesity, moon facies, purple striae, bruises, supraclavicular fat pads, proximal muscle weakness
Acne, hirsutism, amenorrhea, decreased libido
HTN, Osteoporosis,
Cushing’s disease tests
24 hr Free Cortisol
Dexamethasone suppression test
ACTH
MRI/CT- pituitary, adrenals
Glucose, Pregnancy
CXR
S&S of too much cortisol
can produce some of the hallmark signs of Cushing’s syndrome — a fatty hump between your shoulders, a rounded face, and pink or purple stretch marks on your skin.
symptoms of Cushing’s disease
oWeight gain and fatty tissue deposits, particularly around the midsection and upper back, in the face (moon face) and between the shoulders (buffalo hump)
oPink or purple stretch marks (striae) on the skin of the abdomen, thighs, breasts and arms
oThinning, fragile skin that bruises easily
oSlow healing of cuts, insect bites and infections
oAcne
chloride
moves often with Na
normal levels 98-108
what disorder may cause hypochloremia?
cystic fibrosis
potassium main jobs are:
transmission of nerve impulses
maintenance of normal cardiac rhythms, skeletal and smooth muscle contraction
what does cortisol do to K+?
promotes excretion (drops it)
what does aldosterone do to K+?
excretes at DCT and collecting duct and secretes from sweat glands
what does insulin do to K+?
drives K+ into cells
What does glucagon do?
raises blood glucose levels
blocks entry of K+ into cells
Hypokalemia is caused by what acid-base imbalance?
alkalosis
H+ leaves cell and K+ enters cell
hypERkalemia is caused by what acid-base imbalance?
acidosis
Sterling law of the heart
you cannot lose more than 2L or your heart will stop.
serum calcium (Ca)
8.5-12 mg/dL
functions:
bones, teeth, blood clotting, hormones and cell receptor function
Controlled by:
parathyroid hormone, vitamin D and calcitonin
Calcitonin
Lowers blood calcium levels
difference between oncotic and osmotic pressure
Oncotic goes up with more solutes – pressure from proteins
Osmotic pressure is the “pulling” force on water due to the presence of solutes in solution.
Direct relationship
Hydrostatic pressure
Hydrostatic pressure is the “pushing” force on water due to the presence of more fluid in one region than another
Opposite of oncotic and osmotic pressure
S&S of hypocalcemia
Rickets and Osteomalacia
Osteoporosis
Muscle cramps and tetany (incr. cell permeability to Na>incr. depolarization à incr. action potentials)>Exams
Laryngospasmà asphyxiation
RAS system
Renin-Angiotensin System
Renin cleaves angiotensinogen to angiotensin I.
Angiotensin I is converted to Angiotensin II by Angiotensin converting enzyme (ACE)
Paget’s disease
A disease of unknown origin that is characterized by extensive breakdown of bone tissue followed by abnormal bone formation.
S&S: hearing loss, facial pain, spinal stenosis
Multiple Myeloma
cancer of plasma cells
more common onset in older males
S&S bone pain, anemia, fatigue, hypercalcemia, renal failure, decreased humoral function
S/S of hypomagnesemia
Signs and Symptoms
Muscle irritability
Tetany and convulsions
Tachycardia
Hypertension
Incr. DTR’s
if magnesium goes down calcium is __?
down
If phosphorus is low calcium is?
high
HCO3 levels
22-26 mEq/L
normal chloride levels
95-105 mEq/L
Normal calcium levels
8.5-10.5 mg/dL
Normal BUN levels
10-20 mg/dL
Normal creatinine levels
0.6-1.2 mg/dL
Normal magnesium levels
1.5-2.5 mEq/L
normal phosphate levels
2.5-4.5 mg/dL
Normal fasting glucose levels
70-99 mg/dL
symptoms of iron-deficient anemia
koilonychia
shiny red tongue
aphthous stomatitis
pika
causes of microcytic hypochromic anemia
chronic blood loss
slow leaks
dietary iron deficiency – look at ferratin (will be low), iron level and occult blood, TIBC (Total iron-binding capacity – will be high) (transferrin will be lower compared to chronic blood loss)
Sideoblastic anemia
iron will be high because theres no Protoporphyrin to bind with globin
Will see rings in bone marrow
Causes: alcohol, lead, zinc
microcytic anemia
A healthcare professional is planning a community event to reduce risk of cerebrovascular accident (CVA) in high risk groups. Which group would the professional target as the priority?
hypertension
Atrial fibrillation, rheumatic heart disease, and valvular prosthetics are risk factors for which type of stroke?
embolic
lacunar stroke
MINIinfarcts resulting in sensory deficits or motor deficits
initial paralysis with GRADUAL partial recovery is what type of spinal cord injury?
Upper Motor Neuron
Permanent paralysis is usually the result of __ motor neuron destruction
LOWER
Cognitive operations cannot occur without the effective functioning of what part of the brain?
Reticular Activating System (RAS)
Reticular Activating System (RAS)
a dense network of neurons found in the core of the brain stem; it arouses the cortex and screens incoming information
Which midbrain dysfunction causes pupils to be pinpoint size and fixed in position?
pontine dysfunction
A patient has a spinal cord injury at C4. What should the healthcare professional assess as the priority in this patient?
respirations
Spinal cord injuries occur most frequently in which region?
cervical and thoracic
The neural groove closes dorsally during which week of gestational life?
