NR 507 Advanced Pathophysiology Week 8 Exam Questions & Answers

trigeminal neuralgia
Correct Answer:
inflammation of the fifth cranial nerve characterized by sudden, intense,
brief attacks of sharp pain on one side of the face.
The trigeminal nerve is the fifth cranial nerve. It originates from the brain
and branches into the ophthalmic branch,maxillary branch, and mandibular
branch
Treatment of trigeminal neuralgia involves the use of anticonvulsant
medication.
a. True
b. False
Correct Answer:
True
Bell’s palsy involves an upper motor neuron lesion (False)-
a. True
b. False
Correct Answer:
Bell’s palsy involves a lower motor neuron lesion.

Which of the following are characteristic of trigeminal nerve pain?
a. Often attacks suddenly and is intermittent
b. Pain can be incapacitating
c. Pain is described as sharp and stabbing
d. All of the above
Correct Answer:
all
Which of the following organisms are the most common causes of bacterial
meningitis in newborns?
a. Streptococci pneumoniae
b. Group B streptococci
c. Cryptococcus
d. Varicella zoster
Correct Answer:
Group B streptococci are the most common bacteria causing bacterial
meningitis in newborn.
The ability for the bacteria that causes meningitis to exit the primary
infection site to enter the meninges is based on the organism’s virulent
factors which include:
a. Colonization
b. Immune Evasion
c. Meningeal invasion
d. All of the above
Correct Answer:
All affect the virulence of the bacteria.

The cells responsible for producing cerebrospinal fluid (CSF) in the ventricle
cavity are:
a. Ependymal cells
b. Synaptic cells
c. Glial cells
d. Nerve cells
Correct Answer:
The epidymal cells are responsible for producing CSF.
The basement membrane of the blood-brain barrier is surrounded by
astrocytes (glial cells).
a. True
b. False
Correct Answer:
This statement is true. The basement membrane of the blood-brain barrier is
surrounded by astrocytes (glial cells).
Meningitis
Correct Answer:
Meningitis is inflammation of the meninges. The meninges are the layers
that surround and protect the brain. It can be caused by either a bacteria,
virus or fungus

Bacterial Meningitis
Correct Answer:
Newborns: Group B streptococci; E. Coli; Listeria Monocytogenes
Children and Teens: Neisseria Meningitidis; Streptococcus Pneumoniae
Streptococcus Pneumoniae; Listeria Monocytogenes
viral meningitis
Correct Answer:
More common:Enteroviruses, Herpes simplex, HIV
Less common: Mumps, varicella zoster, lymphocytic choriomeningitis
Fungal meningitis
Correct Answer:
Affects immunocompromised:
Cryptococcus
Coccidioides genuses
Tubercular Meningitis: Mycobacterium tuberculosis
Parasitic Meningitis:P. Falciparum

endometrial cycle
The 28 days of the menstrual cycle as they apply to the events in the uterus. The endometrial cycle has four subphases: menstruation, the proliferative phase, and the secretory phase, and the ischemic phase .

proliferative phase
The second phase of the uterine (endometrial) cycle, during which the endometrium (shed off during menstration is rebuilt). This phase of the cycle is under the control of estrogen, secreted from the follicle developing in the ovary during this time period. The proliferative phase typically lasts from day 6 to day 14 of the menstrual cycle.

secretory phase
The third phase of the uterin (endometrial) cycle, during which the rebuilt endometrium is enhanced with glycogen and lipid stores. The secretory phase is primarily under the controll of progestone and estrogen (secreted from the copus luteum during this time period), adn typically lasts from day 15 to day 28 of the menstrual cycle.

ischemic phase
Approximately 3 days before menstruation to onset of menstruation. due to the decreased production of estrogen or progesterone and the endometrium becomes blood starved

menstrual cycle
Cycle during which an egg develops and is released from an ovary and the uterus is prepared to receive a fertilized egg.

Ovulation
The process of releasing a mature ovum into the fallopian tube each month

uterine prolapse
the condition in which the uterus slides from its normal position in the pelvic cavity and sags into the vagina

risk factors for uterine prolapse
menopause, pregnancy, coughing, constipation, obesity, pelvic floor trauma, vaginal birth, hysterectomy, connective tissue disorders, spina bifida

uterine prolapse treatment

kegel exercises
estrogen therapy
maintaining a healthy bmi, preventing constipation, treating chronic cough
pessary
surgical option s last resort

polycystic ovarian syndrome
defined as two of the following three features

irregular ovulation
-elevated adrogens (testosterone)
and the appearance of polycystic ovaries on ultrasound

differentials for pcos

thyroid dysfunction
hyperprolactinemia
congenital adrenal hyperplasia

Characteristics associated with PCOS
-metabolic dysfunction

dyslipidemia
insulin resistance
obesity

polycystic ovarian syndrome treatment
(1) diagnosis and education;
(2) lifestyle change – loss of 10% of body weight may help;
(3) birth control pills help with some symptoms;
(4) diabetes medications & dietary treatment may slowly normalize physiology (lower sugar, lower insulin, fewer androgens)

testicular cancer
malignant tumor in one or both testicles commonly developing from the germ cells that produce sperm; classified in two groups according to growth potential

conditions that increase risk of testicular cancer

being a man between the ages of 20-45
cryptochidism (undescended testicle)
family history
previous testicle cancer
white men are more likely

symptoms of breast cancer
change in the shape or appearance of your breasts, skin or nipple changes such as dimpling of the skin, Squeeze each nipple gently to identify any discharge, chest pain (mets to the lung)

signs of premenstrual dysphoric disorder
physical – breast tenderness, abdominal bloating, headache and swelling of extremities
emotional – depression anger, irritability and fatigue
resolve with menstruation

causes of dysfunctional uterine bleeding
can be due to structural (polyp, malignancies and hyperplasia) or non structural causes (coagulopathy, ovulatory dysfuction, endometrial

treatment for abnormal uterine bleeding

NSAIDS
(reduce prostaglandin, causes vasoconstriction, and decreased menstrual bleeding)
Oral contraceptives
Depo provera
Levonorgestrel intrauterine device

Pathophysiology of prostate cancer

more than 90% of all cancer arising from the prostate are adenocarcinomas (glandular tissue)
tumor becomes clinically relevant when local invasion or distant metastasis
— starts with genetic mutation of luminal or basal cell
RF are old age, obesity and high fat low fiber diet

Treatment of prostate cancer
chemotherapy, radiation, hormones, prostatectomy

HPV and the development of cervical cancer
HPV is a necessary precursor to development of cervical dysplasia which is a necessary step for the cell changes leading to cervical cancer

multiple sex partners, smoking, long history of oral contraceptive use use of vaginal douches and immunocompromised are at higher risk as well

body’s process for adapting to high hormone levels
negative feedback system occurs telling the endocrine system to stop secreting hormones because there are enough hormones in the bloodstream

Cushing’s syndrome

a condition caused by prolonged exposure to high levels of cortisol
adrenal glands secrete cortisol
severe muscle bone and skin breakdown
elevated blood glucose levels and high insulin levels
central obesity
amplify catecholamines on blood vessels and causes high blood pressure
inhibit gonadotropin releasing homone messing up ovarian and testicle function
dampens inflammatory and immune response
caused by medications (steroids)
excess ACTH by benign pituitary adenoma (cushings disease)

Causes of hypoparathyroidism
Autoimmune damage to parathyroids, surgical excision, DiGeorge syndrome

DiGeorge Syndrome
failure 3rd/4th pharyngeal pouches to develop; T cell deficiency; absent thymus

lab results that indicate primary hypothyroidism
occurs from thyroid dysfunction

increased level of TSH
low free T4

pathophysiology of thyroid storm

autoimmune disease where b-cells produce antibodies against thyroid proteins
create a hypermetabolic state due to too much thyroid hormone (T3 and T4)
effect of excess thyroid hormone is magnified due to more unbound thyroid hormone, tissues becoming more sensitive to the thyroid hormone, or body being more sensitive to catecholamines activating the sympathetic nervous system

Signs of thyrotoxicosis

fever
agitation confusion seizures and coma
cardiac arrhythmias and high output cardiac failure

Dermatomes
area of skin innervated by cutaneous branches of single spinal nerve

substance release at the synapse
neurotransmitters are sent across open space to surrounding synapse to send a signal

spondylolysis
the breaking down of the vertebral structure; uni or bilateral
-risk factors are extreme sport during adolescence

pain, lumbar spine pressure sensation, antalgic gait, hamstring tightness
tx pain management, boston brace, pt

motor and sensory areas of the brain

frontal lobe controls movement and executive function
cerebellum works with coordinating movement, precision and balance (muscle memory)
midbrain also effects motor control
parietal effects sensory information
pons = sentation

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