4th
What is the result of a Chiari type II malformation associated with a myelomeningocele?
downward displacement of the cerebellum, brainstem and fourth ventricle –
We have an expert-written solution to this problem!
Chiari type II malformation
downward displacement of cerebellum and medulla through foramen magnum -> block CSF flow
associated w/ lumbosacral meningocele
prognosis: low-normal intelligence, language disorders
Which cerebral vascular hemorrhage causes meningeal irritation, photophobia, and positive Kernig and Brudzinski signs?
subarachnoid
lithium toxicity causes:
Tremors, Hyoponatremia
Which endogenous opioid is located in the hypothalamus and pituitary and is a strong μ-receptor agonist?
endorphins
We have an expert-written solution to this problem!
Antibodies
IgG: Largest amount
IgA: mucosal secretions of the cervix & breastmilk
IgM: the Monospot test (First to arrive)
IgE: allergy and parasite
Which factor is responsible for the hypertrophy of the myocardium associated with hypertension?
Angiotension II
causes of potassium
DKA
Diarrhea
Acidosis
Cell death-Lysis
Renal failure
Addison disease
Spironolactone (hyper) vs. diuretics (hypo)
Rhabdomyolysis
Insulin administration/deficiency
urinalysis with proteins in a patient with DM initial treatment?
Microalbuminuria is the first manifestation of diabetic nephropathy. Treatment with an ACE inhibitor or angiotensin receptor blocker is the treatment of choice. Depending on the patient, more frequent blood glucose and blood pressure monitoring may be in order, but is not specific to this disorder and does not treat it. The patient may benefit from a moderate or even severe sodium restriction for several reasons (nephropathy, hypertension, etc.) but that is not as specific to nephropathy treatment as the medications are.
what is associated with diabetes insipidus (DI)?
Low urine-specific gravity
Thalassemia
No globin (protein)
causes microcytic anemia
alpha and beta
Basophilic stippling
metformin can cause what deficiency
B12
*A healthcare professional is evaluating laboratory results for a patient who has disseminated intravascular coagulation (DIC). What results would the professional consider consistent with this condition?
Elevated d-dimer
Elevated creatinine
Decreased protein C
ELEVATED lactate dehydrogenase
LOW pH
The coagulation cascade consists of the extrinsic and intrinsic pathways that converge only at factor _.
X
ALL is a progressive neoplasm defined by the presence of greater than _ in the bone marrow or blood.
30% lymphoblasts
The translocation of genetic material from genes 9 and 22 creates an abnormal, fused protein identified as BCR-ABL1 describes what type of leukemia?
CML
*Prader-Willi syndrome is inherited from the _
father
Angelman syndrome is inherited from mother.
Visual disturbances are a result of a pituitary adenoma because of what?
pressure of the tumor on the optic chiasm
In the later stages of an inflammatory response, which phagocytic cell is predominant?
monocytes
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Which organ is stimulated during the alarm phase of the general adaptation syndrome (GAS)?
Hypothalamus
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What is a common cause of ADH secretion?
tumors, such as small cell carcinoma of the duodenum, stomach, and pancreas; cancers of the bladder, prostate, and endometrium; lymphomas; and sarcomas.
Reduced PTH causes what?
Symptoms associated with hypoparathyroidism are related to hypocalcemia. Hypocalcemia causes a lowering of the threshold for nerve and muscle excitation so that a slight stimulus anywhere along the length of a nerve or muscle fiber may initiate a nerve impulse.
*muscle spasms
*tonic-clonic seizures
*larygeal spasms
*asphyxiation
why does gigantism occur only in children and adolescents?
epiphyseal plates haven’t closed yet
A patient has acromegaly. What assessment by the healthcare professional would be most important?
sleep patterns
*from excess GH
A student asks the professor to differentiate Type 2 diabetes mellitus from Type 1. The professors’ response would be that Type 2 is best described as what?
Type 2 is resistance to insulin by insulin-sensitive tissues
S&S of shock in newborn
A. Decreased heart rate variability
B. Temperature instability
E. Hypoglycemia
Which information does the professor teach the class regarding how a child’s body compensates for cardiogenic shock?
-Splanchnic arteries are constricted to divert blood from the skin, kidneys, and gut to the heart and brain.
-Peripheral blood vessels are constricted to raise blood pressure.
-Adrenergic responses produce tachycardia to increase cardiac output.
-The renin-angiotensin-aldosterone system is stimulated when renal function decreases.
A healthcare professional is assessing a patient who has cancer and a hemoglobin of 8.8 mg/dL. What factors should the professional assess the patient for?
A. Chronic bleeding
B. Malabsorption of iron
C.Malnutrition
Early detection of acute leukemia would include which symptoms?
C. Anorexia
D. Bruising
E.Bone pain
A pediatric patient presents with pallor, fatigue, fever, petechiae, and purpura. What diagnostic testing does the healthcare professional help prepare the patient for?
A. Complete blood count
B. Renal function studies
C. Bone marrow biopsy
D.Chest x-ray
Which type of nerve fibers transmits pain signals?
C. A-delta (Aδ) fibers
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